ABSTRACT
Anxiety is a combination of emotions, bodily sensations and thoughts that form a continuum from normal to abnormal. Anxiety is abnormal when it affects the child’s ability to participate in expected age-appropriate social or academic activities – in other words, when it causes significant impairment. In some circumstances, young people with severe anxiety may benefit from medication, preferably combined with some psychological intervention. It is not always obvious to parents or professionals that these behavioural or somatic symptoms are a reflection of anxiety or worry – particularly if alternative explanations are easier to accept. If a child looks pale, a parent is more likely to assume that a doctor is needed – rather than a child mental health professional. Isolated fears are common in young children: of the dark, of monsters, or of strange toilets. Such fears become problematic phobias only if they cause excessive distress or avoidance. Assessment should include detailed enquiry about physical sensations, thoughts and feared consequences.
