Anxiety is a common and normal emotion but it can affect each of us in very different ways. If severe, it can be extremely debilitating and affect day-to-day functioning. When experiencing an anxiety attack it can feel as if you are going to pass out or have a heart attack. If a child experiences severe anxiety, they can get exactly the same feelings and symptoms as adults. They may look pale, clammy, cry, shake, and say they are going to be sick or pass out.

Anxious adults are regularly referred for counselling or given medication and/or advised to take up exercise, meditation and sometimes given breathing or muscle relaxation techniques. Many adults have usually encountered a fair amount of stress and anxiety in their lifetime and will usually, without realising it, have developed some coping strategies, talking to friends or family, having a glass of wine (maybe 2!), etc. When these don’t work, they head to a doctor.

Now imagine you are a child. You have no idea why you are experiencing these symptoms, you have no idea how to cope with them. It can be frightening and overwhelming enough for an adult who can take control by talking to someone to articulate what they’re feeling; make a doctor’s appointment; search for information online, etc. A child has no control in this situation.

There can be many different reasons why a child may start to resist going to school. It can happen gradually, or it can happen overnight. The reason can be obvious, or it can baffle both parents and school staff, but when a child is frightened adults must pay attention, as their reactions can help or can make things a whole lot worse.

A significant point when school refusal occurs is to consider whether anxiety is the actual CAUSE of the refusal, or whether there is an underlying difficulty that is causing the anxiety AND the school refusal.




An important point to keep in mind is that not all anxious children and young people will display obvious characteristics of anxiety. Some will hide or ‘mask’ their anxiety for fear of being told off or laughed at in class – containing their feelings of anxiety inside, while others will appear angry, aggressive or controlling.

In a school environment children will often hide their feelings to avoid drawing attention and being ridiculed or told off. This means that they hold the anxiety inside until they get home and then they can release these emotions. This creates the situation where the school thinks they are 'fine' but the family experiences high levels of distress. 

BLENDING - copying others to try and blend in but not really understanding the context or expectations 

MASKING - feeling anxious but hiding inner feelings and acting as if you are ok to protect yourself 

This can be significant especially when a child has or may have ASD, as Dr. Luke Beardon explains

Just because a child has the ability to ‘mask’ their autism at school does not mean that they are not greatly impacted by their autism on a daily basis. In fact, it is often this ‘masking’ behaviour (acting, or copying other children) that lead school to believe that there is no problem at school; however, it may be that the child is behaving in this way precisely because they are stressed and have discovered that by copying others they can ‘hide’ their very real problems. When at home, all of the emotional distress may then be released in what is seen as a safe environment. 




The Conversation - Child Mental Health

A range of academic articles about Child Mental Health


Are you a parent or carer who is concerned about the mental health of your child or teenager? Do you just want some hints and tips on parenting? MindEd for Families has advice and information from trusted experts and will help you to understand what problems occur, what you can do to best support your family, and how to take care of yourself. MindEd for Families is written by a team of specialists and parents, working together.


MIND provide advice and support to empower anyone experiencing a mental health problem. 

MIND campaign to improve services, raise awareness and promote understanding.


We are a growing movement of people changing how we all think and act about mental health problems.


We’re the UK's largest provider of relationship support, and last year we helped over two million people of all ages, backgrounds, sexual orientations and gender identities to strengthen their relationships. Find out more about what we do and how we can help you here.


We work to relieve and support those living with anxiety and anxiety-based depression by providing information, support and understanding via an extensive range of services, including 1:1 therapy. We work regularly with external agencies and healthcare professionals to improve services for those living with anxiety and anxiety-based depression and also campaign to raise awareness of the conditions.

We can provide support and help if you’ve been diagnosed with, or suspect you may have an anxiety condition. We can also help you deal with specific phobias such as fear of spiders, blushing, vomiting, being alone, public speaking, heights – in fact, any fear that’s stopped you from getting on with your life.


Relax Kids offers children and young people self-regulation and resilience techniques with a range of books, audios, classes and training..


OCD-UK has been working for children and adults affected by Obsessive-Compulsive Disorder since 2004.

We provide advice, information, and support services for those affected by OCD, and campaign to end the trivialisation and stigma of OCD.


If you're not sure whether therapy could help, what type of therapy you need, or how to find a safe and effective counsellor or psychotherapist, we'll help you find the information you need.


Find a counsellor or therapist near you


Pooky Knightsmith's YouTube channel. 

Every Tuesday and Friday I upload videos about mental health.  These draw on both my professional and personal experience and aim to educate and inspire. I’m always keen to hear your ideas about what you’d like me to record next, so leave a comment or email me if you’ve got an idea or a question:


An introduction to preadolescent depression - Clinical Psychology based research


This website aims to help you to help your young person by directing you to sources of support, advice and information