Anxiety: When to worry and what to do

Written by: Dr Pooky Knightsmith | Published:
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Many students seem to be struggling with anxiety. Dr Pooky Knightsmith discusses how to recognise which students need support and what you can most helpfully do

First things first – we need to understand that anxiety is a perfectly natural response of our bodies and minds that can keep us safe and help us perform at our best.

If we needed to run from a grizzly bear, or over-power an attacker, or win a race, or perform to our best through an entire three-hour exam, we’d struggle without a good dose of anxiety. But sometimes you can have too much of a good thing, and this is something that many pupils are struggling with.

Anxiety can take many forms – you may find pupils becoming more isolated, becoming disproportionately sensitive to feedback or seeming on edge. Less obvious, but common, signs are tiredness (it takes a lot of energy to be anxious for extended periods), irritability (we’re less well able to emotionally regulate when our brain is overrun with anxious thoughts), and a change in attendance or time-keeping.

Where you spot these signs, have an exploratory conversation with the child, or pass your concern on to the relevant member of staff.

The key things that tell us that this has tipped over from manageable, healthy anxiety into something that needs some form of support or intervention are impact and longevity. If a child’s anxiety is having a negative impact on their ability to engage, enjoy and achieve in their normal daily life and if this has been happening for a period of weeks or more then it’s time to intervene.

Depending on the severity of the issue you may want to involve parents, GPs or external agencies such as CAMHS right away, but it is worth recognising that there are many things that a child and their supporting adults can do to improve things too.

In all that you do, it is important not to provide solutions for the child, but rather to work with them to understand the issues and to co-create suggested ways forwards – this will help the child to feel more in control of the issue and will help them develop the skills they need for their on-going wellbeing.

First steps: triage

First, work with the pupil to recognise any immediate triggers or stressors which are weighing heavily on them and making each day more of a struggle than it needs to be.

Consider whether there is anything that can be practically done to relieve some of these stresses. Sometimes something as simple as a homework extension, or being allowed to spend breaktime somewhere quiet can help a pupil to manage. In the first instance, we are trying to help the pupil feel more calm and in control of the situation as well as realising this is not something that they have to tackle alone.

Working out who and what their support network consists of is helpful at this stage – and thinking about who it is helpful to talk to about the issue. Parents, friends and teachers will often feature highly on this list.

It can help to tell these people both what the issue is and specifically how they can help as this can make things feel less daunting for everyone and most people will do their best to help when given clear instructions.

Next steps: healthy coping strategies

Next, the pupil needs to develop healthy coping strategies to enable them manage their anxiety on a daily (or sometimes minute by minute) basis. This may be done with your support or the support of a specialist depending on the severity of the issue, but key things that may help are:

  • A regular routine that acknowledges trigger points.
  • A member of staff they can refer to if needed.
  • A range of strategies for calming themselves.
  • Time limits on homework.
  • An emphasis on reinstating regular sleep, exercise and eating patterns.
  • Questioning negative thought patterns.

It can take a little while to develop and embed these new habits, but they are habits for life and will tend only to be truly effective if a young person feels in control of them. While a pupil will find this difficult to manage alone, staff, parents, professionals and friends should take a mentoring or facilitative role in supporting the pupil rather than a guiding one if the pupil is to successfully manage their anxiety in the longer term.

For a wide range of resources about managing anxiety and for a text and information line, visit the Anxiety UK website.

  • Dr Pooky Knightsmith directs the children, young people and schools programme at the Charlie Waller Memorial Trust, a charity that provides fully-funded mental health training to schools. Visit and email or call 01635 869754 to make an enquiry. For more information on the charity itself, visit

Mental Health Advice

Dr Pooky Knightsmith provides regular support and advice in SecEd. Her next article is due to appear on April 27. To read the previous articles in this series, go to If there are specific issues you would like to see addressed, email or tweet @PookyH

Further information

Anxiety UK:


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