Anxiety disorders can manifest in many different ways. Physical symptoms can include tachycardia (fast heart rate), tachypnoea (rapid breathing), dyspnoea (laboured breathing), dizziness, sweating, tremor, nausea, dry mouth, muscle tension, gastrointestinal upset, polyuria (frequent and excessive urination), disturbed sleep, appetite changes, chest pain, headache and facial flushing. 

Emotional changes can include being preoccupied with upsetting or negative thoughts; nervousness; difficulty concentrating; hypersensitivity to sights, smells and sounds; being unable to enjoy leisure time; and feeling frightened, overwhelmed or out of control. There may also be behavioural changes such as withdrawal or isolation, aggression, tearfulness, clinginess, reluctance to try new things, and self-neglect or self-harm.

The younger the child, the less likely they are to know why they are feeling the way they do, but, regardless of age, sensitivity is needed when broaching the subject. It is also important to bear in mind that anxiety is a very individual experience, and the presenting symptom may be changes to someone’s normal demeanour noticed by a family member or friend, and perhaps knock-on effects such as struggling with work, or a deterioration in relationships.