From childhood to midlife and beyond: how to handle anxiety at every age

Talk about your fears, normalise difficult emotions, get up and move: experts share their strategies for managing anxiety at different stages of life

We are living in an age of anxiety. A 2023 survey by the Mental Health Foundation found that one in five people in the UK experience anxiety all or most of the time. In 2024, 500 children a day were being referred for NHS anxiety treatment in England.

It is one of the epidemics of our time, says Owen O’Kane, a psychotherapist and the author of Addicted to Anxiety: How to Break the Habit. “When we look at what is happening in the world at the moment, the one thing we have an abundance of is uncertainty. If you look at a textbook definition of anxiety, it is an intolerance of uncertainty.”

Anxiety is part of our fight, flight, freeze response, explains O’Kane, which is a helpful mechanism to keep us safe, as he found growing up in Northern Ireland during the Troubles. But some people have a dysfunctional relationship with anxiety, which, O’Kane says, means they are “in a heightened state of alarm and vigilance all of the time”.

“We need anxiety. It just sometimes misreads the room,” says counselling psychologist and broadcaster Dr Sian Williams, the author of The Power of Anxiety: How to Ride the Worry Wave. “When we don’t feel like we have control, anxiety presents us with the worst-case scenario so we can feel prepared. Sometimes that is useful, but sometimes it fills in gaps where there is no knowledge, and that is when it can become unhelpful.” The problem, says Williams, is that fighting or avoiding anxiety “not only doesn’t make it go away, but makes it worse. So if that is not going to work, how do we live with it? How do we use our anxiety in a way that can benefit us?”

Whatever stage of life you are at, it is never too late to address anxiety – or help others with theirs – so anxious thoughts no longer control how you live.

Childhood

If you have a child who is showing signs of anxiety, don’t panic, says Dr Meredith Elkins, a clinical psychologist specialising in the treatment of anxiety in children at Harvard Medical School’s McLean hospital, and the author of Parenting Anxiety: Breaking the Cycle of Worry & Raising Resilient Kids. “Families need to understand that anxiety in a child isn’t a character flaw. It is normal for kids to experience periods of anxiety, particularly around times of transition. There are developmentally appropriate ages and stages when anxiety increases. We want to make sure that we’re not communicating that their experience in these moments is a cause for concern – that can further fuel the anxiety.”

Instead, validate and normalise anxious feelings, says Elkins, through supportive statements. She gives the example of telling a child it is understandable to be terrified on the first day of school, that most kids feel that way and they will get through it. Elkins says it’s important to “resist the urge to shut down life because of anxiety”. It would be easy to avoid situations that trigger anxious feelings, but that will only exacerbate them and “removes the chance for exposure, the chance to learn”.

At what point does anxiety stop being a healthy part of childhood? Elkins says to look out for three things: interference – if it is affecting what a child or a family can do; distress – if the level of upset seems disproportionate, given the child’s age; duration – “something ongoing for several weeks or months warrants a clinical diagnosis”, she says.

There is a strong link between neurodiversity and anxiety, and treatment can be adjusted accordingly: “If a kid struggles with agoraphobia and feels overwhelmed in crowded places, our aim is usually to get them into crowded places. But with a kid who is neurodivergent and may have sensory processing concerns, getting them to engage with their peers and go to a football match or concert may be more accessible with noise-cancelling headphones.”

Adolescence

It is arguably not a great time to be a young person. “Normalisation of the spectrum of human emotions is key,” says Elkins. “So many teens see anxiety as their identity. We know that it is not necessarily a lifetime diagnosis or disability, but a punctuated time when things are hard, and it is treatable.”

Talking about your own fears can help them to see emotions as “normal, natural and sometimes inexplicable”, Elkins says. “Whatever we’re expecting in our kids, it is really important for us to model it ourselves.” This could be, she suggests, addressing an issue with a family member you have been avoiding, travelling by yourself if you struggle with that, or dealing with something difficult at work. “If we can do hard things and handle our own distress, we model that for our kids.”

If your child will talk to you about their feelings, encourage them to explore what is worrying them. “Teenagers are old enough to self-reflect. Ask them: ‘What is the core fear here? Is it that I’m going to go to a party and everyone’s going to completely reject me? Is it that I’m going to fail an exam?’” If you dig into it a bit, there can often be ways to make a situation feel less troubling. When your teen doesn’t want to engage, “sometimes parents need to set a limit on how much anxiety can be ‘driving the bus’”, says Elkins. “If the child is nervous about a family gathering, can they come for part of the event, take breaks, or stay in the kitchen?”

A huge concern for parents is that social media plays into anxieties, says Elkins. “Unless parents feel they have a really solid handle on what their kid is seeing and how they are interacting online, social media opens a Pandora’s box of problems.” Elkins is often asked how to cope with this. “If you feel your kid cannot safely be on social media, or it is increasing their distress, then you need to have a hard conversation. You could say, ‘We are not comfortable with this for you right now,’ or that you are going to observe what they’re doing on social media and gradually give them more responsibility over time.”

At every age, the decision to medicate anxiety can be divisive. “For some people, medication can be a helpful support mechanism to get them to a point where they feel they are able to cope,” says O’Kane, but he stresses the importance of therapy alongside medication to work on the root causes of the anxiety.

Early adulthood

Dr Lauren Cook is a California-based clinical psychologist and the author of Generation Anxiety, which she identifies as millennials, gen Z and gen Alpha, all of whom have grown up with a constant stream of worrying news on their feeds. “Our brains are not wired to get that much negative information,” she says. Many are struggling in the current economic climate: “You see how difficult it is for young adults to find affordable housing – they often have to move away from their families to find it.”

When you leave home, you have more autonomy, which can initially lead to lifestyle choices that may increase anxiety, such as eating unhealthily, drinking too much alcohol or having too many late nights. “There is emerging research on how sugar and alcohol affect our brain health, and the impact this has on anxiety as it increases inflammation in the body,” says Cook. As well as opting for a diet that makes you feel good, she advises: “Move your body for 20 minutes a day; get out for a walk – it doesn’t have to be vigorous exercise – and get some sunshine on your skin.” This can help combat anxious thoughts. Yoga, meditation or mindfulness are worth exploring too.

Another big factor at this age is connection, which younger people can struggle with. “Especially gen Z – they are tagged the loneliest generation,” says Cook. “One of the best things you can do is initiate – ask somebody to brunch or out for coffee, and just talk to them. Put the phone away. We know even having a phone on the table spikes cortisol, so make sure your phone is out of sight when you’re sitting talking to people.”

Finances and the climate crisis raise anxiety around having children. “I had a couple I was working with where the whole question was: do we have children or not?” says Cook. “A lot of people are saying: ‘I don’t know if I want to raise a child – people who are parents seem unhappier.’”

For those who decide to have children, “worry is part of loving a child”, says Elkins, who also runs a clinic helping parents with their own anxiety issues. “It only becomes disordered when worry is persistent, intrusive and overwhelming.” There is strong evidence to support CBT and mindfulness-based approaches for reducing anxiety in the perinatal period, Elkins says. She also emphasises the importance of protecting sleep, as tiredness can amplify anxiety, and suggests leaning on support: “Parenting was never meant to be done alone.”

Middle age

Being in the sandwich generation – simultaneously caring for children and older parents – can be a deeply stressful time, says Aimee Spector, a professor of the clinical psychology of ageing at University College London. “A woman aged 51, the average age of menopause, is very likely to have teenage kids living at home who they are still looking after, and parents they are caring for too.

“Perimenopause is a period of mental health vulnerability,” says Spector. “The anxiety about having a hot flush often makes your heart rate higher and makes you hotter.” There is robust evidence that suggests HRT alleviates hot flushes and night sweats, and as a result anxiety too, although guidelines suggest it should not be prescribed for menopause-related mental health conditions alone.

Cognitive behavioural therapy (CBT) can help if HRT is not an option (or isn’t sufficient) to help manage menopausal symptoms. “If you are feeling less anxious, then if hot flushes do happen you might have less of a negative experience,” says Spector. “The reduction in worry potentially reduces the number of hot flushes.”

Brain fog can make women worry they are showing signs of dementia, says Spector. For this, she recommends “looking after yourself, having good sleep, taking pressure off yourself in terms of deadlines, and reducing clutter in your work and life so you are not doing too many things at once”.

Middle age can be an equally anxious time for men. “There are those who argue that there is a ‘manopause’, that as testosterone drops so does their sense of autonomy. There is confusion about their roles as a man,” says psychotherapist and author Julia Samuel. “On the whole, men are not as good at talking about their feelings with each other, but they are with women.” Having as wide a “village” as possible is important for everyone, because sharing a problem, even if it’s not with a therapist, can be invaluable. “By the time you get to your mid-40s, friendship gets thwarted by work, child duties, parent duties, exhaustion. Prioritising friendship is an important part of wellbeing,” says Samuel.

Williams recommends accessing early-morning light, getting out in green spaces and pet ownership, referring to a study that found walking with a dog is better for relieving anxiety than walking alone. “Rest is crucial,” adds Williams, as is being aware of gut health, which is intrinsically linked to stress via the vagus nerve. Fermented foods could be worth trying, as well as breathwork.

Cold water therapy has benefits too, says Samuel: “There is evidence that it stops you spiralling because it gives you a break from yourself. Your whole system shifts. Even having a cold shower, or putting on the cold for a minute at the end of a warm shower, can change your mood.”

Older age

Health anxiety is increasingly common as we get older. Some memory loss is a natural part of ageing, but there can be a lot of worry around losing cognitive function. “There can often be a fear of going out and not remembering what you are doing,” says Spector. “A fear of falling is a big one too, because a lot of older people die from falls. So often old people fall and then get too anxious to go out. Because they’re not going out, they’re not moving, they’re not getting physical exercise, they’re not socialising.”

Psychological therapies, such as CBT, are helpful, but the barrier can be getting older people to talk about their worries. “There is still a lot of taboo around mental health and talking about feelings with some older generations,” says Spector. “It is getting better, but it varies hugely in terms of ethnicity: in some cultures, it wouldn’t necessarily be appropriate to go and talk to people about your feelings.” But it can be integral to breaking the cycle of worry: “Accessing psychological therapies is really important, because anxiety can be fairly straightforward to treat this way. People shouldn’t be embarrassed about it. It is very normal for us to feel more anxious as we get older and frailer. There isn’t a good evidence base for treating anxiety in older people with medication.”

How else can you support someone in this situation? “Consider the strengths the person had when they were younger,” says Spector. “How can they be harnessed to try to overcome a fear of going out? If there is something that they are really interested in – say knitting – we could try to get them interested in going along to a group again.”

This time of life can feature more grief than at other points. “Grief feels like fear,” says Samuel. “Everything feels dangerous. You have a longing for the past and find it difficult to look into the future. Grief will always put you in touch with the previous losses in your life and bring up your own mortality.” There is evidence that journalling may help, says Samuel, and “music is medicine: dancing in the kitchen, going to a Zumba class, being in a choir”.

Anxiety can make you feel unsafe in your mind, body and home, says Samuel. Finding a pastime that acts as a circuit breaker can “enable you to connect with yourself – and feel safe”.

In the UK, the charity Mind is available on 0300 123 3393 and Childline is on 0800 1111. In the US, call or text Mental Health America at 988 or chat 988lifeline.org. In Australia, support is available at Beyond Blue on 1300 22 4636, Lifeline on 13 11 14, and at MensLine on 1300 789 978