Anxiety – Friend or Foe

By Dr. Philippa Fabbri

Anxiety-friend-or-foe, people are feeling overwhelmed, exhausted, anxious, and/or worried for an increasing number of varied reasons, from science denial and conspiracy theories to political uncertainty, school closings, and infection spikes.

 From science denial and conspiracy theories to political uncertainty, school closings and infection spikes.

Background and introduction

My name is Philippa Fabbri and over the past 20 years of being in the field of Special Needs Education, particularly focusing on anxiety and school-related concerns, I have gathered data and information about how best to support a child who is struggling for whatever reason. I realized how massively this condition can affect a person’s life while studying, reading, and researching it due to the high incidence of cases coming in and when chatting to parents in interviews and consultations.

 These are some of my experiences:

As a parent, a teacher and someone who had transition anxiety as a child, It was only when I began studying,  reading and researching it, due to the high incidence of cases coming in and when chatting to parents in interviews and consultations, I realised how massively this condition can affect a person’s life. It really is becoming a national crisis.

  1. Last year, especially in the aftermath of Covid, parents were looking for alternative schooling options. Children are not coping with the traditional schooling approaches; there’s too much pressure, the pace is too fast, competition is becoming unhealthy and learning barriers and challenges are being ignored or are not accommodated.

Anxiety is not always easily identified or diagnosed and some kids hide it better than others. There are also marked differences in the presentation of the disorder between the genders, with boys showing fear and anxiety differently to girls.

  1. The South African Depression and Anxiety Group (SADAG) states that anxiety affects as many as 8-11% of children and adolescents, which can affect their ability to get on with their lives. Childhood and adolescence are the core risk phases for the development of symptoms and syndromes of anxiety, ranging from transient mild symptoms to full-blown anxiety disorders.

Young people commonly experience anxiety disorders, which adversely affect their educational achievement, family life, and leisure activities. Anxiety disorders often co-occur with other anxiety disorders, depression, and behavioural disorders.

Types of Anxiety Disorders

People with anxiety disorders frequently have intense, excessive, and persistent worry and fear about everyday situations. They may have repeated episodes of sudden, intense anxiety and fear or terror, which peak within minutes, resulting in a panic attack. These feelings interfere with daily activities and are difficult to control. They are generally out of proportion to the actual danger and can last for a while. Symptoms of anxiety disorders may start during childhood and continue into adulthood.

Here are the main types of anxiety disorders. Is your child affected by any of the following?

  • Separation Anxiety: usually disappears over time, but is present when dropping off at school, parties, sleep overs etc.
  • Specific Phobias: dogs, the dark, snakes, fear of germs (OCD) and small spaces
  • Generalised Anxiety Disorder: worrying all the time about everything.
  • Social Anxiety: afraid of embarrassment, painfully shy, avoiding social situations
  • Panic Disorder: agoraphobia, afraid of leaving the house, avoid shopping malls, places where there are lots of people.

Symptoms and Behaviour Changes

Anxiety symptoms may vary from person to person, but generally, the body reacts in a very specific way. When you feel anxious, your body goes on high alert, looking for possible danger and activating your fight or flight responses.

Look for signs, and changes in behaviour, and listen to what your child is telling you. What can you change? And what can’t you change?

Internalising behaviours vs externalising behaviours

Externalizing behaviours and disorders are characterized primarily by actions in the external world, such as acting out, antisocial behavior, hostility, and aggression. At school we may observe the following behaviours:

  • lashing out
  • school avoidance/absenteeism
  • aggression
  • irritability (bad behaviour) or withdrawal
  • sadness
  • lack of engagement

Internalizing behaviors and disorders are characterized primarily by processes within the self, such as anxiety, somatization, and depression. Behaviour to watch for at home:

  • avoids interaction
  • prefers to be alone
  • lack of enthusiasm
  • fighting with siblings
  • irritability
  • withdrawal
  • low mood

Causes of Anxiety Disorder

According to the Mayo clinic, the causes of anxiety disorders aren’t fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits also can be a factor.

Broadly, causes of anxiety disorder can be divided into three main areas:

  • Biological causes – your genes, your body’s natural responses to threats, and the fact that some people are just more predisposed to developing anxiety. These are all internal factors.
  • Psychological causes – Post Traumatic Stress Disorder which is a reaction to something that occurred in the past. This is an external factor.
  • Social (or Environmental) causes – it could also be learnt and copied from people in the child’s environment; another external factor.

And without proper research-based treatment, anxiety can persist into adult life with detrimental effects.


Exposure Therapy is the cornerstone of Cognitive Behavioral Therapy (CBT), which is currently the gold standard treatment for anxiety. Exposure Therapy, which helps people confront their fears, usually takes place in the psychologist’s office on a weekly basis and is effective in curing around 50% of cases.

CBT teaches a person to be aware of what is going on in their body and mind when they become anxious. The trigger (exposure) causes a response (physiological changes in the body) along with your thoughts, that develops into a certain behaviour (fright, flight or freeze) which then causes an emotional reaction (usually negative). There is another dimension to this and that is awareness of what is going on. Awareness of the feelings, emotions and thoughts without judgement. Treatment should usually include a combination of strategies – the first step being to acknowledge that there is an issue that needs to be addressed (friend or foe).

Anxiety – let’s talk about it! I can help you develop strategies to manage it – as opposed to allowing it to manage you.

If you’d like to book a consultation, get in touch:

Anxiety – Friend Or Foe

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