Anxiety Disorders

It is normal for people to worry or feel nervous some of the time but if worry is taking over much of your day or if it prevents you from doing things you would like to be able to do, it is worth seeking help.

Anxiety disorders are so common and so treatable. I really wish people would access help more often as having treatment really can significantly change the life of someone suffering anxiety for the better. Normally within about 3 months, I and my cognitive behavioural therapy, (CBT), colleagues can get you functioning really well and you will have learned new skills that you can take forward with you and use throughout life to manage anxiety. You might need some medication to kick start you feeling better and to take the edge of the anxiety enough for you to do the CBT. If this is the case I only use evidence-based medication and I will talk it through with you in detail to allay any worries, you may have.

In the UK, anxiety disorders are estimated to affect 5-19% of all children and adolescents, and about 2-5% of children younger than 12.

The title “anxiety disorders” covers many disorders, below is an explanation of some of the common ones.

Phobic anxiety disorders

With this type of anxiety a young person normally experiences intense fear or worry from one particular object or scenario, such as spiders, dogs, heights and so on. They normally avoid or dread the cause of their anxiety and I have seen young people who have almost ruled family life by avoiding the item they are scared of. For example, I saw a young lad who would not go out for fear of seeing a dog. He was treated very swiftly to the relief of him and his family.

Agoraphobia

This term is used when someone has a fear of leaving home, a fear of open spaces or a fear of crowds. I have seen young people who are terrified of going out, going to shops, going on trains or planes and some have become completely housebound. It is important in these situations to see a psychiatrist, not only to get treatment for the agoraphobia but also to check there is not something else going on for the young person too, such as depression or an autistic spectrum disorder. The earlier this anxiety disorder is caught the easier it is to treat.

Social phobia

Social phobia is one of the most common reasons that young people come to see me. Often the young person has a history of being slightly anxious when younger, but not always. However, their anxiety has now grown to the point that they are avoiding many or most social situations. They are often so self-conscious, with a low self-esteem and worry what they look like, what they should say in a social situation and what people are thinking of them. Often their anxiety about these situations progresses to panic attacks which might then lead them to worry there is something wrong with their own health.

I have so many success stories from treating young people with social phobia and it is one of the most satisfying disorders to treat as I see young people getting better month by month until they are different, happy, confident young people who function well.

Panic disorder

Panic disorder is a horrible disorder for a young person to have. They find that out of the blue, they cannot breathe, they might have chest pain, dizziness, feel sick, sweaty and at times feel like they or other things are not real. Often they worry they might be dying or might be about to wet themselves or be sick. They then live in fear of this happening again. Often young people will have been investigated for physical health problems and nothing abnormal is found before doctors suggest the young person sees a psychiatrist. Again this is so treatable and I do urge parents to bring a young person who is suffering with this to get them a psychiatric assessment.

Generalised anxiety disorder

This involves excessive anxiety which happens much of the time about anything. I have seen a large number of young people really struggling with this. They find that they lie awake for hours at night worrying about things they have said or what might happen the next day. Often they cannot concentrate in lessons and they might have become quite snappy with the family. Many young people describe feeling exhausted as they cannot switch their brain off from worry. I have seen a multitude young men (and sometimes young women) who isolate themselves to their room “gaming” as that is the only time they can relax. This often really frustrates their parents. It is really important young people struggling with these symptoms see a psychiatrist as many have depression alongside and once there is a clear diagnosis, this again can be treated very effectively.

Obsessive-compulsive disorder (OCD)

Frequently people do not realise that obsessive compulsive disorder is an anxiety disorder. Again this is very common in the young people I see. Often the young people try and hide this as they “feel like I’m going mad”. Parents find this illness very difficult to manage too as it seems so irrational to them and yet it often leads to the whole family life being ruled by it.

The main feature of this disorder is that the young person keeps getting unpleasant thoughts in their head, which they do not want but they cannot get rid of and they keep coming back and back. The thoughts are often about something bad happening to someone they love, or something violent or sexual, so they can be very hard for a young person to talk about to family members. At times the young person may experience these as intrusive images or even urges. Some young people might end up doing routines or rituals to try and get rid of these bad thoughts. Often these rituals do not make any sense to them or those around them. For example, they may need to walk around a chair 4 times anticlockwise before sitting in it to prevent something bad happening to their mother. They do not enjoy doing these rituals but get very distressed if they are not completed perfectly or if they are interrupted. Often family members end up helping with the rituals, such as straightening all the shoes by the door or brushing every crease out of a duvet just to be allowed to get on with the day. These rituals can become very time consuming if not treated.

The good news is that this disorder is also very treatable. Normally those with it need a combination of medication and CBT and at times family therapy. The earlier you access treatment for this the easier it is to treat. Again, it is important that a psychiatrist assesses the young person to be sure that there is not another diagnosis alongside the OCD such as an autistic spectrum disorder.

Post-traumatic stress disorder

This is caused by a young person experiencing something that they perceive as very frightening or life-threatening. It is important to remember that an event that might not be perceived this way by an adult, may have been by a young person. Some young people are more likely to develop this than others if they are already a nervous anxious child, for example. After the trauma, the young person may start having nightmares or memories of the event that they do not want and that distresses them all over again. Often they become quite jumpy and startle easily and they might avoid certain situations that only vaguely resemble the situation of the trauma. At times there is a gap of several weeks or even months between the trauma and the symptoms occurring.

Once the young person has seen a psychiatrist to make the diagnosis it is likely they will be offered talking therapy, either cognitive behavioural therapy or eye movement desensitisation reprocessing and the psychiatrist will monitor to see that these are effective and if medication is needed in addition.

Other anxiety disorders

There are other anxiety disorders that might be diagnosed by a psychiatrist such as “somatoform disorders”, including hypochondriacal disorder. These disorders involve having physical health symptoms without a physical health cause or worrying excessively about a physical health illness. I see these less commonly in young people and when I do often the young person has undergone considerable unnecessary tests for physical illness. Again this is treatable and it is best treated as early as possible in the course of the illness. In children under 12, I often see “Separation anxiety”, where the young person struggles to go anywhere away from their parent, often because they are worried about their parent or that no one will be able to manage their worries like their parent can. Please seek help from a psychiatrist if your child has this difficulty as we can help.

Below are written comments from feedback from recent young people who have been seen by her in her clinic:

Brilliant Doctor, I gave up and Dr Hayley picked me back up and got be back to myself. I feel like she actually cares and respects what I say.
She is very helpful
Dr Hayley saved me from suicide and helped me turn my life around. She is the best!
Dr Hayley has been very good for my daughter – she has been kind, caring and has explained her condition to us very well. My daughter was really poorly but is now well on the way to a good recovery thanks to Dr Hayley’s treatment and care.
Lovely Dr who was there to listen and help anyway possible. Full in detail and good natured with myself and my son. Got a lot from it and finally felt we were listened too. Lots of advice and next steps to follow.
Dr Hayley was incredibly thorough, supportive and engaged. My daughters confidence with the process soared and throughout the 2.5 hour process. I am profoundly grateful that expertise and care exists in professionals like Dr Hayley. She is life-changingly good.
Thank you so much for a faultless service. I’ve recommended you already to friends!
Dr hayley is always so positive and encouraging. She listens well, is very professional and is very calming. Always a positive and helpful experience. My daughter won’t speak to any therapists however she is happy to open up to Dr Hayley. Thank you.

Dr Hayley is phenomenal – she has transformed our daughters life and we are grateful every day that we found Dr Hayley and got the help we so desperately needed.

Dr Hayley is such a lovely and compassionate psychiatrist. She has transformed the life of my son. I am so grateful.
An excellent doctor who is thorough and non-judgemental and takes a collaborative approach.
Thank you so much. Straight forward. Caring. & already actioning a plan. I’ve recommended you to two people already

Dr Hayley is always really professional but totally relatable and understanding. Would definitely recommend her to others.

Dr van Zwanenburg put my 10 year old at ease immediately which helped her open up
Dr van Zwanenberg was fantastic, everything we’d hoped for.
Very approachable and friendly style, felt that she really listened and put our anxious daughter at ease. Explained very clearly what the problem was and how we were going to deal with it as a team. Highly recommend.
Very kind and knowledgeable
We love Dr Hayley. She is the only person my daughter will engage with. She has been incredibly helpful in all kinds of ways, not only with medication but with diagnosis, advice and referrals. My daughter has come along way since seeing Dr Hayley
Dr Hayley is very supportive and I would thoroughly recommend her through this organisation
Very good doctor.
Without Doctor Hayley I am certain I would not be alive today and she has been a massive help to me and my family.
Very friendly and helpful.
I was highly recommended to yourselves by someone who had previously been to see you. I will also highly recommend you also. My husband and I Felt very at ease during the whole process.
Van Zwanenberg was able to see us much more quickly than we had expected for which we were very grateful, and we were touched by the level of care and personal attention we and our son were afforded when we met. The speed, depth and quality of the written follow up was impressive, too.
The doctor was really personable and helped to make my son feel comfortable, she asked great questions to elicit information to help the diagnosis and was very good at listening to our feedback

We have received a very positive experience using Dr van Zwanenberg. We have felt listened to and supported without any judgement getting our daughters autism diagnosis. We would highly recommend.

She is so kind and supportive
Very happy with the service Dr Hayley has provided.
Dr Hayley probably saved my son’s life. A great Doctor.
Dr Hayley and her colleagues provide outstanding accessible compassionate and effective care for young people with emotional and mental health difficulties including ADHD. We can not thank her and her colleagues enough for the extraordinary difference they have made to my son’s well- being and helping him approach his full academic potential.
Thank you, I am very grateful for your professional, committed and caring approach that underpins your clients’ healing of minds, developing self-confidence and sustainable growth as autonomous individuals in becoming. I hope you recognise you save lives and give hope with your calm faith that your clients will, and do get better.
Dr van Zwanenberg was very friendly and put my son at ease so he felt comfortable to talk openly. She was very reassuring and seemed to understand him straight away.
As always Dr Hayley was fantastic. She is always one step ahead and any additional admin requests etc are never too much bother. We will be sorry to lose her, as my daughter moves on soon to an adult psychiatrist now that she’s 18. I will be surprised if we can get such attentive service from any other psychiatrist. Many thanks indeed for your amazing support over the past few years.

Very happy with Dr Hayley. She She’s very kind and makes us feel at ease within the session. listens carefully to problem and tries to recommend a right solution. She’s very prompt in replying emails or in event of asking for prescription, which itself has made me feeling better in the stressful situations we have been experiencing. I am very happy with her and would recommend to others. Thank you Dr Hayley.🙏🏼🌸

Can’t recommend Dr van Zwanenberg enough for child ASD/ADHD assessment and follow up. She’s very empathetic & puts everyone in the family at ease.
Dr Hayley took an impressive amount of care in advance of our initial assessment appointment, to evaluate our son’s situation from many angles. We felt listened to and reassaured by her suggestions of strategies to help manage his symptoms. My son commented after the appointment that “She was vey kind and understood me”. We have also appreciated her quick responses to our questions outside of the appointment itself
So happy my son is finally getting the help he needs to free himself of a life of anxiety. Thank you.
The level of care and communication from Hayley has been exceptional throughout and I have already strongly recommended her to several other parents.
Dr Hayley has made my child’s life happy again, and our families too. She has identified and helped him with his anxiety and adhd. Her practice is run with precision and care with excellent communication from Dr Hayley and her team. I can’t thank them enough.
Hayley was amazing with my daughter and she felt very reassured that she would help her get back to her old self!
Hayley has always been very accessible and helpful if we’ve needed to contact her between appointments.
Thank you ever so much for a very thorough assessment.
Empathetic, caring!
Dr van Zwanenberg’s tone, manner & approach was perfect for our child, she listened to us all and helped set wheels in motion. Thank you
I really thought I was going to lose my daughter. Lose her to her own despair and potentially her own life. I searched for what seems like too long to find her the support, acknowledgment and treatment she needed. Finding Dr H was not just a life line but a true life changer. The care, understanding and treatment my daughter has received is truly outstanding. With Dr H’s consultation and understanding, my daughter has been able to reconcile her feelings of despair and inadequacy. I now have a confident, happy, social daughter who is starting university in the autumn and is looking forward to life. I can not thank you enough Dr H. Honestly, thank you so very much.
Dr Hayley she is a amazing person, very caring, patient and helpful
Dr Hayley van Zwanenberg is a very good doctor
Dr H has made a lasting improvement on both my daughters’ states of mind and their approach and outlook to life. I can not rate her services highly enough.
Dr Hayley was wonderful with my son. She put him at ease very quickly and consequently he was very happy to open up to her and talk freely. Thank you so much.
As always Dr Hayley listens, is empathetic, encouraging and non-judgemental and gives sound professional advice. Thank you.
Dr Hayley was very calming and listened carefully to my concerns
Hayley was wonderful. She engaged with my son beautifully despite his almost constant hyperactivity and chattiness during the appointment! She has a lovely warm approach while remaining very professional and highly knowledgable. I wouldn’t hesitate to recommend her.
Dr Hayley is the only doctor that we trust to help us with our daughter’s mental health; more importantly, our daughter also trusts her. She genuinely cares. She talks to her, understands her and engages with her and us. She quickly identifies the problem and suggests realistic, pro active plans to tackle the particular issues at hand. She is always available for us to contact by phone and email (no matter how small the problem) and has telephoned us during the day and sometimes in the evening when the situation requires it. As parents, we have at times really struggled but she always manages to reassure us and we feel very lucky to have her as our doctor.
Very early in our treatment but Dr Hayley has already made a huge improvement to our daughter and her health.
When dealing with a person with mental illness it is essential that the patient feels that they are being believed by the Doctor who provides the treatment. Dr van Zwanenberg is able to build trust and rapport and is sympathetic, understanding and non judgmental in her approach.
We feel blessed that Dr van Zwanenberg was available when my daughter was referred. It was a relief for my daughter to be understood and feel that there was hope for getting better. Dr van Zwanenberg has been endlessly kind and provided the expertise needed so that we felt completely supported. Although we have not had to use it a lot she has been available for advice in between appointments, which again adds to our feeling of being well supported. We would wholeheartedly recommend her and know she would do the best for anyone who came to see her.