Test anxiety: why exams make us anxious and what helps

Test anxiety is not a separate illness in the NHS guidance, but a recognisable pattern of stress and anxiety linked to tests, exams and assessment. The NHS says tests and exams can be a challenging part of school life for children and young people and their parents or carers, and that University can be stressful because of exams, coursework deadlines, new people and thinking about the future.

Student Minds explains the biology in plain terms: fear and anxiety are part of our survival mechanisms, with the brain’s alarm system triggering a fight-flight-freeze response in which adrenaline rushes through the body, the heart rate and breathing speed up and the reasoning part of the brain can shut off. If the exam, or rather its outcome, is perceived as a threat, this can cause high levels of anxiety, and experiencing anxiety when you are trying to recall information can inhibit remembering.

The NHS says stress is a natural feeling designed to help you cope with challenging situations and, in small amounts, can be good because it pushes you to work hard and do your best. The problem arises when it becomes overwhelming.

The NHS lists the signs in children and young people, and a separate list for students. They overlap and include both feelings and physical changes. None of them on their own means a person has a mental health condition.

• Worrying a lot and feeling tense or irritable.

• Headaches, stomach pains, feeling short of breath or breathing very fast.

• Not sleeping well, or finding it hard to concentrate.

• Losing interest in food or eating more than normal.

• No longer enjoying activities that were previously enjoyable.

• Being negative, low in mood or hopeless about the future.

• Nail biting, skin picking or teeth grinding.

Student Minds says anxiety is not the same as motivational nerves, which almost everyone experiences. They can be confused because they have similar symptoms, such as butterflies in the stomach and a raised heart rate, but when you are motivated a different circuit is activated in the brain, which can speed up thought and help you focus. It suggests that accepting anxious feelings as a sign that you care about the exam is a useful starting point.

The NHS likewise tells parents to remind their child that it is normal to feel anxious and that nervousness is a natural reaction to exams. If anxiety is getting in the way rather than helping, it suggests practising the activities that will happen on the day, such as doing practice papers under exam conditions or seeing the exam hall beforehand.

The sources agree on a set of simple steps. Student Minds frames them across the exam timeline, and the NHS focuses on the preparation period.

The NHS says to watch for signs of stress, encourage a balanced diet, help your child get enough sleep (most teenagers need 8 to 10 hours), be flexible around exam time, help them study, talk about exam nerves, encourage exercise and make time for treats. It says young people can share their worries with a parent, tutor or study buddy and that it may help to talk to teachers if you think your child is not coping.

It also warns against adding to the pressure. It quotes Childline saying many children feel that most pressure at exam time comes from their family, and recommends listening, giving support and avoiding criticism, being reassuring before a test, and discussing the parts that went well afterwards.

The NHS says some young people feel much better when exams are over, but that is not the case for all. It advises getting help if anxiety or low mood is severe, persists and interferes with everyday life, and says seeing a GP is a good place to start. For students it says to consider getting help if you are struggling to cope, if what you are trying yourself is not helping, or if stress is affecting your life or university work, and suggests talking to friends, family, a tutor or a GP.

It adds that very high stress can lead to mental health problems such as depression and anxiety, and can affect academic performance. If you or someone you know is in crisis or at risk of harm, contact NHS 111, a GP urgently, or 999 in an emergency. The NHS student stress page also points to counselling for student mental health problems.