Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Contact local emergency services or an urgent mental health service if there is immediate danger.
These situations are emergencies even when anxiety appears to be the main problem.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Seek prompt medical advice if a child stops eating or drinking adequately, has severe or unexplained physical symptoms, or appears very withdrawn or depressed.
Get urgent help if the child talks about suicide or self-harm, has harmed themselves, or cannot be kept safe.
3
Does any of this apply?
Book an appointment
Arrange a routine appointment with a primary care professional or child mental health professional if the anxiety:
Lasts four weeks or longer
Regularly prevents school attendance or other normal activities
Causes ongoing sleep problems or frequent physical complaints
Requires a parent or caregiver to remain constantly nearby
Is becoming more intense despite supportive routines
Began after trauma, bullying, loss, or a major family change
Every sign above is quoted from the sofidex article on Separation anxiety in children. If you are not sure, err upward — it is always reasonable to be checked.