Do You Have an Anxious Child? How to Tell and What to Do About It

Anxiety has long been one of the more common mental health issues that people seek help for. However, anxiety in children in particular is often overlooked and/or misunderstood. So much so that 80 percent of children with a diagnoseable mental disorder are not being treated (Child Mind Institute). This is shocking considering that the median age of onset for childhood anxiety is six years old. Early intervention with any type of disorder is ideal as it helps to prevent it from becoming a chronic issue.

There are several specific disorders that fall under the umbrella of anxiety which I discussed generally in my previous post. Today I’d like to focus on what Anxiety looks like in children with the hopes of helping more parents and caregivers identify it.

What Causes Anxiety in Children?

I’m sure you’ve heard of nature vs. nurture. That rings true here, though I don’t think that these two things are necessarily working against each other. In fact, they work in tandem with each other for better or for worse.

Nature: There is the nature component which encompasses the child’s genetic makeup. If a child has a parent or other close relative with an anxiety disorder, he or she is more likely than his or her peers to develop one. If there is a genetic component there is likely a biological one as well. Without getting too deep into the neuroscience of it all: anxiety has been linked to a disruption in the levels of  two chemical messengers in the brain: serotonin and dopamine.

Nurture: If a parent is anxious, it is likely that their anxiety is on display from time to time (depending on severity). There are several ways that a child could be exposed to their parent’s anxiety. If a parent is an excessive worrier, who verbalized their worries, the child may internalize this behavior. Children are experts at modeling the behaviors of those around them. So, if they grow up understanding and observing that the only way to remain safe is to worry-they will worry.

The general environment also plays a role. Traumatic things may happen to a child that are beyond a parent’s control. Examples of traumatic events are a dog bite, major surgery, neglect, abuse, and the loss of a caregiver. Some examples of environmental factors that can influence anxiety are: divorce, major life changes such as moving, the birth of a sibling, going to a new school, and having difficulty navigating peer relationships.

The one factor that I feel is fairly consistent across the board with most of the children and families I see is that children these days are simply doing too much.

Parents more and more are taking responsibility for their children’s enrichment, learning, and fun.  I certainly applaud parents who take an active role in these domains of their child’s life. However, sometimes it is too much. What “too much” is varies from child to child. However, I often discuss with parents the importance of their child having downtime.  Kids need to be able to sit and relax just as much as us adults do after we put them  to bed.  The flurry of comings and goings with little to no breaks in between, can be enough to ignite anxiety in a young, susceptible child. In fact being bored is such an important aspect of child development!

Anxiety vs. Opposition

Children with Anxiety are often misunderstood. Perhaps, all of a sudden they are having issues in school. Maybe they are refusing to go to school or a different place altogether. The most common word I’ve heard to describe a child with undiagnosed anxiety is “oppositional”. It certainly seems that way on the surface if we look strictly at the behavior (refusing to do things, throwing tantrums, lying). However, when we delve deeper and look at more than just the behaviors we can uncover something different.

What Does an Anxious Child Look Like?

Children who are anxious often display similar behaviors in different contexts. Here are some things you can look out for:

• The perfectionist. He or she always wants to please others. School is super important, and getting bad grades can evoke a significant emotional reaction. He or she puts a lot of pressure on themselves to do well in school.
• The worrier: worries everyday, and about things that are beyond their control.
• He or she avoids certain people, places, or things. Avoidance can play out in a bunch of different ways. Perhaps they tantrum until you let them stay home from school. Perhaps they walk a different route to school. Avoidance is a coping mechanism used to avoid the negative symptoms associated with some anxiety disorders such as panic attacks.
• Changes in temperament. He or she suddenly becomes super clingy or moody.
• Consistent worries about their own safety or the safety of others.
• Consistent complaints of physical ailments such  as stomach aches, headaches, or obscure body aches. When you take your child to see the doc, they are medically cleared every time.
• Sleep problems. Your child may have difficulty falling or staying asleep. Or maybe they sleep too much.
• Concentration is problematic. Perhaps you are suddenly getting reports from teachers that underscore attention problems.
• This one is probably most obvious. Children with anxiety are rarely calm or relaxed. This can be hard to notice if you are constantly on the move though.
• Anxious children are often in bad moods as well. Positive thoughts are not as prevalent as negative ones in the anxious mind. As a result, bad moods are prominent.

How to Tell If Your Child Suffers from Anxiety

Of course, just because your child displays some of these signs or behaviors does not mean they have an anxiety disorder. The important piece to remember is that these things have to pose significant difficulty to their daily functioning. Some level of anxiety is normal, developmentally appropriate, and important. Children go through phases of anxiety as they grow up but the key is that these are phases and they don’t last longer than what is developmentally appropriate. A great example of a developmentally appropriate anxious stage is separation anxiety. This develops around the child’s first birthday and goes away within a few months in most cases. If it lingers intervention may be necessary.

What Can Parents Do

Parents can do a lot to help their child cope with anxiety. The science of it all helps us to understand the various ways that we can be creative in the process.

Fourteen Creative and Practical Things Parents Can Do to Help Their Child Through Anxiety:

1. Be aware and mindful of your child’s moods and feelings. If you are aware, you can reflect back to them what you are noticing. This starts a dialogue between you and your child which opens the door to both of you finding ways to make things better.
2. Talk in a calm voice to your child. This is crucial but can be difficult to do. Anxious energy can permeate the atmosphere and infiltrate the moods of those who are around it. Talking calmly creates a space for the child to move away from the anxious energy they are feeling.
3. Recognize that anxiety is extremely difficult to control. So, when your child handles his or her anxiety well use praise to mark it. This will help build the child’s self-esteem which will in turn help them to feel more confident in their ability to handle things.
4. Which leads me to my next point. Help your child remain as independent as possible. Encourage them to do things on their own, and reassure them that they have the ability to do so.
5. Learn what the triggers to your child’s anxiety are. If you know the triggers that lead to them being upset, you can help talk them through potentially upsetting situations before or after they happen.

6. Prepare your child for transitions.This is one that takes some major adjustment for some parents. Children are used to being told what to do and when, but they aren’t usually told with much advanced notice when things will change. Anxious children crave some sense of control and agency. Letting them know ahead of time that something is going to change will allow them to prepare themselves.

7. Listen to your child. This goes along with number 1 on this list, but is too important to be in the shadows. Listening to your child and what they are saying may take some decoding on your part. Are they truly saying “I hate school” or rather “I’m worried about failing my quiz today”. Knowing what your child’s triggers are will help you to listen more effectively. When you listen effectively, you will in turn become a more effective problem solving partner for your child.
8. Encourage exercise and movement based activities. Exercise always ends up on these lists and for good reason!
9. Settle into a routine. Children crave routines and boundaries. Especially anxious children. This helps them to know what is coming. Predictability crushes anxiety which preys on the unknown.
10. Maintaining healthy eating habits is also important. Caffeine in particular is known to exacerbate anxiety. Most kids are not drinking lattes throughout the day but caffeine is  found in lots of other things like soda and chocolate.
11. I mentioned this earlier but it’s so important I felt compelled to say it again. Downtime is so important. children need to be able to relax, veg out, and decompress. Give their minds and bodies a break.

12. Another active thing that parents can do with their child is to role play situations to help their child become more confident. This allows for the child to feel more prepared which in turn will help them to feel less anxious in anxiety provoking situations.

13. Break down large tasks into smaller ones. Children are more likely to feel like they can complete a task if it does not feel large. For example: “Clean your room” can be broken down to separate tasks. “Make your bed”. ” Pick up your toys”. Bring your laundry downstairs”.
14. Last but certainly not least is self care. Being the parent or the caregiver of an anxious child can be overwhelming and anxiety provoking. Taking some time for yourself to decompress will bring out the best in you as a parent.

Lastly, I want to take some time to talk about the rest of the family including siblings. It can be overwhelming having an anxious child in the mix. However, I always say that having an open and honest dialogue about what is happening is best. There can sometimes be a tendency to try to keep things as “normal” as possible. While the sentiment of this is certainly coming from the right place, it isn’t always the most helpful. Explaining to siblings what is going on perhaps with the input of the child experiencing anxiety can be powerful. Having a few sessions of sibling therapy can make a potentially polarizing situation one that brings siblings and families closer together. Anxiety can be a difficult beast to wrangle but with the proper supports, no family is immune to overcoming its difficulties.