[Pediatric Anxiety Epidemic Video From TEDxTalks ]
It’s normal for every child to experience fear and nervousness as they grow and learn about the world around them. However, if a child’s fears are consuming them to the point that they cannot participate in daily life, they may be experiencing an anxiety disorder. Anxiety in children greatly shapes how they function in the future and in their adult lives. Addressing your child’s anxiety as soon as possible is crucial in order to achieve the best possible outcome for his or her future.
Common Types of Anxiety in Children
There are a few types of anxieties that are most common in children. Although most anxiety disorders tend to include fear or nervousness, they are differentiated by identifying the different triggers that cause the child to feel anxious and fearful.
Panic disorder is characterized by sudden bouts of uncontrollable fear that lead to physical and mental discomfort. Panic attacks are often sudden and commonly occur for no obvious reason. Furthermore, panic disorder includes the fear that the attack will happen again. If your child has experienced at least two panic attacks, they may have this type of anxiety disorder.
Separation anxiety in children is common, especially in younger children who feel afraid when their parent is out of sight. This type of anxiety is usually normal in children between 18 months and three years old.
If a child is a bit older than this and experiences inconsolable tantrums when separated from a parent or family member, they may be experiencing separation anxiety. Inability to sleepover at a friend’s house or even go to school can also be telltale signs that your child has separation anxiety.
If a child has a specific and intense fear of a certain object or situation, they may have a certain phobia that causes them to have anxiety. Common fears that are experienced can be fear of dogs, heights flying, etc. The child will go to lengths to avoid these situations by throwing tantrums. Also, when experiencing their phobia they may be terribly upset, extremely clingy, and even fall victim to headaches and stomachaches.
Generalized Anxiety Disorder (GAD)
Different from any other anxiety disorder, GAD is when there are multiple triggers that cause the anxiety. A child with GAD will be cripplingly nervous about attending school, taking a test, talking in front of people, missing the bus, etc. Generalized anxiety in children usually means that the child worries about the same things as their peers, but to an extremely excessive degree. This type of anxiety causes them to have trouble functioning daily as they are exceedingly fearful and self-critical about their interactions with others in each and every scenario that they may or may not encounter throughout their day.
Post-Traumatic Stress Disorder (PTSD)
Children that have experienced trauma in their lives are likely to have symptoms of PTSD. PTSD can occur after a traumatic event was experienced, such as the death of a loved one, natural disaster, domestic violence or sexual assault. This type of anxiety in children is usually experienced when there is a lack of knowing/understanding from the child’s support system(loving parents, family members, etc.) or when there is no presence of a healthy support system for the child. Children with PTSD will likely avoid certain people, places, and things that can trigger frightening memories about the traumatic event that was experienced. Furthermore, children with PTSD can become immune to feeling emotions entirely. This means that the child will be numb to both sorrowful and joyful situations.
Social Anxiety Disorder
Social anxiety disorder can seriously hinder a child’s performance in school and social situations. Children with social anxiety fear being embarrassed in a social setting, are very self-critical and lack self-confidence. Social anxiety disorder is characterized by the avoidance of social situations, such as an after-school activity, starting a conversation, or even leaving the house. If a child is experiencing social anxiety they will be nervous, fearful, reclusive, and evasive if there is a situation where they must interact with peers or with adults.
This type of anxiety in children occurs when a child is very active and talkative at home (or another place they are comfortable), but in another setting, they are remarkably quiet and avoid eye contact. It is typical that a child will withdraw in school and avoid speaking when talked to and shut down when they should participate in class. Likewise, they will be motionless and show no sign of expression on their faces if they are in an uncomfortable situation.
Symptoms of Anxiety in Children
Although it is common for children to experience some fear as they develop awareness and understanding in different situations, it is not common for a child to be crippled daily due to their thoughts and feelings. Here are some signs and symptoms to look for if you suspect your child may be suffering from anxiety:
Constant worrying-lasting for weeks or even months
Trouble falling/staying asleep
Irritability and inconsolable tantrums because of fear
Trouble concentrating in school
Frequent complaints of headaches and stomachaches-even when no sickness is present
Will not eat in front of others (at school, daycare, etc.)
Excessively afraid of making mistakes
Worries when being dropped off/picked up from school (fear of uncertainty)
Nightmares about fearful events (losing a loved one, personal attack, being attacked by an animal, natural disaster, etc.)
Asks questions about uncertain events (What if…happens?)
Anxiety in children can be very apparent in their actions and thoughts. It is typical for a child to ask questions about the day, such as “What are we doing today? What should I wear?” However, if the child is asking fearfully or the questions are incessant, they may have an anxiety disorder.
If you suspect that your child is experiencing some of these symptoms, it is important to contact your health care provider to receive an appropriate diagnosis.
What Contributes to Childhood Anxiety?
First, a child can inherit an anxiety disorder if there is a history of anxiety in the family. Anxiety is sometimes caused by an imbalance of chemicals in the brain that affects the mood. It is possible to receive these traits from their parents, or even from someone farther back in the family tree.
A child growing up around a parent or guardian that is noticeably stressed most of the time may adopt the same behaviors. Since a child is very impressionable, they will pick up on how their parents react to events, as well as how their parents deal with them.
The absence of a loving guardian can also affect a child’s sense of confidence and security. Children need love and praise as they are growing and experiencing life events. If children do not receive praise and love throughout their development, they can become insecure and worried about their place and their safety in the world.
Traumatic life events are hard to overcome for anyone, let alone children. Anxiety can arrive because of a tragic event such as the death of a loved one, natural disaster, home robbery, divorce, or another intense life event.
Children who experience these events at a young age will foster the idea that the world is not a safe place. This causes them to live in fear of daily life because they are worried that the events will happen again.
Diagnosis of Anxiety in Children
In order to diagnose a child with an anxiety disorder, their behavior and their cognitive function are assessed. The child may be asked a series of questions, and their thinking patterns must prove that they are biased against a phobia, certain situations, people, places, or things. Aspects of their behavior, such as tantrums and social interactions are also examined. Generally, a physician will require information from multiple sources such as a parent or teacher in order to consider a diagnosis and how severe the anxiety in the child may be.
Treatments for Anxiety in Children
Children are incredible learners because they can easily adopt new behaviors and thought processes. That is why anxiety in children is very treatable if it is caught in the early stages. There are a few ways to treat anxiety in children in order to give them the skills they need to manage their anxiety (rather than just taking medication to fix the problem temporarily).
Cognitive Behavioral Therapy
This type of treatment is based on the idea that children feel a certain way because of how they think and act. If the thought process and behavior can be changed and managed, the child’s emotions will change for the better.
CBT will expose the child to the anxiety trigger in structured, incremental steps, and in a safe setting. As they become accustomed to each of the triggers, in turn, the anxiety fades, and they are ready to take on increasingly powerful ones. As the child is shown their trigger in a safe environment, they are taught that it is not as scary as it seems. Changing the way they think about their fear reduces their fear greatly.
Teaching Children to Separate Themselves From Anxiety
An effective way to treat anxiety in children is to change their view of it. They may feel that the anxious feelings are uncontrollable and a part of who they are. Instead, teaching them to separate themselves from the anxiety gives them a newly-found power against it. Some therapists teach children to refer to their anxiety as the bully in the brain and to fight back against it when they feel scared thoughts. This gives children the power to control their anxiety.
This method involves creating a hierarchy of fears. First, a child’s fear or phobia is identified. Then, the therapist gives the child a situation and then asks the child how difficult it would be on a 1-10 scale.
For example, a child with a fear of dogs would be asked, “How difficult would it be to watch a video of a scary cartoon dog?” The child might answer a 3 (not as scary because the dog is fake). Then the therapist would ask, “How scared would you be if you saw a video of a REAL scary dog?” and that one might be a 5. Then they would be asked, “How about if a real, scary dog was in front of you?” and that would be a 10.
Then, “we expose the child to the trigger in its mildest possible form and support him until the anxiety subsides. Fear, like any sensation, diminishes over time, and children gain a sense of mastery as they feel the anxiety wane.”
Exposure therapy treats anxiety in children because it teaches them that their fears are more manageable than they thought.
10 Ways to Cope with Your Child’s Anxiety
As a parent, it’s difficult to know what is right for your child and what they need to hear when they are dealing with anxiety. Often times you may find yourself telling them, “There is nothing to worry about, you’re okay.” This is not bad, but your child needs you to work with them. Your child needs to be brought back down to Earth when their emotions are running wild. Here are a couple ways you can help them in their time of need.
Breathe with them.
During an anxiety attack or out of fear, the emotional part of the brain takes over and makes everything seem out of control. Instead of telling your child, “you’re fine,” hold your child close to you and take deep breaths that are in sync with them. This will re-center your child and give them a sense of control and calm from the built up anxiety. Having your support can calm your child’s jitters and your presence can effectivly improve their feelings.
Anxiety in children can make it tough for them to engage in enjoyable activities (sports, classes, etc). This means that it is important that they still have time for fun. Schedule time during the day for them to let loose at home. This could also double as quality time that you spend with your child.
Take care of you, take care of your child.
Your child’s biggest role model is you. If you take care of yourself and schedule your own downtime, your child will learn the importance of self-care.
Do not dismiss your child’s feelings.
When your child expresses their worries to you, don’t simply say “You’re fine, there’s nothing to worry about.” This creates the illusion that you don’t understand them or see where they’re coming from. What they are worried about may not be a big deal to you, but it is a big deal to them. Do not diminish your child’s feelings. When they express anxiety or worry to you, tell them, “I understand, why are you feeling this way?” Your child needs your support during this time, so speaking with them will help them process how they are feeling.
When your child is having a hard time, remind them of the times when they overcame their fears. Always remind them of the positive progress they have made. This will give them the courage and the power to manage their fears and anxiety.
Anxiety in children sometimes causes irrational fears. If your child has a fear, try to discuss a rational approach with them. If they are afraid of dogs and cannot watch a video of a dog, explain to them that the dog cannot hurt them in the video. The same goes for other fears, help them find and understand logic.
Reward your child’s braveness.
When your child faces their fears, praise them with a special treat, or even some extra love. Your praise will build their self-confidence and encourage them to face their fears again in the future.
Set a routine for your child.
Routines teach children structure, and structure can ease anxiety in children that are unsure of themselves or their surroundings. Set a scheduled bedtime, a set time to wake-up, a routine for breakfast, etc. This gives them predictability and also lessens tantrums because they know what to expect next.
Always remain calm for them.
Your child will look to you first to learn how to act and react. If you are nervous and anxious, your child will pick up on those behaviors. When you endure a stressful situation, be an example for them and remain calm and collected.
Reassure your child that it is okay to be imperfect.
Children with anxiety can be hard on themselves, whether it be about their performance in school or sports. Remind them that it is okay to mess up and that everyone makes mistakes. It is important that they know that other people struggle with the same issues.
At the end of the day, what your child needs is patience and support. Your child is at a very sensitive point in their life, and the tools they acquire now will have a huge impact on their adult life. With diligence and dedication, your child will be equipped to overpower and manage their anxiety!