Parenting the Anxious Child

It is said that 40 million Americans live with an anxiety disorder, which is more than the occasional worry or fear. We all experience anxiety to some level. Anxiety in children is common when separated from their parents or from familiar surroundings. However there is a type of anxiety that is more severe and may be misdiagnosed. Anxiety left unchecked or treatment may become paralyzing to everyday life.

Below we’ve gathered several lists for you. What does anxiety look like? How can it manifest, when is it critical to consult a doctor and what methods are available to self calm. Here we go….

Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood.

Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment.

According to research from the Mayo Clinic, several types of anxiety disorders exist:

• Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.
• Anxiety disorder due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem.
• Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.
• Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they’ve occurred.
• Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning.
• Separation anxiety disorder is a childhood disorder characterized by anxiety that’s excessive for the child’s developmental level and related to separation from parents or others who have parental roles.
• Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others.
• Specific phobias are characterized by major anxiety when you’re exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.
• Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of misusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs.
• Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don’t meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive.

Parents should be alerted to the signs so they can intervene early to prevent lifelong complications. The American Academy of Child & Adolescent Psychiatry offers you different types of anxiety in children.

Symptoms of separation anxiety include:

• constant thoughts and intense fears about the safety of parents and caretakers

• refusing to go to school

• frequent stomachaches and other physical complaints

• extreme worries about sleeping away from home

• being overly clingy

• panic or tantrums at times of separation from parents

• trouble sleeping or nightmares

Symptoms of phobia include:

• extreme fear about a specific thing or situation (ex. dogs, insects, or needles)

• the fears cause significant distress and interfere with usual activities

Symptoms of social anxiety include:

• fears of meeting or talking to people

• avoidance of social situations

• few friends outside the family

Other symptoms of anxious children include:

• many worries about things before they happen

• constant worries or concerns about family, school, friends, or activities

• repetitive, unwanted thoughts (obsessions) or actions (compulsions)

• fears of embarrassment or making mistakes

• low self-esteem and lack of self-confidence

Severe anxiety problems in children can be treated. Early treatment can prevent future difficulties. Parents should consider seeking an evaluation from a qualified mental health professional or a child and adolescent psychiatrist. Click here for a pdf of the above symptoms.

Tips for Parenting the Anxious Child

At certain ages all children experience fears. Some children may have more difficulty with anxiety than others. The following suggestions may be useful in addressing your child’s anxieties or fears:

■ Encourage and reward independent activities.

■ Your child may experience physical symptoms when he is stressed; don’t overreact to them.

■ To help your young child conquer her own fear, ask her to teach a doll or a stuffed animal how to be more confident.

■ Explain new situations in advance in a simple, friendly manner. Try role playing to prepare for upcoming situations.

■ Help with bedtime fears by buying your child a new and specific stuffed animal, a “special companion,” which can help him feel less scared at bedtime.

■ Establish clear and regular morning and bedtime routines, and stick with them. Let your child use a night light, if it helps her feel less scared. Children feel more secure with a wellstructured and predictable, but not overly rigid, daily routine.

■ Assess whether television or video game violence may be contributing to your child’s fears. Television and video game violence can make your child scared even if he wants to watch it and says that it does not bother him. For more information on television and video game violence and how it affects children, read Cantor J. 1998. Mommy, I’m Scared: How TV and Movies Frighten Children and What We Can Do to Protect Them. New York, NY: Harcourt Brace.

■ Be aware that apparent daydreaming and concentration problems at school may be caused by your child’s preoccupation with fears and anxiety.

■ Ask a librarian to help you choose books to read to your child that address specific fearsome situations.

■ Don’t get involved in lengthy discussions about fears. Reassure your child that you are doing all you can to keep anything bad from happening. Role play upcoming situations that are likely to cause your child anxiety.

■ Be open about and explain stresses on the family (e.g., a parent out of work, an impending move, a sibling experiencing serious problems) to your child in simple terms, and reassure her that the adults in the family will take care of things. Children are sensitive to adult anxiety and may exaggerate situations that are not explained to them.

■ Try to avoid extremes (e.g., being too rigid, too permissive, or overprotective).

■ Be honest and objective about family problems that might make your child fearful. If the problems are too complex to address within the family (e.g., parental abuse of alcohol, abusive behavior, marital problems or parental illness [mental or physical]), seek counseling.

■ Be aware that the object or situation your child identifies as the cause of her fears may be a substitute for something she is hesitant to express (e.g., fear of “monsters” may really be fear of a person; fear of “the dark” may really be fear of the arguing she hears from another room). Consider whether there are “family secrets” your child may be afraid of or not allowed to discuss openly. Seek counseling if you find it too difficult to communicate with your child about her fears.

■ Suggest that your child write a story or draw a picture of scary things, and look for clues to help you understand his fears better. An older child might write a letter or keep a journal.

■ Preoccupation with death or dying or other morbid subjects may be a sign of depression. If your child is overly concerned with these things, have him evaluated by a health professional. Click here to download the pdf of the above Tools for Parenting the Anxious Child.

For more methods to curb anxiety Locke Hughes with WebMD offers these 10 expert-backed suggestions to relax your mind and help you regain control of your thoughts.

1. Stay in your time zone.

Anxiety is a future-oriented state of mind. So instead of worrying about what’s going to happen, “reel yourself back to the present,” says Tamar Chansky, Ph.D., a psychologist and author of Freeing Yourself from Anxiety. Ask yourself: What’s happening right now? Am I safe? Is there something I need to do right now? If not, make an “appointment” to check in with yourself later in the day to revisit your worries so those distant scenarios don’t throw you off track, she says.

2. Relabel what’s happening.

Panic attacks can often make you feel like you’re dying or having a heart attack. Remind yourself: “I’m having a panic attack, but it’s harmless, it’s temporary, and there’s nothing I need to do,” Chansky says. Plus, keep in mind it really is the opposite of a sign of impending death — your body is activating its fight-or-flight response, the system that’s going to keep you alive, she says. 

3. Fact-check your thoughts.

People with anxiety often fixate on worst-case scenarios, Chansky says. To combat these worries, think about how realistic they are. Say you’re nervous about a big presentation at work. Rather than think, “I’m going to bomb,” for example, say, “I’m nervous, but I’m prepared. Some things will go well, and some may not,” she suggests. Getting into a pattern of rethinking your fears helps train your brain to come up with a rational way to deal with your anxious thoughts.

4. Breathe in and out.

Deep breathing helps you calm down. While you may have heard about specific breathing exercises, you don’t need to worry about counting out a certain number of breaths, Chansky says. Instead just focus on evenly inhaling and exhaling. This will help slow down and re-center your mind, she says.

5. Follow the 3-3-3 rule.

Look around you and name three things you see. Then, name three sounds you hear. Finally, move three parts of your body — your ankle, fingers, or arm. Whenever you feel your brain going 100 miles per hour, this mental trick can help center your mind, bringing you back to the present moment, Chansky says.

6. Just do something.

Stand up, take a walk, throw away a piece of trash from your desk — any action that interrupts your train of thought helps you regain a sense of control, Chansky suggests. 

7. Stand up straight.

8. Stay away from sugar.

It may be tempting to reach for something sweet when you’re stressed, but that chocolate bar can do more harm than good, as research shows that eating too much sugar can worsen anxious feelings. Instead of reaching into the candy bowl, drink a glass of water or eat protein, Chansky says, which will provide a slow energy your body can use to recover. 

9. Ask for a second opinion.

Call or text a friend or family member and run through your worries with them, Chansky says. “Saying them aloud to someone else can help you see them clearly for what they are.” It can also help to write your fears on paper. 

10. Watch a funny video.

This final tactic may be the easiest one yet: Cue up clips of your favorite comedian or funny TV show. Laughing is a good prescription for an anxious mind. Research shows that laughter has lots of benefits for our mental health and well-being; one study found that humor could help lower anxiety as much as (or even more than) exercise can. 

Acknowledgements: WebMD, Bright Futures and the American Academy of Child and Adolescent Psychiatry