“I don’t want to go to school. My tummy hurts again.” Your child groans, puts their pillow over their head, and pleads with you to skip school today. You happen to remember that they have a presentation due today that involves speaking. You sigh, wondering if this tummy ache has anything to do with their nerves about talking in front of the class.
Does this situation sound familiar? If your child experiences excessive worry in their day-to-day life, they may be dealing with anxiety. The thought of helping a child with anxiety may send you into a spiral of worry yourself, but you can learn how to help a child with anxiety.
Worry vs. Anxiety in Children
Children, from infancy to late teenagehood, experience worry and fear from time to time. In fact, humans’ innate sense of worry is instinctual for a reason. Worrying about things can help you prepare for what’s ahead. But, when that worry, fret, and fear happens at an exaggerated frequency, you may be dealing with anxiety.
“We all worry,” said Sheena Miller, LPC-MHSP, Clinical Manager at Integrative Life Center. “It’s natural that your child has worries too. The key is determining if these worries are typical and fleeting or if they’re something that’s causing your child ongoing distress.”
So, how do you know when worry in a child is normal versus when you may need to intervene?
Worry in children may include:
- Separation anxiety around ages 3-5
- Some worry or dislike of going to the doctor
- General worry, anticipation, or fear about new events or situations
- Distrust or anxiety around new people or strangers
Signs of anxiety may include:
- Avoidance of the thing they worry about
- Physical illness (frequent stomach aches, headaches, with no other medical explanation)
- Tantrums, crying, and symptoms of panic at an increasing frequency
- Changes in appetite or sleeping
- Increased irritability, grumpiness, frustration
- Being overly self-critical
Even if your child does exhibit some of these signs, it may not be anxiety. Make sure that you work with your child’s doctor to rule out anything medically that could contribute to some of these issues.
Types of anxiety in children:
- Phobias. This type of anxiety concerns something specific for more than a few weeks, such as fear of getting sick, spiders, or water.
- Social Anxiety. This type of anxiety occurs surrounding social situations. It could include worry or fear about going to school, hanging out with friends, parties or celebrations, or public spaces for fear of being judged or embarrassed.
- Separation Anxiety. Extreme upset and distress when separated from parents or caregivers. It’s common for ages 3-5, but if it happens in older children, it may be a cause for intervention.
- Generalized Anxiety Disorder. Worry about the future, worry about everything in general, a sense of doom, or nervousness.
- Panic Disorder. A sudden and intense onset of fear. Some indications one may be experiencing a panic attack include sweating, rapid heartbeat, feeling like you need to escape or an impending sense of doom. Panic attacks are usually followed by weeks of worry that you will have another attack.
- Obsessive Compulsive Disorder. OCD can cause children to experience thoughts and emotions that are unwanted and pervasive. To work through those thoughts, children sometimes engage in repetitive behaviors called compulsions.
- Body-Focused Repetitive Behaviors. These recurrent behaviors are generally related to sensory stimulation and grooming, which aim to reduce anxiety. Examples of BFRB include nail biting, hair pulling (Trichotillomania), skin picking, and joint cracking.
- Trauma Disorders. Trauma disorders like Post-Traumatic Stress Disorder (PTSD) or Acute Stress Disorder occur after a traumatic event, such as abuse, a car accident, bullying, physical illness or injury, and others.
How Does Anxiety Manifest in a Child’s Life?
Like many mental health issues, it’s unclear what the exact cause of anxiety in children is. Researchers and mental health professionals agree that it’s probably a combination of factors, including genetics, trauma and life experiences, and a child’s environment.
It’s helpful to be aware of a child’s life situation and notice the changes in a child that would be signs of anxiety. Sometimes, a child’s anxious behavior is learned by being around other anxious people, while some children are simply more anxious than others.
Children can develop anxiety from stressful life events, such as:
- Tension in the home; parents fighting or arguing
- Frequently moving homes or schools
- Being abused or neglected
- Death of a loved one
- Becoming seriously ill or injured
- School-related issues such as bullying
How to Help a Child with Anxiety
As a parent or an adult with an anxious child, you may feel lost about how to help. Here are some strategies for parents and caregivers to help a child with anxiety.
“Remember, you are not a failure of a parent if your child is dealing with anxiety,” Sheena said. “What’s important is that you’re paying attention to the signs, working to help alleviate your child’s anxiety, and seeking help when you know you need it.”
Ask Open-Ended Questions
When asking your child about their worries, try using open-ended questions instead of questions where the answer is either “yes” or “no.” For example, instead of “Are you afraid of the dark?” you could say, “I noticed you were hesitant to turn the lights out. Can you tell me more about what you’re feeling?” These questions allow the child to express their thoughts, which can help you understand what they’re going through.
Validate Their Feelings
Validation is key in learning to manage any mental health issue. Validating a child’s feelings doesn’t necessarily mean you agree with them. It just shows support and encouragement. It could sound like, “I hear you say that you’re scared of going to the doctor. You’re already worried about the next time you’ll get a shot. I understand why you would be scared.”
Provide Alternative Thinking
Open your child’s viewpoint by explaining how worry is inherent in humans’ lives. Explain how, long ago, people had to plan how they would avoid animal attacks, and that’s where worry came in. They were able to plan out their actions. Try something like, “Is there a way that we can prepare for your doctor’s appointment so that you’re not as scared? Maybe we can have the doctor explain everything they’re going to do before they do it?”
You could also discuss their anxiety in the context of life by saying something like, “You’re so worried about this test. In five years, you may not even remember this test!” Take care not to invalidate your child’s feelings with this tactic. Rather, ensure they’re considering context that may help them cope.
If you know that your child has social anxiety and has a birthday party coming up for a close friend, recognize that this situation could trigger their anxiety. Perhaps try to prepare your child ahead of time. Make sure they have some coping mechanisms, like a stress ball to squeeze, a breathing technique to try, or a “happy place” to go to in their mind, before they enter the anxiety-provoking situation.
Teach Routine Affirmations
Affirmations can help a child remind themselves that they are worthy and capable. Depending on their situation, affirmations could sound like: “I am brave,” “I can do this,” “I have my parents that love and accept me no matter what,” or “No matter how this test goes, I will know I worked hard and did my best,” etc.
Practice Coping Techniques
Share with your child some coping mechanisms that work for you when you’re stressed or worried (child-appropriate, of course). For example, if you get nervous about going to the dentist, tell your child how you go to your “happy place” in your imagination during your teeth cleaning.
Be creative! Your child may enjoy shaking or dancing to get the worries out, talking about it, deep breathing, coloring, singing, practicing the thing they’re nervous about, hugs, baking, reading a book, or something else. Encourage your child to come up with some things that may help them on their own, and, when in doubt, suggest things you think may help.
Reduce Stressful Situations
Sometimes, we can’t avoid putting our children in situations they would rather not be in. They can’t avoid the doctor or dentist and will eventually have to take a test at school. Set clear expectations with your child so they know what’s coming. “You have a doctor’s appointment coming up next week. Let’s take some time each day to practice our deep breathing until then, and we’ll also look around to figure out what treat you want to get after you go.”
When to Seek Treatment for Your Child
If you’ve tried teaching your child coping mechanisms, talking it out, ruling out medical causes, and a medley of other actions, it may be time to take your child to a mental health professional.
If your child’s anxiety is disrupting their daily life (or yours, or your family’s, for that matter) for more than a few weeks, consider seeking a counselor or therapist that works with children. Numerous types of treatment are scientifically proven to help children who experience anxiety.
The mental health professionals at Integrative Life Center are trained to tailor anxiety treatment to your child’s needs in a comfortable environment that empowers both your child and your family. Contact Integrative Life Center to learn more.