It is important to start off by acknowledging that though worry doesn’t feel good, some anxiety in children is a necessary and important part of healthy development. Worry is what helps us to stay out of danger, be careful when crossing the street and study hard for an upcoming test. In small doses worry can be beneficial and helps to keep us on track, however too much worry can cause significant stress in children and needs to be addressed. The question then becomes how much worry is too much worry and what to do if you think your child may be experiencing too much worry?
Knowing the difference between a healthy amount of worry and an unhealthy amount depends on the severity of the worry and how much it is interfering with you child’s everyday life. A child who worries about monsters under their bed before going to sleep at night and is put at ease by a quick “monster check” performed by mom or dad is demonstrating a developmentally appropriate fear of danger. A child who refuses to go to bed, will not be alone in his room, is up most of the night terrified and then cannot wake up in the morning to go to school is showing a more concerning degree of anxiety. Some specific anxieties common to young children are fears of the dark, monsters, thunderstorms, animals and strangers. Fears that last a short period of time and get better as a child gets older are often developmentally typical.
When your child is dealing with common anxieties there are several things you can do to help your child cope. Helping your child by naming worries, talking about scared feelings and teaching them basic coping skills such as taking deep breaths, learning how to relax their bodies, helping them to use positive self talk (i.e. “I can do this” or “I am brave”) and reinforcing brave behaviors are all effective ways to help your child overcome his or her fears.
It is important to remember that your reaction to your child’s anxiety plays a significant role in what happens next. Anxiety grows the more you tend to it and our anxieties as parents have a way of constantly sneaking into our interactions with our children. The difference between telling an anxious child “mommy will be back in 5 minutes” and “mommy will back in 5 minutes, okay?” is astonishing. In the second statement, a child will usually break down because the child picks up on the parent’s anxiety whereas in the first statement the child is being reassured that the parent knows they can handle the situation. This is the same reason that when you react to a child who falls down and scrapes their knee by simply stating “You are okay” and remaining calm the child will most likely follow your lead. On the other hand if you come running over in a state of panic and ask the child “Are you okay?” your child will most likely become anxious and cry. Showing your child confidence and keeping your worries at bay will help your child to overcome his or her fears.
When anxieties are more severe they often get worse with time, and result in avoidance or what may appear to be oppositional or acting out behavior. This acting out behavior is often misunderstood as children being oppositional when in actuality they are attempting to control their environment as much as possible in order to help manage their underlying anxiety. A child who is generally eager to please and compliant who refuses to go to bed is most likely attempting to avoid anxiety as opposed to trying to give you a hard time. Key signs that your child may need professional help coping with worries are if the worry interferes in your child’s everyday life and if your child is avoiding things that trigger the worry. Specific signs of anxiety disorders to be aware of and look out for in children are outlined below.
Common symptoms of separation anxiety include:
- constant worry about the safety of parents and caretakers
- school refusal
- somatic complaints such as stomachaches or headaches
- 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, snakes, 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
Symptoms of selective mutism include:
- persistent lack of speech in at least one social situation, despite the ability to speak in other situations
Symptoms of generalized anxiety include:
- many worries about things before they happen
- constant worries or concerns about ordinary everyday things
- fears of embarrassment or making mistakes
- low self esteem and lack of self-confidence
Symptoms of obsessive compulsive disorder include:
- repetitive, unwanted thoughts (obsessions) or actions (compulsions)
If you find that you child demonstrates the symptoms of one of these disorders it is important to consult a mental health professional immediately. Untreated anxiety in children can lead to a host of different problems in adolescents and adulthood. Cognitive-Behavioral Therapy (CBT) has been found to be the most effective treatment for childhood anxiety disorders. CBT educates the child and family about anxiety and how to manage it through the use of relaxation strategies and coping thoughts. CBT helps children develop the skills they need to face and overcome their fears head on. Parents are an important part of the treatment process and should learn what the child is learning so they can support the child in using the skills in the real world.