Anxiety is a feeling of worry or fear that is experienced as a combination of physical sensations, thoughts, and feelings. Anxiety in children just like in adults is a normal part of life. Many children have fears and worries and may feel sad and hopeless from time to time. And it starts really young. Toddlers, for example, are often very distressed about being away from their parents even if they are safe and cared for.
Childhood anxiety occurs in about one in four children between the ages of 13 and 18 with the symptoms commonly appearing around age six. Approximately 7.1% of children aged 3-17 have been diagnosed with anxiety. There however is a difference in the degree of severity between normal childhood anxiety and anxiety disorders. Anxiety disorders are more problematic interfering with what would normally be expected for a child of a particular age or developmental stage. The focus here will be on normal childhood anxiety.
Symptoms of anxiety in children
- Excessive anxiety and worry
- Feeling overwhelmed
- Inability to control fear or worry
- Thumping heart
- Rapid breathing or feeling unable to breathe
- Tense muscles
- Sleeping poorly / sleep disruption
- Inattention or poor focus
- Poor concentration
- Somatic symptoms like headaches or stomachaches
- Muscle tension
- Panic attacks
- Feeling sick
- Dry mouth
- Refusing to go to school
- Irritable bowel syndrome (IBS), diarrhoea or needing to pee more than usual
- Meltdowns before school about clothing, hair, shoes, socks
- Meltdowns after school about homework
- Difficulties with transitions within the school and between school and an activity/sport
- Difficulty settling down for bed
- Having high expectations for schoolwork, homework, and sports performance
Common types of anxiety in children
Separation anxiety: being very afraid or upset when away from parents and caregivers. It manifests in a refusal to attend camp, sleepovers, or playdates and worries that bad things will happen to loved ones while separated.
Social anxiety: being very afraid of school and places where there are other people. It is a strong fear of social situations with the child being very anxious and self-conscious around others. They may also worry about being judged or humiliated when around other people. How To Overcome Social Anxiety
Phobias: having extreme or severe irrational fear about a specific thing or situation such as dogs, insects, thunderstorms, worry about vomiting, or going to the doctor among others.
General anxiety: being very worried about the future and about bad things happening. 5 Ways To Deal With Anxiety And Panic Attacks
Panic disorder: having repeated episodes of sudden, unexpected, intense fear that come with symptoms like heart pounding, having trouble breathing, or feeling dizzy, shaky or sweaty.
Causes of anxiety in children
Some children are more vulnerable to anxiety because of:
- Biological factors such as genes and brain wiring.
- Psychological factors such as temperament and coping strategies.
- Environmental factors such as an anxious parent or troubling early childhood experiences and environment.
Examples of things that can make children feel more anxious
- Experiencing lots of change in a short space of time such as moving house or school
- Being around someone who is very anxious
- Struggling at school such as feeling overwhelmed by work, exams, or peer groups
- Having responsibilities that are beyond their age and development, such as having to care for other people in the family
- Experiencing family stress around things like housing, money, and debt
- Going through a distressing or traumatic experience in which they do not feel safe such as being bullied, witnessing or experiencing abuse, loss in the family such as the death of a loved one
Helping children with anxiety
Left untreated childhood anxiety can worsen as children grow, impacting both their physical and emotional health.
1. Start by slowing down
Encourage the child to take deep breaths to calm the physical effects of anxiety such ask racing heart and difficulty breathing. Practice with them breathing in and out and holding your breath for about three seconds until they feel calmer and can talk about it. Health: 7 Benefits Of Deep Breathing Exercises
2. Make time to worry
Set aside time to worry when you stop everything and deal with the anxious thoughts. This daily ritual of a set ‘worry time’ can help with stopping anxious thoughts from taking over.
3. Break down the big worries
Help your child break down the big worries into manageable chunks as you gradually work towards the goal. For example for a child afraid of swimming, instead of avoiding the pool altogether, break it down into small goals. Start by sitting around the pool watching other children swim, then when they’re comfortable move closer to the pool then dangle legs in the pool then stand in the shallow end, and so on.
4. Encourage positive thinking
Children with anxiety generally get stuck in worst-case scenarios or ‘what ifs’ of different situations. Help them shift this thinking by reminding them when they have dealt with similar issues in the past and how things worked out. Help them challenge the scary thought with facts and evidence such as we know for a fact that crocodiles can’t survive under the bed.
5. Try things
Children with anxiety often worry about making mistakes and things not being perfect. This leads them to avoid situations and activities. Rather than sitting out, encourage them to try and just have fun with things regardless of whether it’s a success or failure.
6. Be supportive
Validate their feelings and support them. For example for a child with social anxiety, don’t accommodate them by allowing them to avoid social situations. Instead, tell them you understand that it is an uncomfortable situation that may make them fearful, but also let them know that you have faith in their ability to face it and support them as they face it. How To Overcome Social Anxiety
7. Model helpful coping
Children are constantly observing their surroundings and picking up all sorts of clues from adults in their lives. This gives you an opportunity to model good coping behaviours. When you get anxious or stressed, verbalize how you’re coping with the situation. For example, you could say that while something looks scary, you’ll still try and give it a go.
It’s helpful to also evaluate your behaviour. If you’re prone to helicopter parenting always swooping in to rescue your child, the next time they are struggling with something give them a little more time to figure it out on their own before jumping in to help them. Figuring things out for themselves is an important step in building resilience.
8. Be honest and upfront about scary stuff
Children worry about big things like death, war, and terrorism among other things they see on the news. This is normal. Talk through their fears and answer any questions truthfully. Don’t sugar-coat the facts. Just try and explain to them what is happening in a way that validates their fears and puts them in perspective. Make the explanation age-appropriate in a way that does not overwhelm them but also does not leave gaps in their understanding.
For a child who worries for example about their mom being sick. Instead of saying something like mom can’t get sick, explain that even if mom gets sick you’ll work very hard to get better with the help of doctors. If they are afraid of getting a shot, be honest that it may hurt a little bur you know they are brave and can handle it. Death, poverty everywhere, pandemics, police brutality, economic stress, floods, droughts, wars and occupations, and more are some of the things that might worry them.
This is a scary world and children will pick up on some of that. The important thing is to be observant enough to pick up on the symptoms of anxiety and help children manage as best you can. If it feels really serious, consider speaking to your paediatrician.
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