Helping Kids with Anxiety
By Chanelle Gosper
In this article:
When I was a child, I recall being referred to as a “worry-wart” by some adults in my life. With good intentions, they told me there was nothing to worry about – not the test I was fretting over, because I usually did well in school, or forgetting my lines in theatre since I had rehearsed them plenty of times. I shouldn’t worry about whether my clothes looked right when they were the same style everyone else appeared to be wearing, or worse, that my friends would suddenly stop liking me and I would be a social outcast.
And yet, I would ruminate on things I had said and done, or might say and do, and worry they would be terrible, with irreversible consequences. I guess in general, I worried I would be judged and found lacking.
The general dismissal of these worries by the adults in my life, while well-intentioned, did nothing to reassure me. Telling me there was nothing to worry about did not negate the fact I seemed naturally inclined to worry – in fact, it only served to make me feel worse about myself for feeling the way I did. Did anyone else feel this way for apparently no reason? Why can’t I stop feeling worried something bad will happen? Do I need to worry about how I’m always worrying???
Why do we feel anxious?
Everyone worries or experiences anxiety around certain scenarios in their lives at some point or another. In fact, it is very common to feel anxious about a test or performance, regardless of your ability. The feeling of anxiety is a basic brain response to perceived danger and is there as a survival instinct to help us avoid it. For some people, however, anxiety can become a significant problem, developing to the degree that it interferes with their ability to function on a day-to-day basis. In my own life, some of the new worries that came with adulthood turned into a full-blown anxiety disorder, which manifested itself as rapid heartbeat, shaking hands, severe insomnia, avoidance and, on one occasion, a panic attack. At least as an adult, I was eventually able to recognise these symptoms for what they were, as well as how the disruption to my mental health was impacting my life. The ability to look inwards, self-reflect and then take steps to work on overcoming the anxiety is a blessing that has come with maturity. But what if you are a child and haven’t yet developed the skills or understanding?
My worrying as a child wasn’t debilitating, but had I experienced the anxiety of my later years at that age, it certainly would have been. And many children do. While experiencing fear and anxiety is a normal part of development, such as separation anxiety in toddlers, for some children anxiety becomes persistent, distressing, and impairing[1].
But if it is a normal part of development, how do we recognise when anxiety has become a problem? And what can we do to help kids with anxiety?
Recognising when anxiety is a problem
Anxiety disorders can be challenging to identify in children when their symptoms mirror those that occur as part of normal development, or when they have difficulty expressing how they are feeling and how long they have been feeling that way. Physical symptoms stemming from anxiety, such as stomach cramps or sleeplessness, may also be difficult to recognise, particularly when the child has not expressed any other concerns. It’s always best to refer any concerns you may have about how your child is feeling to a health professional for assessment. In very general terms however, if anxiety has become a problem for your child, you would expect to see symptoms that are severe, frequent, recurring and persistent [2].
To help understand what to look for, we’ve included an overview of the most common childhood anxiety disorders and their symptoms below.
Separation Anxiety Disorder
Many of us parents or early-childhood educators have watched young children become upset when it’s time for their loved one to leave, perhaps at kindy drop-off or when heading off to work. While this is normal in very young children, some older children may experience worries and fears about being away from home or family that are not typical for their age. The symptoms of separation anxiety disorder are a lot more severe than those we see in early child development; persisting for at least four weeks to be classified as a disorder [3]. Some examples of these symptoms are:
- Refusing to sleep alone
- Repeated nightmares about separation
- Lots of worry when away from home or family
- Clinginess
- Panic or tantrums when separated from parents or caregivers
- Afraid of being alone
- Refusing to go to school
- Muscle aches or tension
Specific Phobia
As you may guess from the name, specific phobia refers to extreme anxiety and fear of particular objects or situations [4]. While being afraid of things like thunder, lightning and the dark are developmentally normal around the age of two – three years old, some children may develop some specific fears that are severe enough to impair their ability to function in everyday life. Being afraid of animals or loud noises might be a common passing phase for many children for example, but avoiding going to school because there may be a dog or someone mowing their lawn on the way indicates the child’s anxiety may not be typical.
Generalised Anxiety Disorder
The Australian Psychological Society describes generalised anxiety disorder (GAD) as being characterised by persistent and excessive worry, often about daily situations like work, family or health. [5] As you might expect, GAD presents a little differently in children than in adults, often in the following ways [6]:
- Worry about the quality of performance or competence at school or sporting events, even when performance is not being evaluated
- Excessive concerns about being on time
- Worry about catastrophic events such as earthquakes or war
- Overly-conforming
- Perfectionism
- Excessively dissatisfied with a less-than-perfect performance
- Require excessive reassurance about performance and worries
- Worry about the quality of performance or competence at school or sporting events, even when performance is not being evaluated
- Excessive concerns about being on time
- Worry about catastrophic events such as earthquakes or war
- Overly-conforming
- Perfectionism
- Excessively dissatisfied with a less-than-perfect performance
- Require excessive reassurance about performance and worries
Obsessive-Compulsive Disorder (OCD)
Many of us have heard someone say something like, “OMG, I am so OCD when it comes to being organised!” Despite its common, albeit flippant, reference in modern society, obsessive-compulsive disorder (OCD) may in fact be one of the most misunderstood and misrepresented anxiety disorders in modern times. OCD is not simply a desire to keep one or all parts of your life neat and tidy. Consider ‘obsessions’ as recurring, persistent and distressing thoughts and ‘compulsions’ as repetitive behaviours or rituals a person is compelled to do in response to fear and you may have a better understanding of how distressing and debilitating this disorder can actually be. For a child, as with adults with OCD, these thoughts and rituals may feel unstoppable and take over their life. Examples of how OCD presents in children are generally similar to adulthood, as follows:
- Excessive fear of germs
- Handwashing
- Checking and/or ordering rituals
- Fear of something bad happening to self or loved ones without a ritual being performed
- Impaired ability to concentrate and gradual declines in school work
- Excessive fear of germs
- Handwashing
- Checking and/or ordering rituals
- Fear of something bad happening to self or loved ones without a ritual being performed
- Impaired ability to concentrate and gradual declines in school work
Social Phobia/Anxiety
As children grow, we see a shift from parents and family as their primary influence to peer groups playing a greater role. Most of us will recall the experience of looking to friends for ideas on brands to buy, clothes to wear and music to listen to. At a basic level, most of what drives this is a need for connection and belonging, but it also goes hand in hand with a developing sense of self. Understandably then, many children may feel anxious about the judgment of peer groups as they consider this a reflection of their self-value. While this is once again a normal developmental phase, for some children the fear of being criticised or viewed negatively by their peers can become excessive, persistent and severe enough to have a significant impact on their day-to-day life. If your child develops social anxiety disorder, you might see signs[1] that include:
How do we help kids with anxiety?
The great thing about recognising when something has become a problem is that we can then take steps to address it, and thankfully, there are a variety of very effective measures to help kids with anxiety – or even those prone to worrying, like I was. Your child’s health professional will talk through some options for your child that are specific to their needs, but there are also things you can try at home or in school to help work through their anxiety.
Mindfulness practices
The benefits of mindfulness practices found in yoga and other forms of meditation have been widely reported in academic research, with numerous studies reporting improved self-regulation, body awareness, concentration and relaxation in children after at least six weeks of regular practice. [8] Of particular interest is the ability of yoga and mindfulness practices to improve emotional well-being, particularly anxiety, among primary school-aged children [9].
Breath
Central to any mindfulness practice is awareness of the breath and using this awareness as an anchor to the present moment. When you consider that anxiety is the mind’s response to the possibility of something terrible happening, you can see how beneficial it would be to stop the mind drifting into the unknown, worst-case imagined future and keep it in the present where all is safe.
Be mindful (pun intended!) that for the breath to be used as an effective tool, there’s a ‘right way’ and a ‘wrong way’ to do it. Try working with your child to do the following:
- Relax your shoulders away from your head and neck
- Take a slow, deep breath in through the nose
- Bring the air down toward the belly
- Exhale slowly through the mouth
- Relax your shoulders away from your head and neck
- Take a slow, deep breath in through the nose
- Bring the air down toward the belly
- Exhale slowly through the mouth
Rotation of consciousness
Another very effective mindfulness tool to help children with anxiety is the practice of rotation of consciousness, one of the fundamentals of Yoga Nidra. This involves taking the child’s awareness around to different parts of their body, one small part at a time.
Starting from the right thumb, the child is given instructions to focus attention on each body part down the right side of the body and then the left, following with the back of the child up from the feet and then down the front of the body starting from the head. Through focussing attention on each small part of the body, the child’s energy is also directed to those areas, systematically allowing the child to notice and relax tensions there.
Not only does this technique physically relax the child and bring them into the present moment, it has a direct impact on the autonomic nervous system, which is responsible for regulating body functions that occur without conscious effort – essentially, those we need to survive. The autonomic nervous system is made up of two sub-systems that work in opposition to each other – the sympathetic nervous system (which regulates heartbeat and breathing and manages the response to emergency situations) and the parasympathetic nervous system (which regulates digestion and blood flow and manages routine operation of body functions). The slow rotation of attention on different body parts activates the pineal gland within the parasympathetic nervous system and stimulates the release of melatonin, which relaxes the body and counteracts the stress hormone cortisol. The fight-or-flight response of the sympathetic nervous system is calmed, slowing heartbeat and breathing. It is easy to see how this would have a positive impact on both the physical and emotional symptoms of anxiety.
Support your support
It can feel overwhelming as a parent or educator to know how to help children who are experiencing severe anxiety, even with step-by-step instructions. Thankfully, there are extensive resources available to help support parents and teachers both with managing symptoms and teaching kids the tools to self-regulate their own emotions. A link to one such kid-friendly tool is available here. The Me Hearties Wellness program is an excellent course to develop the foundational skills children need to build emotional self-regulation, self-acceptance and a balanced approach to the body, and easily works as a support course for any other approach you may be taking with your child. You can find more information about the program here.
Thinking back to my own childhood, I can see how a different approach to my worrying would not only have helped me better understand and deal with the way my mind was reacting to fear, but also equipped me with the tools I needed to manage those greater worries later in life. Perhaps the greatest gift we can give our kids is a toolkit for self-love, self-acceptance and the skills they need to navigate the emotional ups and downs of life.
If you would like to see more techniques for helping kids with anxiety or have other concerns you think we could help with, please contact us via the link below.
Reference:
[1] [6]Beesdo, K., Knappe, S., & Pine, D. S. (2009). Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. The Psychiatric clinics of North America, 32(3), 483–524. https://doi.org/10.1016/j.psc.2009.06.002
[2] [7] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington DC: Author.
[3] Stanford Children’s Health (2022) Separation Anxiety Disorder in Children. Accessed: https://www.stanfordchildrens.org/en/topic/default?id=separation-anxiety-disorder-90-P02582
[4] [5] Australian Psychological Society (2022) https://psychology.org.au/for-the-public/psychology-topics/anxiety
[8] Sun, Lamoreau, O’Connell, Horlick and Bazzano, (2021), Yoga and Mindfulness Interventions for Preschool-Aged Children in Educational Settings: A Systematic Review, International Journal of Environmental Research and Public Health, https://doi.org/10.1016/j.pedhc.2020.07.008
[9] Shreve, M., Scott, A., McNeill, C. and Washburn, L. (2020). Using yoga to reduce anxiety in children: exploring school-based yoga among rural third- and fourth-grade students, Journal of Pediatric Health Care Vol 35 (1), https://doi.org.10.1016/j.pedhc.2020.07.008