My Child is Anxious. What Can I Do?

Anxiety is a common problem that affects children of all ages. Fear, worry, and stress are to be expected at times. Other times the problem is bigger and more concerning. If your child is anxious, there is hope because anxiety is treatable. In this article I discuss how to recognize if your child might be experiencing anxiety and what to do about it.

What Does Anxiety “Look Like” in Children?

Children can exhibit a variety of symptoms and behaviors in response to anxiety, and every child is different. Typical reactions include worrying, becoming fearful about something she was not previously fearful of, complaining of headaches or stomachaches, perfectionism, irritability, becoming withdrawn or secretive, developing sleep problems such as insomnia or nightmares, and refusing to do things that did not used to be a problem. Children who are anxious may also have tantrums or be more argumentative than they previously were. They may pick at their skin, hair, or nails, or develop an obsession about something. You may notice that your child is “not himself” and wonder what is happening.

There are some differences in how anxiety “looks” depending on the age of the child. When toddlers and preschoolers are anxious, they usually regress, that is they lose developmental milestones they have already mastered. This usually happens in the areas of language, sleep, and toileting. For instance, they may have toileting accidents after having already mastered toileting, or start using baby talk. They may also become whiny and clingy and have difficulty separating from you. Young children often play out their anxieties with dolls and other toys. For instance, they may act out scenes of attack or danger with dolls or animal figures.

School-aged children play out their anxieties as well, often in pretend play scenarios with other children. Getting lower grades in school than the child used to, can also be a sign of anxiety in elementary-aged children. In pre-adolescence, it is common for children to express worry about societal or global threats such as war, pollution, or natural disasters. Adolescents experiencing severe anxiety may isolate from family or friends, become defiant, or use alcohol or drugs to cope. 

Why Do Children Become Anxious?

Many things can trigger anxiety, including normal life events. For example, changes in the home or family, disruptions to normal routines, sickness, separation from family members or friends, difficulty mastering academics skills, having to perform or be evaluated in front of others, or adjusting to a new environment such as moving or changing schools can all be anxiety-provoking. When children see or learn of something harmful happening to someone they know, they may also worry that it will happen to them.

The biggest triggers of anxiety are things that are a threat to the child’s personal safety or that are a threat to the parent-child bond. In adolescence, being rejected by one’s peer group is also a major cause of anxiety. Additionally, children are sensitive to their parents, and if a parent is anxious, children will often become anxious as well.

How Can I Help My Child?

There are many things you can do to help prevent and reduce your child’s anxiety. Some of these things can be built into your family’s routines. First, keep routines predictable. This is especially important if your family is going through any kind of change, or if something stressful has happened. Everyone feels safer when they know what is coming next. Limit your child’s exposure to network news and other media portraying dangerous events happening to people. Be in charge in a way that is wise and kind and consistently meets the child’s needs.

Regularly spend time with your child. You can share a favorite activity together and listen to your child’s thoughts. Create an environment that makes it feel safe and natural for her to bring up her concerns. However, don’t press your child to talk if he doesn’t want to. Always address your child’s concerns respectfully, honestly, and in a way that is appropriate for the child’s developmental level. While there may be details of a situation that are not advisable for your child to know, being secretive or pretending things are fine when they are not will increase his anxiety. If your child is worried about a specific situation, be careful to not make false promises about things you cannot control. Instead, clearly communicate what you are doing to keep your  child, (or family member, pet, etc.) safe.

Let your child know that everyone has times when they are worried and afraid about something, and the way she is feeling is okay. Let her know that there are things that she can do to feel better, and that you are going to help her with those things. You can also encourage your children to express their thoughts and feelings in healthy ways, such as through drawing or writing or other creative outlets. Let them see you doing this, as well, and they will find it more natural to do it too. 

Does My Child/Teen Need Professional Help?

Many times, stress is a normal part of life and can be resolved within your family. However, there are situations for which it is best to seek help from a qualified professional.

Parents should seek professional help for their child:

• If a child is exhibiting behaviors that are concerning to parents and talking about it within the family does not resolve the issue.

• If stress-related behaviors are interfering with everyday tasks, such as sleeping, eating, schoolwork, enjoying time with friends, participating in activities, etc.

• If your child has experienced a traumatic event.

• When a child has any behaviors that are out of character for him/her or that are especially concerning to the parent.

Trust your judgment and intuition as a parent; if you think something is wrong, seek help.

How Do I Choose a Good Therapist?

When looking for a therapist, find someone who has experience working with children or teens, depending on the age of your child. Many therapists will speak with you for a few minutes on the phone to answer any questions you have about the process and how they conduct therapy. There are a number of different ways to treat anxiety in children. Talk with several therapists and ask each one how they approach the kinds of problems your child is experiencing. This process will also help you decide who you feel comfortable with. Successful therapy with children includes some communication and partnership with the parent, although the nature of the parental involvement differs according to the therapist and the type of therapy. So while it is important for your child to feel comfortable with the therapist, it is important that you as the parent feel comfortable with the therapist as well.

With the right help, and your support, your child can overcome their anxiety and learn skills that will be helpful to them for the rest of their lives.