Anxiety in Children
The COVID-19 pandemic sent the rates of anxiety soaring in children and teens. A meta-analysis of studies found unprecedented 19% of children and teens were experiencing anxiety subsequent to the pandemic. If your child is struggling with anxiety, know that you are not alone.
When parents notice their child is feeling anxious, their first reaction is normally to want to know what caused the anxiety and how they can help, but then they can often be at a loss on how to proceed. Parents may also offer too much support in an attempt to reduce their child’s anxiety, which can unfortunately backfire. Understanding the different ways children experience anxiety and what truly helps to reduce it can empower families to take the steps needed for raising resilient kids. First, let’s take a look at what anxiety looks like in children.
What does anxiety look like in children?
Children express anxiety in many different ways, sometimes overtly and sometimes more subtly. When they express it with noticeable, “big” behaviors with outward expressions, they are more likely to get help than those expressing anxiety with more subtle, inward expressions. Looking for subtle signs of anxiety in otherwise “good” or “calm” children will help keep them from suffering silently.
Common internal or thought-based signs of anxiety:
asking excessive questions about a stressful event
thinking about the same thing over and over again
imagining scary situations playing out
imagining dangerous/harmful things happening to themselves or loved ones
having nightmares/bad dreams
Common physical or body-based signs of anxiety:
general uneasiness, complaints of stomachaches or headaches
muscle tension, rigid posture, making fists, clenched jaws
fast heart rate
excessive sweating with cold hands
poor or excessive appetite
Other common signs of anxiety:
avoiding tasks or stressful situations by hiding or distractions
biting nails, chewing objects
yelling and angry outbursts that may include hitting or throwing things
crying or shutting down
being timid/shy or withdrawn
being overcontrolling/rigid with rules or bossing others
checking on their caregivers or excessively seeking reassurance/clingy
What are some common worries children experience?
Adults often dismiss the worries of children because they compare them to the stresses of adulthood. However, the worries children have are very real to them and can cause a lot of distress. Here are some common worries children experience:
worrying about harmful things happening to themselves or others, including accidents or dying
worrying about hurting the feelings of others, saying “no,” or being “bad”
worrying about being left out by their peers or not fitting in
worrying about being abandoned/forgotten by their family and being “unlovable”
worrying about doing poorly on a test/getting poor grades
worrying about being embarrassed in front of others
What causes anxiety in children?
From an early age, children pick up cues from their parents’ facial expressions and body language, tone of voice, and choice of words. Kids internalize these cues and how their parents react to the world around them. When a person perceives anything to be a threat to their safety, the nervous system activates into fight/flight/freeze/fawn mode, and we react accordingly. Of course, for life or death situations, this activation is vital to our survival.
However, when a situation is not life or death, but our nervous system still responds to it as if it is, we still activate the fight/flight/freeze/fawn reactions. Here is what that looks like in our children:
Fight: yelling, arguing, having angry outbursts, throwing things, punching, kicking
Flight: running away, hiding, avoiding a situation
Freeze: shutting down, becoming non-responsive, standing in one place, tensing body, panicky behaviors
Fawn: agreeing with someone just to avoid conflict, going along with whatever someone else wants, hiding your own desires, being unable to say, “No”
How can I, as a parent, help my child?
Parents want their children to be well-adapted individuals ready to thrive in a challenging world. They want them to be resilient and to be able to bounce back from adversity. They notice when their children are struggling and want to make things easier for them. Or conversely, parents see them struggling and want them to figure it out for themselves.
As a parent, knowing when to proverbially step on the gas and when to step on the brakes is a learning process. It is important to give yourself permission to make mistakes and show your child that you, too, can learn from them. Admit out loud in front of your children when something is hard, and coach yourself through it with some positive affirmations like, “I can take my time doing this,” “I got this,” “I can handle this,” and “I am proud of myself for taking small steps.” Kids often think they are alone with their experiences, or that there is something wrong with them, so it’s helpful to normalize and validate your own feelings, as well as theirs, to help them feel hopeful about the future.
How can therapy help my child?
If your child suffers from anxiety, know that there is support and professional help available.
Kids benefit from art and play therapy—mixed in with talk therapy—to help them identify their thoughts and feelings, to notice the cues their body gives when they are feeling triggered, and to learn coping skills for handling stressful situations.
Negative thought cycles can often spiral as distressing thoughts signal the fight/flight/freeze/fawn system in our body and make our bodies feel like an actual threatening event is happening, even when it is not. The rush of adrenaline that we experience during a perceived threatening event makes us feel the panic response in our bodies and leads to us reacting as if there was a threat.
In therapy, kids and parents learn how to use “brain hacks” to notice what their body cues are signaling to them, what their thoughts are telling them, and how to slow down to assess if there is an actual threat of harm. It takes some time, patience, and practice to be able to catch these thoughts and use coping skills (like breathing, cognitive reframing, mindfulness, progressive muscle relaxation) to get your body to reabsorb the adrenaline.
Finally, working collaboratively with a mental health professional can help you to recognize if your response to your child’s anxious responses are in any way impacting their coping abilities. Parental over-accommodation, while always grounded in well-intentioned support, has been found to increase anxiety in children and reduce resilience and coping skills. Parent involvement in therapy is also important since, to paraphrase Robert Frost, “the only way around is through” when it comes to difficult feelings. You must be able to support your child to gradually face and develop adaptive responses to anxiety provoking situations.
Anxiety is a common condition affecting many children at this time. Fortunately, there is also a wealth of tools available for helping kids and their families learn to manage and reduce their anxiety. With time and practice, children can learn to recognize triggers for anxiety, identify thoughts and bodily sensations that indicate an increase in anxiety, and be supported to feel empowered to work through the anxious feelings.