Anxiety is a normal part of everyone’s life as it is a natural body response to danger or fear. For example, if a child sees a rattlesnake on the playground, we want the child’s body to ring the “anxiety alarm” so that they remain safe and leave the area of danger. Anxiety usually comes with feelings of urgency to fight or flight, increased breathing and heartbeat, and shaking and tingling of the hands and these normally go away when the danger is removed. Sometimes children feel symptoms of anxiety when there is no danger present and this can be thought of as a false alarm.
Children who experience a lot of anxiety or false alarms are often thought of as worriers. Parents, caregivers, and others can provide helpful support to children who experience frequent anxiety. The key to helping a child who experiences anxiety is to educate, normalize, and validate their feelings. Tell the child that they are not the only person who experiences these feelings. Assure them that they are not strange or weird because they worry so much. Explain that everyone has anxiety and that it is a natural body response. It may be helpful to call the anxiety by name. For example, if a child is expressing feelings of fear that is a false alarm, say, “I think this may be your anxiety/stress/worry speaking.” It is important to use the child’s words when addressing their feelings. We can validate a child’s feelings by showing that we understand how scary or uncomfortable the feelings must be. It is important to refrain from telling children not to worry as this can be very confusing because they do not always understand they have control over the feelings.
It is important to recognize when a child may have an anxiety disorder. The core of recognizing a problem with anxiety is when a child avoids things they need or want to engage in because of their fear, worry, stress, or anxiety. If a child really wants to join a team sport or go to a sleep over, but they avoid these activities, this may be a sign that the anxiety is impacting their life. Another sign of an anxiety disorder is when the feelings are interfering in the child’s life at school or the family’s life by causing consistent distress. Some children are not capable of explaining their emotions and keep their anxious feelings bottled up inside and this can come out at home. Parents may see tantrums, avoidance of school work, or lack of interest in social situations. Children who have experienced persistent anxiety for six months may have an anxiety disorder.
Separation anxiety is a common type of anxiety in children and includes inappropriate and excessive anxiety about separation from the child’s caregiver. While separation anxiety is most common in younger children, older children may also experience it. This type of anxiety commonly includes a child’s fear of harm coming to them or their family. These fears often include monsters with younger children, sicknesses, natural disasters, or vehicle accidents. You may get a lot of “what if” questions like what if someone breaks in our house, what if there is a fire, or what if you get in an accident. Generalized anxiety disorder includes a child’s excessive worrying about a number of events for six months or more. Children may experience restlessness or be keyed up, feel easily fatigued, have difficulty concentrating, or be irritable. Questions that children may ask are what if we run out of money, what if I don’t do well on the test, or what if the teacher does not like me.
Anxiety can feel so bad that children are likely to assume the outcome is going to be terrible. However, usually it is never as bad as it feels or as a child may think. Use questioning with your child to help them explore the realistic possibilities. For example, if a child is worrying about doing poorly on a test, explore the possible outcomes if this does happen. Through this type of exploration in a calm manner, children can usually see that it will not be as bad as they are initially thinking. When supporting a child, be sensitive, educate them about anxiety, give positive responses, be calm and consistent, help them slowly face their fears, and seek additional support and resources.
School counselors are an excellent resource for students with excessive anxiety. School counselors are trained mental health professionals that have specific skills to help children of all ages with academic, career, and personal/social development. In addition, licensed professional counselors may diagnose and provide consistent therapy to children experiencing an anxiety disorder. You may find the following websites helpful in locating a counselor in the area: http://www.nbcc.org/CounselorFind, www.goodtherapy.org, and https://therapists.psychologytoday.com/
Dr. Jonathan Ricks writes about worried children, separation anxiety and generalized anxiety disorder. He is also an assistant professor at The University of North Carolina at Pembroke.