ANXIETY IN CHILDREN –
A GROWING EPIDEMIC
As a parent I was always fascinated when my kids were growing up, that my kids displayed two different types of personality. One was easy going and the other more a live wire. I realized early on that my live wire was going to inherit my anxious nature. My daughter, the easy going one, well… her anxiety wasn’t so obvious… Now I know anxiety is a good thing (it helps protect one from danger and allows us to react faster to emergencies), but I just wish I was not so well endowed with it… or anyone for that matter…
Anxiety – What Is It There are two types of anxiety, acute and chronic.
Acute anxiety is generally fed by fear of what is in front of you – you see a rabbit zigzagging in front of your car and you think the car is going to hit it, and then the unpleasant feeling passes when you see the rabbit hasn’t been hit (or as the case may be….is).
Chronic anxiety, however, is generated by fear of what might be…. In children it may be a case of nobody is going to like me if I wear my hair too short, or not wearing the “right” clothes.
The reality is all children are going to worry about something at some point in their lives. As they develop and get older most of these disappear. However when chronic anxiety and worry have become so big they get in the way of daily functioning, then you may be getting into the area of Anxiety Disorders, where the anxiety/worry is long standing and out of proportion to the actual likelihood of the feared event, and their lives and actions are impacted by the fears that rule them.
What Causes Anxiety There are three determinates that causes anxiety
1. Biological – About 30-40% of people inherit a genetic predisposition towards anxiety or have a heightened sensitivity towards stress (ever noticed some babies are more relaxed than others), – About 30-40% of people inherit a genetic predisposition towards anxiety or have a heightened sensitivity towards stress (ever noticed some babies are more relaxed than others), but that alone will not cause anxiety. When neurotransmitters in our body are out of whack (Serotonin and dopamine are two well-known neurotransmitters) this will cause anxiety.
2.Family – Early life experiences may cause a vulnerability to feelings of “lack of control”.When children repeatedly experience a lack of control over events in their lives, they begin to view the world as undependable or dangerous. An overly protective parenting style may communicate the world is a dangerous place, and will inhibit a child’s ability to develop coping skills. An under protective, or low care parenting style presents a chaotic and stressful world. A child who is separated from their primary caregiver at an early age is also affected by these feelings. Then there is abuse; be it physical, emotional or sexual, which will also affect a child’s perception of lack of control. (It will also be dependent on the individual’s perceptions and reflections of themselves and the world around them).
3. Environmental/Social – We learn new ways of thinking and behaving through observation as well as by direct experience. So, it becomes easier to understand children may pick up direct or indirect cues just by observing how others act and learn to respond how others might respond. Therefore, the way a parent may handle their anxiety, either directly or indirectly may teach a child to mimic similarily. TOO MUCH SCREEN TIME is an obvious influence.
Growing Culture of Fear There is also a growing culture of fear, where spontaneous play has become discouraged. The type of skills that children could be learning, and gaining more confidence in, are taking public transport, learning directions, calling friends and arranging get togethers, playing outside. Traumatic events can also trigger anxiety.
Schooling Pressures A tremendous lot of pressure is also put on our kids to succeed in school. Originally teaching involved enforcing ethical and moral behavior in class, as well as the three R’s. Now children are expected to get A’s, and incentivised to do so. Not only are they expected to strive academically with excellence, they are allotted a tremendous after school schedule of sports, activities and homework.
What Are The Most Common Anxiety Disorders In Children?
Phobias – Common phobias in children may include fear of spiders, or fear of heights, or fear of injections, producing intense fear even though the threat of harm is minimal.
Social Phobia – Is where a child may exhibit extreme shyness or may fear he/she will be seen negatively, so will avoid social interaction, speaking out, may be highly self-conscious and will have difficulty forming friendships.
Generalised Anxiety Disorder – Is where a child may have excessive and unrealistic worries about a broad range of possibilities, future or past. The child may often be lacking in confidence and need lots of reassurance
Post Traumatic Stress Disorder – Follows traumatic events, such as a serious accident or life threatened event. These children may experience flashbacks, as though they are reliving the event, or they may express or recreate the event through drawing or playing. They may also develop loss in concentration and become irritable, and sleep patterns may change.
Obsessive Compulsive Disorder –This is where the anxiety is in the form of distressing thoughts and repetitive patterns that are difficult to stop. A common example might be fear of germs causes the child to continuously wash their hands.
Separation Anxiety Disorder – Young kids may not understand that the separation from their parent is only temporary. An older child may stress that something bad is going to happen to their parent while they are separated. Fear of separation is considered developmentally normal up to the age of two.
How Anxiety In Children May Present Anxiety will present three ways in children
Physically · They may become clingy or seek reassurance more often · Sleeplessness, diarrhea, headaches, stomach aches, tiredness, · Lacking in concentration, irritability · Cries over small things
Thoughts · Your child seems to be scared about a lot of things · They seem to have lots of worries · They might be more negative about things
Behaviour · They may get upset easier · They might try to avoid situations they are concerned about · They might start regressing in capabilities (e.g. asking your help in things they are perfectly capable of doing) · Doesn’t want to get ready for school · They might overplan, preparing for every possible contingency, where it is not necessary, because that is their way of controlling the situation.
A child’s natural strategy to overcome anxiety is to avoid the situation or get their parents to deal with it for them.
HOW CAN WE HELP OUR ANXIOUS CHILDREN?
Firstly, it is important to seek help if you feel your child has an anxiety disorder, because if not addressed anxieties can increase, along with the associated problems.
In general, though, it will help to recognize our anxious children tend to lack confidence in their abilities and may feel overwhelmed easily. Because they tend to avoid the things that cause them anxiety, they don’t get the chance to learn what they fear will not usually happen. Some strategies that will help include
· Slow deep breaths (breathe in three seconds, hold three seconds and breathe out three seconds). This will help them calm the physical effects of anxiety. Get your child to take some. Once calm you can talk through what is worrying them.
· Normalise – Explain that everyone gets anxiety at some point. Sometimes it happens for no reason at all, but there are things you can do to make it go away. You can explain it happens because there’s a part of your brain that thinks there’s something it needs to protect you from.
· Create a worry box. Have a designated time each day of say 10 minutes for your child to sit down and write or draw what is worrying them. When the time is up shut the worry up in the box.
· Break down the worries into manageable chunks, creating mini goals along the way.
· Help shift thinking patterns of what if… by: – Reminding them of similar times in the past where things worked out ok – Help them challenge scary thoughts with facts and evidence, e.g. Monsters cannot live under their bed (their beds are too low!). – Make a what if plan for how they will respond if things don’t go as they’d like.
· Try – Anxious kids often worry about making mistakes, or not doing things right, and so will avoid the situation. The emphasis needs therefore to be on having a go, and having fun whether successful or not.
· Model – Don’t just preach, show them. Verbalise how you are coping with a situation when you get stressed or anxious. You could say “This looks a bit scary….but I’ll give it a go”…
· Give your child some control – If your child is anxious about intruders, get him to help shut windows and lock doors at nights. This then gives him some control over the situation.
· Discuss – Discuss their worries about terrorism, death, or scary thing. Talk through their fears and answer questions truthfully. Try and explain it in a way that gives perspective
· Encourage activities that will promote a sense of independence such as chores, helping out others, volunteering. This will increase their self confidence.
· Work out – Exercise is a proven way to lessen anxiety.
· Give a name to the emotion – This is a powerful way to regulate feelings rather than feel consumed by them.
· Turn off the doom and gloom from the television for a while.
· Be positive and realistic – you can’t say that a child’s fears are not real, that another child won’t laugh at him in show and tell, but you can express confidence that everything will be ok, that he will not be asked of anything he cannot handle, and that if he faces it his anxiousness will drop over time.
· Acknowledge but don’t empower their feelings. Validation doesn’t necessarily mean agreement. Use empathy.
· Encourage them to accept and tolerate their anxiety. It will drop over time as he continues to have more contact with what is stressing them.
· Be their emotional rock. As a parent we need to keep our own anxiety in bay while sympathising with theirs. We need to show their problems do not make us anxious
– Don’t Reassure them that everything will be ok. That is trivialising their anxiety. – Don’t Be an overprotective parent – that just makes their world scarier – Don’t argue in front of your child – that increases their anxieties – but do acknowledge there are difficulties and you will find a way to sort it. – Don’t Create any critical stance you may have of your child, in your quest for their perfection – Don’t Incorporate your financial worries into their world, but share what makes us anxious and how you will deal with it – Don’t Avoid things just because they make a child anxious – it will reinforce the anxiety – Don’t Ask leading questions – Encourage your child to express how he feels, not “Are you anxious about the test” – Don’t Reinforce their fear by unintentionally transmitting your anxiety about their anxiety, e.g. fear of dogs. – Don’t protract the anxiety. The greatest anxiety time is before the event. As an example if a child is going to the doctors, don’t start discussing the event two hours before hand, just minimal information prior and then when closer to event have a discussion, helping them to think things through. – Don’t advocate too hard. By all means stand up for your child but not at the expense that it raises their anxiety levels. If something happens at school and your reactions is to race off to the school, then you are telling your child they can’t tell you something in confidence, and you don’t have faith in him to fix his own problems. You advocate for them with their full knowledge and consent. So, the priority is to help them find a way to solve the problem. – Don’t compensate for their weaknesses. People gain their confidence from playing to their strengths, not compensating for their weaknesses. Learn to do the things they are good at. Don’t stress about the rest.
– Don’t Say – Don’t say DON’T WORRY – Say can you tell me more about your worries? – Don’t say ITS NO BIG DEAL – Say I can see you’re feeling anxious about this – lets try some deep breathing – Don’t say YOU’LL BE FINE – Say I’m here to help you – Don’t say THERE’S NOTHING TO BE AFRAID OF – Say Let’s talk about that together – Don’t say YOU JUST NEED TO SLEEP MORE – Say – Lets read a book together before bed to help us relax for sleep – Don’t say I’LL DO IT – You will end up being the fixer upper. Say – I know you can do this. I’m here to support you. – Don’t say IT’S ALL IN YOUR HEAD – Say It sounds like you’re worry brain is really loud right now. Lets take a walk together and calm that worry brain down. – Don’t say HURRY UP – Anxious kids move at a snails pace. Telling them to hurry increases their feelings of guilt and helplessness – Say How can I help. – Don’t say STOP THINKING ABOUT IT – Say Let’s talk back to that worry brain by telling it positive stuff. – Don’t say I DON’T KNOW WHAT YOU NEED – Say Let’s brainstorm ways to help calm our minds right now.
WHAT CAN AN ANXIOUS PARENT DO TO CHANGE
– Learn stress management techniques. If you are anxious it is going to be hard to communicate a sense of calm to your child. As your toleration grows your child will start learning too, as she gets her cues from your behaviour.
– Model stress tolerance. Try to maintain a calm, neutral demeanour in front of those little sponges. Be aware of your facial expressions, the words you choose, and the intensity of the emotion you express
– Explain your anxiety. You may not want your children to see your anxiety, but by discussing why you reacted in a certain way it then normalises it, and models how they can then cope or change, with similar issues.
– Strategise for future situations that trigger your stress and how you will manage it.
– Know when to disengage. If you feel yourself becoming overwhelmed in the presence of your child take a break.
– Find a support system. If not physical, look for a support group over the internet where you can join like-minded people for support.
It is important to realise it is possible to treat anxiety symptoms in the present, regardless of past experiences, or strongly held beliefs and assumptions that were formed in the past.
Remember the goal for most kids is not to eliminate anxiety, but to make it manageable so they can get on with enjoying life.
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