Dr Joanne Stuart
Anxiety in Children
Anxiety and stress in children can show up in a number of ways. This can depend on your child’s age, personality and coping skills, for instance. As a result of this, the symptoms can sometimes be hard to spot. This article will help you as a parent to be able to spot and make sense of your child’s anxiety, and have some strategies to help them manage their feelings.
Symptoms of anxiety
If you think about it in terms of how the body reacts to stress and anxiety, it is to make sure that you are ready to either fight or flee, the ‘flight or flight’ response as it is called. So, the symptoms tend to be a manifestation of this, but they lasts longer than a fleeting moment and become more of a feature of day to day behaviour, thoughts and emotions.
In terms of trying to flee, you might see your child withdrawing from activities they used to enjoy, or saying they don’t want to go to school. They might have problems concentrating or sleeping, or they could develop a nervous habit such as pulling their hair or biting their nails. They might complain of physical symptoms associated with being in a high state of alert from anxiety, such as headaches, or stomach pains, and this could lead to problems with eating. They might also wet the bed. They may ask for a lot of reassurance, either about their health, or about situations they find themselves in.
Some children respond more with the ‘fight’ response, and in this situation, you might have observed your child becoming more oppositional or argumentative, being short tempered, moody or aggressive. They might get into trouble at school. It is easy to see this as just bad behaviour, but if this represents quite a change for them, then it might be worth talking to them to see if there is something bothering them.
What causes anxiety in children?
What children need mostly is some security and routine. Anything which impacts on this could have a negative impact on their emotions. So, for instance, moving home, having a new baby, a parent getting a new job which takes them out of the house for longer, could all be triggers for anxious feelings. Arguments at home, or family separation can be particularly difficult. Children rely on consistency, and are so sensitive to change, because they are faced with so much new information each day, if things which are usually settled are suddenly different, then this can be overwhelming.
Other issues such as tests and exams, or having learning problems, can also make them feel anxious as they can affect their self esteem. If other children at school are bullying them, then this can affect their sense of belonging, and make them feel worried. Some children can be worried by things they watch on the TV, for instance even the news, if they get anxious about negative news stories and how they could affect themselves or their family.
What can I do if I think my child is stressed or anxious?
Firstly, it is good to talk to them, and find out what is happening. Is it something that they have misunderstood, and maybe worrying about needlessly? Or is it something you can resolve? If that is not the case, or if you feel that they need some more support from you, then it is first helpful to explain a bit more about why we get anxious and what it feels like, so they can understand it better. I often talk about anxiety being like a table with four legs; these legs are the physical feelings, emotions, thoughts and actions.
So, for instance if your child has just got a new sibling, their ‘table’ might look like this:
- Emotions: anxious, angry, and jealous.
- Physical sensations: tummy ache, headache
- Thoughts: no one cares about me anymore, I’m not important
- Behaviours: being more clingy, finding ways to get attention
These legs all work together to keep the anxiety (table top) up, and the way to resolve this is to knock the legs away, and bring the anxious feelings down.
Helping them to work on their anxiety
The reason behind the anxiety will obviously shape what is the best way to resolve how they are feeling. However, some basic principles can be of help.
Emotions: in relation to this, after they have learned a bit about how anxiety works, then helping them identify when they are feeling anxious can be really helpful. It is sometimes useful to think with them about what the anxiety looks like, for instance by drawing it, or giving it a name. This helps them to realise that they are separate from it, and gives them a sense of control over it. If they had called the worry their ‘scary monster’ for instance, you might notice them withdrawing and say ‘I wonder if you are getting that feeling in your tummy now, has the scary monster come to bother you again?’ Depending on your child’s age, you could also think with them about how much the anxiety is bothering them, from 0-10, or use sad and happy faces if they are a bit younger.
Physical feelings: Activities such as breathing and relaxation can be helpful for children. For younger children, you could get them to pretend to blow up a balloon when they get the anxious feelings, or you could get them to imagine they are floppy ‘like a rag doll’ to help them relax. If they are a bit older, then doing some basic breathing strategies, or tensing and releasing type relaxation, could work for them. Please see the other articles we have written to help here.
Thoughts: If you notice that they are often down on themselves, for instance if they are worried that they have to take a test and they are saying things like, ‘What if I do badly? What if I don’t know how to answer the questions?’ then it is helpful to think with them about how they can answer those thoughts back. How true is it that they will do badly? What would their friend say if they told them they were worrying? What would happen if they did do badly?
This approach can also work in helping them solve situations that they are worried about, for instance helping them to work out the best way to proceed if they are not sure what to do. For instance’ helping them think about the pros and cons of different choices can help them feel more confident in making decisions.
Another strategy which can be helpful is to set aside a time to talk to your child each day, if they are worried. Getting them to write down their worries in a notebook, or put them in a box, and then go through them at your assigned time can help to create some structure, so that the worries don’t take over. You could encourage them to put the worries out of their mind, unless it is the time to discuss them. Younger children may benefit from their parent keeping hold of the box, as this helps them feel like their grown up is taking care of the worries and gives the child more of a feeling of being looked after.
Behavioural: This part involves thinking about what they can do differently to help fight the anxiety. For instance, is the anxiety stopping them from doing something? One way to help them with these kinds of problems is to break the issue down into manageable parts. For instance, they might be worried about performing at their school assembly. You might get them to build their confidence by initially getting them to practise on their own in their room, then in front of just you, then a small group of people, and so on. They could make use of some of the other strategies above, to get control of difficult thoughts and physical sensations and gradually build their confidence.
If you know that there are difficult events coming up or changes which will impact on your child, it can be helpful to talk to them about this, so that they are prepared, and you can think with them about what they might need to be able to cope.
How you manage stress matters too!
Another point is about how you as a parent both manage your own anxiety, and how you show that to your child. I’ve often heard parents say to me, ‘so it’s all my fault!’ I usually respond that that’s not a helpful way to look at it, but you are a huge part of the solution. They will always look to their parents as models for their own behaviour, so it might be helpful to think about whether you are taking enough care of yourself, and managing your own stress. Could you also benefit from doing some breathing, or relaxation, or challenging yourself when you doubt yourself? Also, are you able to manage your own feelings, so that you are able to hold your child’s in mind, and help prepare them for any changes and tricky situations? This is not about being a perfect parent, but about modelling how you can manage difficult feelings and cope with challenging situations, in a way to allow you to get past them.
A final note…
If after trying these strategies you are still concerned about your child, please seek professional advice.
By Gemma Lutwyche