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Key Points:
- Symptoms of anxiety include worry, irritation, social withdrawal, stomachaches, and difficulty sleeping, among others.
- Triggers of anxiety include fears (heights, monsters, etc), academic challenges, social dynamics, and losing a loved one, among others.
- Adults can help children by explaining the biological purpose of anxiety and providing concrete tips such as talking, writing, or singing.
- If anxiety is disrupting a child’s functioning on a daily basis, it may be time to speak to a mental health professional.
As a School Counselor, one of the most common topics I am asked about is anxiety. Anxiety disorders are the most common and pervasive mental health challenge affecting children in the United States. According to the CDC, clinical levels of anxiety impact 7.1% of young people ages 3-17, and the numbers have been rising steadily over the last 20 years. With rates this high, it’s important for any adult living or working with young people to have a basic understanding of this health issue.
In this blog post, I share my responses to the five most frequently asked questions I receive about anxiety and how it can impact young people:
1. What are the main symptoms of anxiety in kids?
One of the most confounding things about anxiety is the many, many different ways in which it presents. For some kids, anxiety is expressed through “classic” symptoms such as worry, nervousness, and avoidance of people, places and things that trigger feelings of distress. For others, it can look more like irritability, indecisiveness, social withdrawal, or even anger.
Some young people manifest their anxiety through physical symptoms such as headaches, stomachaches and/or difficulty sleeping. Repetitive, compulsive behaviors along with generalized fearfulness, specific phobias and the experience of panic attacks can also be seen, even in young children. Educators and coaches often report seeing students act out their anxiety through perfectionism (a fearfulness of making mistakes) and/or being excessively hard on themselves when they make an error on a test or come up short in a game.
What most people who experience anxiety have in common is an overwhelming sense of unease and emotional discomfort in specific situations, usually triggered by a cascade of negative thoughts.
2. What triggers a young person’s anxiety?
There are probably as many triggers for anxiety as there are people who experience it, but especially common triggers for young people include:
- Specific fears of all kinds, both real and imagined, including animals, insects, thunder and lightning, fire, darkness, heights, and monsters under the bed.
- Losing or being separated from a loved one.
- Academic issues such as making a mistake, failing a test, making a teacher upset, and answering a question in front of others.
- Social issues such as not being liked, not being included, and being picked last.
- Getting sick or dying.
- Being late, missing a bus, or forgetting something.
Young people with anxiety often describe having thoughts of "what if" playing on repeat in their heads. They tend to “catastrophize,” imagining extreme negative outcomes, no matter how unlikely, to the situations that play out in their heads.
3. How can I help my child deal with anxiety?
Knowledge is power and so even with very young kids, I like to teach them about what is happening in their brains when they experience anxiety. Kids as young as four and five can benefit from understanding that anxiety (or "worries" as I usually refer to them with children) is something that happens in everyone's brain from time to time. This helps kids to know that they are not alone in their experience of this uncomfortable emotional state,
I teach kids that our brains have a natural alarm system (which I identify as the limbic system for older children). When we are in a dangerous situation, our "alarm" goes off to keep us safe. Having an alarm in our brain is a really good thing—these alarms keep us safe by letting us know when danger is present.
However, sometimes the alarms in our brain get a little over-active and make us think there is danger around, even when danger doesn't exist. This doesn't happen because our brains are broken or bad—it happens because our brains are powerful and active and want to keep us safe. In this way, I aim to help young people reframe their anxiety as a friend—a personal bodyguard of sorts.
I also share with kids that when we realize that a false alarm has gone off, this is the time for us to do one of two things—breathe or move. Scientists have shown us that breathing and movement are the two most efficient ways to regulate the limbic brain, or, in kid-friendly terms, “turn off the alarm in our brains when it is being over-active.”
4. Aside from breathing and movement, what are other effective ways to help kids calm down?
More and more, experts are finding that when it comes to regulating the brain, one size truly fits one. While no single strategy is universally effective for soothing all anxious brains, there are dozens and dozens of brain-based, sensory techniques kids can use to feel more regulated and less anxious. The challenge is to find what works for each individual.
Adults can play a key role by brainstorming various calming strategy options with kids and encouraging them to practice them during non-stressful moments. Children who know how to settle their brains during periods of calm are in the best position to make use of these strategies during moments of anxiety.
Below, I share some of the strategies I have found most useful to kids over time:
- Talk to a trusted adult or friend (This helps kids put language to their emotion and moves them from the part of their brain that is dominated by emotion to the part of their brain that is dominated by logic and reason.)
- Ask kids to write down or draw what is bothering them on a piece of paper, then allow a trustworthy adult to hold the paper for them. This symbolic gesture of "letting someone else hold on to their worries" can be enormously helpful.
- Make it a habit to ask kids to rate the intensity of their worry on a scale of 1-10. Over time, kids learn to realistically consider the size of their problem and can develop a differentiated set of skills for managing small worries compared to medium or large ones.
- Rhythmic sounds and movements have a naturally calming effect on the brain. Engage kids in jumping jacks, tapping on a drum, or playing an instrument to facilitate this calming effect.
- Singing can also be extremely soothing; without even realizing that they are engaged in a calming activity, kids naturally regulate their breathing through the act of singing.
- The same is true for drinking from a straw. Cold water is a great choice to offer young people when they are feeling upset and overwhelmed.
- Mindfulness exercises have been shown to be helpful in calming anxious kids. Most of the things that kids worry about either already occurred (e.g. a friend laughed at me) or they fear will occur in the future ("I might get hurt," "I might fail a test.") Mindfulness exercises help kids keep their focus on the present moment—which is the only thing they have any control over.
5. How will I know if my child's anxiety is severe enough to need professional help. What is the tipping point?
Most kids experience some level of anxiety from time to time. If you notice lasting changes in your child's eating or sleeping patterns or if they withdraw from or avoid activities that they once enjoyed, it may be time to seek professional help. Likewise, when symptoms such as repetitive thoughts, compulsive behaviors, panic attacks, or re-living traumatic memories interferes with a child's ability to function in school or daily living, it is time to consult a professional to help your child gain strategies and skills for managing their anxiety.
