AGHH! Childhood Anxiety

With STAAR testing only a month away, you may start to see changes in your child.  This is normal.

What is Anxiety?
Anxiety can be a normal reaction to a tense situation or stress, that causes feelings of worry, fear, uneasiness or apprehension.  In general, anxiety can help one cope.  However, when anxiety becomes an excessive, irrational fear of everyday situations, it can become a disabling disorder (National Institute of Mental Health).

Fears and worries can be common and developmentally appropriate.  For example, infants tend to develop a fear of strangers.  Toddlers may fear darkness and separation from caregivers.  School age children tend to worry about injury, death, and natural disasters.  Older children may worry about school performance, social status and health issues (American Academy of child and Adolescent Psychiatry).

At times, worries can be functional.  For instance, if children did not worry about doing well, perhaps they would not learn or perform as effectively.  Mild worry can serve as a motivator, encouraging children to prepare and work hard.  A certain degree of worry can also serve as protection for children.  Fears of situations help them make good choices that keep them safe.

However, worries that persist, despite parents' efforts to provide reassurance, may lead to the development of an anxiety disorder, which may impair a child's daily functioning.

In understanding anxiety, it is important to consider the relationship between an event, beliefs or thoughts about this event, and feelings.  It's very easy to assume that an event determines one's feelings.  However, it is one's beliefs, or what he/she tells himself about the event that causes the feelings.  Also, it is important to understand that anxious individuals believe that bad things are very likely to happen to them.  For example if a parent is late coming home, an anxious child will tell himself/herself that the parent has definitely been in a car accident.  While yes, this is a possibility, the reality is probably unlikely.  Additionally, anxious individuals perceive the consequences of these feared events as catastrophic or intolerable.  For example, a child who is afraid of making mistakes views mistakes as the "end of the world" and perceives something terrible and unbearable happening as a result of his/her mistake.

Signs and Symptoms of Childhood Anxiety
Parents are usually the first to recognize their child's emotional or behavioral challenges.  As an initial step, it's important for parents to talk with their child about his/her feelings and worries.  A child with anxiety may talk about their worry, but typically, they do not realize the excessiveness or irrationality of the concern.  An anxious child may also complain of physical ailments such as headaches or stomaches.

It is critical for parents to understand that it is not parents' sole responsibility to "fix" their child's anxiety.  It's okay for parents to seek support.  Knowing when to seek professional help, as well as taking the first step to get help, can be a difficult decision for parents.

The American Academy of child and Adolescent Psychiatry encourages parents to seek support if their child exhibits the following:

• marked decline in school performance;
• poor grades despite strong effort;
• increased activity level;
• refusal to attend school, go to sleep, or participate in activities;
• persistent disobedience, aggression, or unexplained temper tantrums.

Additionally, the Anxiety Disorders Association of America encourages parents to be vigilant of changes in a child's eating habits, relationships with family and friends, speech and language and other developmental milestones, as well as the appearance of regressive behaviors.

Seeking Professional Help
When seeking help, parents may want to start by consulting the child's pediatrician, since they are likely to be familiar with the child and someone the family trusts.  In seeking treatment, consider finding a specialist, someone who is trained to treat anxiety in children, and someone with whom the family is comfortable working.  There is no single treatment for anxiety.  Clinicians will formulate a specific plan for each child and family.

It's a Family Situation
Successful treatment depends on the investment of time and energy of all family members.  Parents must take an active role in a child's treatment.  Parents and the child together need to share the responsibility of practicing strategies that are learned during sessions.

Ideas to Try at Home

• Deep Breathing: Breathe in through your nose and out through your mouth.  Blow away your worries.  Consider practicing deep breathing with bubbles.  This adds a visual component for children and bubbles have a "magical ability" to create smiles!
• Muscle Relaxation: Tighten up muscle groups and slowly release them...head to toe.  Pretend you are a sponge soaking up water, and then squeezing it out!
• Journal: Drawing or writing about feelings, thoughts, or worries helps children get their "heavy" feelings out of them and on to the paper.  Journaling may also help parents "tune in" to their children's worries and initiate helpful conversations.
• Get Active or Exercise: Moving around helps children expend their "heavy" feelings.  Practice "shaking out" worries.
• Create a Family Worry Box: Have family members write down their worries and "lock them away" in the worry box.  At the end of the week, have a family meeting to review the worries and how they were handled.  Focus on how your child coped with their worries.

 Additional Links

• Mary Ellen Flannery posted a great article with many strategies on NEA (National Educational Association) about How to Relax Test-Stressed Kids. 
• Shellee Harrington from Harrington Creative Counseling wrote a great article about the stresses we see in children entitled, Getting Ready for Summer: Children's Stress.
• Bern from Mom to 2 Posh Lil Divas wrote a personal blog entry on School Anxiety: How Do You Help Your Child Deal with School Fears? that explains her journey as a mother of an anxious daughter.