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Anxiety in Children What to do when “feeling anxious” becomes something more

We all feel anxious from time to time, especially when life throws us a curveball. But for many people, anxiety is more than a passing reaction to stress; it can start to affect daily functioning and health. Anxiety disorder is the most common mental health issue among Americans, and it affects 1 in 8 children in the US, with age 11 being the median age of onset in kids.

Lauren Pantoulis, LCPC, specializes in school-based therapy with elementary and middle school students in county and city schools around the Baltimore area. She combats the impact of childhood anxiety on a daily basis. Here, Pantoulis shares with us some important advice for parents to understand about anxiety.

An anxious generation

Rates of anxiety and depression in children and adolescents have risen significantly since the 1950s. Why? The many possible theories include increased isolation due to technology, over-scheduled days, decreased unstructured playtime, “helicopter” parenting and a more intense pressure to excel in academics and athletics, Pantoulis says. There is a genetic component to anxiety — children with family members who have anxiety are at a higher risk to develop it themselves — but conditioning plays a major role. Anxiety can be increased or decreased by repeating certain patterns of behavior.

Triggers of childhood anxiety

Many types of anxiety can present in childhood, including generalized anxiety disorder (GAD), panic disorder, separation anxiety, social anxiety, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and specific phobias. However, traumatic stress and major life events (changes in development, moving, divorce, serious illness, etc.) are major factors in spiking occurrence of anxiety in children, Pantoulis says. School-related anxiety is common and can be tied to learning differences, social stressors and separation from parent/guardian. Children with GAD or social anxiety will tend to isolate from peers, which reduces connectedness and lowers self-esteem.

 Treatment options

Finding the right therapist is key — think about what kinds of treatment you and your child may be comfortable with. Many different professionals are out there to work with your personal preferences for treatment approaches, Pantoulis advises. Cognitive behavior therapy (CBT) and/or medication, alone or in combination, can be effective means of treating anxiety. CBT is a short-term therapy that teaches the individual to be able to recognize negative thoughts or thinking patterns and replace them with positive cognitions. It often involves activities such as keeping a thought journal to track patterns in thinking which may trigger anxiety, she says. Gradual desensitization can also be used where anxiety is linked to a specific object or environment. Use of relaxation techniques can also be very effective. There are many online resources readily available to help parents teach kids age-appropriate techniques for tuning in to signs of anxiety and using mindfulness and/or relaxation to decrease anxiety.

Keeping kids in school

Children with school-based anxiety will often complain of stomachaches or headaches to avoid going to school, but it is important that they get back into the classroom as soon as possible, Pantoulis says. Check in with your child’s pediatrician to rule out other health issues. Look to pinpoint the source of the anxiety (workload worries, bus ride stress, peer issues, bullying fears, etc.). Then consult the teacher and/or school counselor to come up with a strategy that fits your child’s needs. This may involve some adaptations to help ease the return. If a child is socially anxious, pairing up with a designated “buddy” can also be a helpful strategy.

Not all anxiety is the same

Some anxiety may be a temporary phase tied to a major change or transition. It may sometimes be “outgrown” over time, or managed with minimal intervention. Interestingly enough, a “healthy” degree of anxiety can actually improve a student’s school performance, Pantoulis says, but too much is definitely not a good thing. When anxiety is not a fleeting phase and children or adolescents with more severe anxiety problems go untreated, it can lead to depression, academic problems, social isolation, low self-confidence, and an increased risk of substance abuse.

Pantoulis emphasizes that anxiety is highly treatable — and the earlier it is addressed, the less likely it will lead to more problems. Stay in tune with your child’s mental health, to help them stay on track for a strong and healthy future.

Key points for parents:

* Model positive behavior. Children often pick up on the anxiety of their parents and internalize their fears. Help them mirror healthy behavior patterns.

* Keep the same expectations of your child with anxiety as you do of their siblings or peers without it. You may need to change the pace or the way things are approached, but altering your expectations may reinforce their negative thoughts.

* Recognize that anxiety looks different in different children. Some kids may seem depressed, scared or shy, while others may use defiant behavior to escape stressful situations.

* Do a daily check-in. Ask open-ended questions about friends, teachers and schoolwork) rather than a generic “How was your day?” If your child opens up, try to normalize their feelings. Your reaction can make or break those lines of communication.

* Be open to seeking help. If anxiety is significantly restricting your child’s social interactions, negatively impacting schoolwork, manifesting as physical illness or causing your child to be frequently sad/depressed, don’t put off seeking help. Your child’s pediatrician is always a good sounding board and first resource.

About Courtney McGee

Courtney McGee is a freelance writer, cancer warrior, runner/triathlete and compulsive Candy Crusher. She lives in Towson with her husband and their two teenagers, preschooler and high-maintenance rescued hound dog.

One comment

  1. Thank you so much for this piece as my son, who also has ADHD, was recently diagnosed with anxiety. I always grab each monthly issue of Balt. Child and I immediately felt less alone about the diagnosis.

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