Mental Health

Author: Anxiety Canada

Does any of this sound like your child or teen?

• Clinging, crying, and/or tantrums when you separate

• Excessive shyness, avoiding social situations

• Constant worry

• Avoiding situations or places because of fears

• Complaints of frequent stomachaches or headaches

• Experiencing sudden and frequent panic attacks

Be sure to watch our video for more information on how to help your child.

If so, your child may be experiencing anxiety. This website can help.

Here, you will find practical strategies and tools to help you manage your child's anxiety, whether your child is just beginning to show symptoms, or has been diagnosed with an anxiety disorder. To begin, continue reading, to find out more about anxiety—how it looks, how it works, and how to recognize if it is problematic. If your child has been diagnosed with an anxiety disorder, you may prefer to click immediately on this disorder on the menu.

As a parent of an anxious child, you are not alone.

Anxiety is the most common mental health concern for children and adults. Because anxious children and teens are often quiet and compliant, however, they frequently go unnoticed by their parents and teachers. As a result, many never receive the help they desperately need. Unfortunately, untreated anxiety can lead to other problems later in life, such as depression, missed opportunities in career and relationships, increased substance use, and an overall decreased quality of life.

Parents often say that from a very young age, they knew there was something different about their child, but did not immediately recognize it as an anxiety problem. Some waited for their child to "grow out of it," never expecting their child to become even more debilitated over time. Parents of anxious children and teens are often confused about what to do, as well as frustrated, and overwhelmed.

The good news: Anxiety can be successfully managed!

Parents play an essential role in helping their child or teen manage anxiety. When coping skills and brave behavior is rewarded and role-modeled in the home, children and teens can learn to face their fears, take risks, and ultimately gain confidence.

Helpful Hint: As a parent, remember that you are the most influential person in your child's life. See Helpful Tips for Parents and Healthy Habits for the Home for important ways in which you can begin to help your anxious child or teen.

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What you (and your child!) need to know about anxiety

Anxiety is normal. Everyone experiences anxiety at some point in time. For example, it is normal to feel anxious before a big event in your life, prior to an exam, or even before exciting events we choose to do for fun like riding a rollercoaster.

Anxiety is not dangerous. Although anxiety feels uncomfortable, it is temporary, and will eventually decrease.

Anxiety is adaptive. Anxiety helps us prepare for real danger, such as crossing a busy street. It can also help us perform at our best, and motivate us to study for an exam or practice for a big game. When we experience anxiety, it triggers our "fight-flight-freeze" response, and prepares our body to react. For instance, our heart beats faster so blood can get to our muscles and we have the energy to run away or fight off danger. Without anxiety, we would not survive.

Anxiety becomes a problem when our body reacts in the absence of real danger.

For more information on how to explain anxiety to your child, see How to talk to your Child about Anxiety.

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The ABCs of anxiety

Children, teens, and adults experience anxiety in three ways:

• Physically—what we feel in our body

• Mentally—what goes through our mind like worrisome thoughts

• Behaviorally—what we do or our actions, such as avoid or seek-reassurance

The pattern of these experiences varies from person to person, and from situation to situation.

Anxiety is felt in the body. Often, when young children feel anxious, they do not actually recognize or describe it as anxiety or nervousness. Instead, they may say that they feel sick, or have a sore tummy. Teens may complain of headaches, chest pains, or other feelings of tightness or discomfort.

People can experience anxiety in their body in many ways:

• Rapid heart rate

• Rapid breathing, feelings of shortness of breath, or breath holding

• Discomfort or pain in the stomach, nausea

• Feeling very hot or cold

• Sweating

• Trembling or shaking

• Numbness or tingling

• Headaches

• Chest pain or discomfort

• Dizzy, lightheaded, or unsteady feelings

• Feelings of a lump in the throat or choking

• Feeling things are unreal or feeling detached from oneself

If many of these physical signs happen suddenly and intensely, your child may be having a panic attack. Panic attacks are uncomfortable and scary but not dangerous.

Anxious children and teens worry! These worries can be about a current situation or about some future event. Young children may not be able to identify any anxious thoughts even when they are very anxious. This also sometimes happens for older children and adults. Here are some examples of anxious thoughts(notice how many of them begin with “What if….?”.

• That dog might bite me!

• What if I fall off my bike and hurt myself?

• What if my parent forgets to pick me up at school?

• What if the other kids don't like me or laugh at me?

• What if I fail my spelling test or go completely blank?

• What if I throw up at school?

• What if someone breaks into our house tonight?

• What if my parent gets into a car accident and dies?

Anxious children and teens avoid! One of the most common behaviors seen as part of an anxiety situation is avoidance. In a situation of real threat (e.g., an aggressive looking dog), avoidance is very helpful, as the fight-flight-freeze response keeps us safe from danger. In other situations where there is no real danger, avoidance prevents children and adults from learning to cope with a challenging situation. Some examples of avoidance behaviour include:

• Not wanting to eat in the school cafeteria

• Resisting going to swimming lessons due to the fear of putting ones face underwater

• Delaying drop-off at preschool or school because a parent is not there

• Not wanting to raise a hand in class or read out loud

• Not wanting to sleep alone at night (co-sleeping)

Key Point: Avoidance is a habit-forming, ineffective way of coping in the long run. With your patience and consistency, your child can begin to practice coping skills and will learn to face their fears!

Anxious children and teens seek reassurance! It is normal and helpful for children and adults to ask for information, in order to better understand the degree of risk or threat in an unfamiliar situation. Excessive reassurance is when you’ve already answered a child’s questions but they continue to ask for more, with it never seeming like enough information. For example:

• "Are you sure you will be on time to pick me up?"

• "Are you sure there won't be a bad storm tonight?"

• "Can you promise me I won't get sick?"

• "How do you know the kids will like me?"

Anxious children and teens engage in inappropriate safety behavior! Safety behaviors are things we do to make ourselves feel less anxious. Examples of safety behaviours in children or teens include:

• Not attending an activity unless a parent or trusted friend/individual is there.

• Not wanting to be away from home unless they have a cell phone to call or text parents with.

• Not going out unless they have a complete change of clothes with them, in case they are sick.

Safety behaviors are normal to see in young children but can become problematic if your child can’t function without them or becomes dependent on them.

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When does anxiety become a problem?

Anxiety is a normal emotion that is essential for survival—we are born with it. Specialists in child development have also noticed that certain fears are more common at certain ages. For example, it is normal for young children to experience some anxiety around strangers, and for older children and teens to experience some performance anxiety in front of peers.

For some, difficulty with anxiety starts to cause considerable distress or interference in everyday life. Common examples of distress are:

• Crying every day before going to school, because a parent does not stay

• Shaking or screaming if a child sees an insect or animal they find scary, like a bee or a large dog that comes close

• Having an upset stomach every time there is an important test at school or whenever they are asked to present in front of the class

Anxiety may also interfere with normal activities and with the enjoyment of life. Common examples of interference include:

• Refusal to attend school or go on school field trips

• Hesitation to join in play or refusal to play in groups

• Asking to stay home on the day of a school presentation

• Not wanting to participate in most unfamiliar activities

Most people consider anxiety to be a problem when it causes significant distress or interference for the child or the family.

Sometimes the behaviors of anxious children and teens can seem unreasonable to others. These children and teens may be labeled as "difficult", "stubborn" or "too sensitive" due to their persistent resistance and avoidant behaviors. While their actions can be frustrating for the entire family, it is important to remember that an anxious child who lashes out, cries, or avoids situations is often responding instinctually to a perceived threat. Like other animals, your child is reacting by either fighting (e.g. yelling, tantrums), fleeing (e.g. avoiding), and/or freezing (e.g. mind going blank).

Key Point: When encouraging your child to face his or her fears, remember that you are asking your child to fight against an instinctual response to danger!

Visit www.anxietycanada.com for information and community resources.

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