Mental Health

 

Author: Anxiety Canada

 

On this page: Helpful hints Educating your child on anxiety Helpful tips for parents Healthy habits for the home

You can help your child or teen learn techniques to manage their anxiety. Although it is often advisable to seek professional help, especially in more persistent cases, help is not always readily available (perhaps due to cost, long waitlists, or other reasons). Even if you do decide to seek outside help in managing your child's anxiety, you can still play a key role in helping your child.

Specific strategies aim to help children cope with different anxieties and fears, but some general strategies can help any child experiencing anxiety problems.

Helpful hints

Listen! Make sure you take the time to listen to your child's thoughts and feelings. Simply feeling heard can be very helpful to your child. Consider using any of the following suggestions:

• "Can you tell me more about what is making you feel scared?"

• "That does sound scary! Help me understand your worries a little more—tell me what you think about when you feel that way?"

Normalize and Educate! It is important to let your child know that he or she is not alone. Lots of children have problems with anxiety—in fact, we all do. Don't be afraid to talk to children about what you're anxious about and remind them that, in most cases, anxiety is a temporary feeling that is there to help us, not hurt us.

Model it! Model facing fears and provide support and encouragement. Motivate your child through supportive coaching. Let your child know about something that makes you worried and how you cope with it. For example:

"When I drive in the rain, I get nervous, but I calm down and tell myself I can pay extra attention, slow down, and be extra careful."

"I worry about what others think of me, but then I remember that most people have this worry and they might even be worried about what I think of them!"

Avoid giving excessive reassurance! Resist the urge to give excessive reassurance—for example, telling your child, "I promise you’re going to be okay," when you're never actually 100% certain this is the truth. Instead, encourage your child to use their coping strategies (for example, calm breathing or challenging scary thoughts). Or, better yet, encourage them to answer their own questions. For example:

"What do YOU think will happen when we arrive at the party?"

"Can you tell me some different ways of thinking about the same situation?"

Praise! Don't forget to praise your child for their efforts! Remember, facing fears is not easy, so be sure your child knows that you've noticed them being brave and let them know you're proud of them.

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Educating your child on anxiety

Step One: Learning about anxiety

This is a very important first step, as it helps children and teens understand what is happening to them when they experience anxiety. The more we learn about what we’re facing, the less scary it becomes.

What they need to know about anxiety:

Anxiety is normal. Everyone experiences anxiety—we all know what it feels like and for most people, we feel at least some anxiety daily. For example, it is normal to feel some anxiety when meeting someone new for the first time, going somewhere you've never been, or before an exam at school.

Anxiety is often adaptive, as it helps us prepare for real danger (such as looking both ways before crossing a busy street) or performing at our best (for example, helps us get ready for a test or big game). When we experience anxiety, it triggers our "fight-flight-freeze" response and gets our body ready to defend itself (for instance, our heart beats faster to pump blood to our muscles so that we have the energy to run away or fight off danger). Without anxiety, we would not survive. Anxiety can become a problem when our body reacts in the absence of real danger. It can be helpful to think of anxiety as a smoke alarm. We don't want to take the batteries out of the alarm in case there is a real fire, but we do want to fix the alarm so that it doesn't go off every time we make toast.

For more information see the Talk to Your Child about Anxiety module.

Step Two: Learning to relax

The second step involves helping your child or teen learn to relax. Two strategies can be particularly helpful: calm breathing and muscle relaxation.

1. Calm Breathing: This is a strategy that your child or teen can use to calm down quickly. This strategy is best used when your child is showing a lot of physical signs of anxiety (rapid breathing, crying, difficult to console). You can explain to your child that we tend to breathe faster when we are anxious. This can make us feel dizzy and lightheaded, which can make us even more anxious. Calm breathing involves taking slow deep breaths. Encourage your child to breathe in through the nose, pause, and then breathe out through the mouth, pausing several seconds before taking another breath. For younger children, a visual image or example can help. Have them imagine that they are blowing huge bubbles that slowly rise and float away, or that they’re slowly filling their belly with air like a balloon or beach ball. Make sure your child's breathing is slow and consistent.

For more information see the How to Teach Your Child Calm Breathing module.

2. Muscle Relaxation: Another helpful strategy is to help your child or teen learn to relax their body. This involves having your child tense various muscles and then relax them. This strategy is most helpful when used early, when you first notice your child getting tense or “worked up” about something. You can also have your child use "the flop," which involves having your child imagine that he or she is a rag doll and relax the whole body at once.

For a detailed description of muscle relaxation see the How to do Progressive Muscle Relaxation module.

Step Three: Challenging scary thoughts

The next step is specifically targeted at older children or teens. When we are anxious, we tend to see the world as threatening and dangerous. However, this way of thinking can be overly negative and unrealistic. One strategy for helping your child manage anxiety is to help them replace "anxious" or "worried" thinking with realistic thinking. This involves learning to see things in a clear and balanced way, without being overly negative or focusing only on the "bad" possible outcomes. Realistic thinking strategies are aimed at older children or teens because some of these ideas can be difficult for younger children to understand. Remember that learning to think realistically can be difficult at any age, so give your child some time to learn and practice these skills. For more information on helping your child identify and challenge scary thoughts, see the Realistic Thinking for Teens or Healthy Thinking for Younger Children modules.

Note: Younger children may have a harder time identifying exactly what they fear; however, they can benefit from coming up with some coping statements that they can say to themselves to help them deal with feelings of fear or anxiety. For example, "Most dogs are friendly and don't bite," or "This is just Mr. Worry bossing me around; it's not real."

Step Four: Facing fears

The final step in helping your child manage anxiety involves helping your child face their fears. If your child has been avoiding certain situations or places due to fear, it will be important for them to start entering those situations or places. However, it can be easier for your child to start with something that is not as scary and work up to situations and places that cause a great deal of anxiety. Working with your child or teen, make a list of feared situations or places, such as going places alone, entering a crowded grocery store, or riding the bus. Once you have made a list, try to arrange them from the least scary to the most anxiety-provoking. Starting with the situations that cause the least anxiety (e.g., giving a presentation at home to parents), encourage your child to repeatedly enter or practice the situation and remain there until your child notices their anxiety start to come down. Once your child can enter that situation or engage in that activity without experiencing overwhelming anxiety, they can move on to the next thing on the list (e.g., giving a presentation to their close friends but while at home). In many cases, parents are unsure when to "move up a step" and try something harder. If your child appears bored with a step, shows no signs of physical anxiety, and can address their anxious thoughts with ease (e.g., "I worry about people laughing at me, but I've never seen this happen before") you should encourage them to try the next step in their fear ladder.

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Helpful tips for parents

Reduce stress! Excessive stress and tension in your home (for example, arguing, fighting, too many lessons/activities, etc.) can have a negative effect on your child. Look at ways to reduce stress. For instance, plan some fun time each day (even if it is only five minutes) to read a story, go for a walk, watch a favourite TV program or play a game together, or listen to music. Also, try to deal with conflict between family members when it arises (have family meetings to discuss problems). Parents also need to be careful not to express frustration or anger by arguing or raising voices around their children.

Make a routine! Establish a routine by setting specific times for meals, homework, quiet time, and bedtime. Helping your child establish a consistent bedtime routine can help reduce the time it takes to fall asleep each night and improve overall sleep quality and quantity.

Work together! If you are in a relationship, it is important that you and your partner work together to help your child manage their anxiety. If parents are not consistent, it can be very confusing for your child. Try to agree on ways of handling your child's anxiety (for example, both agree to limit giving reassurance or both follow through on setting limits, such as not having your child sleep in your room) and be consistent in terms of rewards or consequences for a child’s behaviour(s).

Give consequences! Although your child may have problems with anxiety, that does not give them the green light for inappropriate behaviour. It is important that you set expectations and limits for your child and follow through on consequences for inappropriate behaviour (such as losing screen time for being non-compliant or aggressive with others in the home). Discuss 'house rules' in advance with all family members at a calm time—common house rules may include "No physical aggression, no verbal aggression, and no lying," although other rules should be considered as well. Children are happier when they know the rules and what happens when they break them! Be sure to give rewards and praise when your child adheres to expectations.

Be supportive! Recognize that it is difficult for children to face their fears. It is important not to laugh at your child or minimize their fears (for example, "don't be silly," or "you're being stupid"). Rather, let your child know that it is normal to have fears ("We're all afraid of something”) and that it is possible to "boss back" your fears. When your child is upset, make sure to listen to them to send your child the message that it's okay to talk about feelings. Let your child know that they are understood, and help them figure out ways to cope with upsetting situations. For example, you could say "I know you feel scared to go to your friend's house by yourself, but you're working on getting comfortable being away from home. How can we tackle those worried thoughts you're having and make sure we’re facing our fears together?").

Encourage independence! Although it is tempting to want to do things for your child, especially when they tend to be nervous and fearful, it is better to let kids do things for themselves! How else will they learn the skills and abilities to cope with life? Encourage your child to try things on their own, take some risks, and do things for themselves. This can include giving him or her responsibilities around the house (cleaning own room or setting the table). It can also include helping your child brainstorm ways to deal with problems or difficult situations (such as how to handle an argument with a friend or make-up marks at school for missed assignments). Encouraging independence does not mean you can’t be supportive, but you shouldn’t take over or do everything for your child. Over time, this helps build confidence, independence, and the ability to tackle life's problems as children eventually become adults.

Avoid giving excessive reassurance! It can be hard not to give your child reassurance, especially when they are scared or anxious; however, giving constant or excessive reassurance prevents your child from learning how to cope on their own. Teach your child to answer their own questions. Model how you think through problems or challenges, which helps your child learn to do it for themselves. Ask them to come up with all the options they can think of to help solve the problem, then decide which options make the most sense to try.

Build self-confidence! It is important to praise your child for their accomplishments and for facing fears! Involve your child in activities that help them feel proud. Find activities that reinforce that they are good at something (sports, music, art, etc.) and that help instill a sense of belonging and connection with others (such as cadets, scouts or girl guides, school helper). You can also give your child responsibilities around the house and let them be in charge of something at home (for example, making sure the dog gets a long walk every day). Remember that confidence comes from doing things and not just from words or praise.

Realistic expectations! It is important to have expectations for your child and help them meet those expectations; however, understand that an anxious child will have some trouble doing things and may need to go at a slower pace. Help your child break down goals into smaller steps that they can accomplish. It is important that your child is taking steps forward, even if the steps are small. Try not to push too hard or too fast, and instead learn from your child’s cues, gently encouraging them to move forward when they seem ready for the next step but may need a little encouragement to take it.

Reactions! Although it is important to be understanding and caring, do not overreact or let anxiety trick you into thinking that something is too hard or impossible for your child (for example, thinking it’s too hard for your child to sleep alone). Keep things in perspective. Yes, it might be challenging, but it can be done! On the other hand, sometimes we have a hard time understanding our child’s anxiety or why something is so difficult for them. When we don’t acknowledge that our child is having a hard time with anxiety, the child may try to hide it (and suffer alone). Alternatively, the symptoms may worsen, creating more distress for everyone and making the anxiety harder to treat/resolve when the child eventually receives help.

Dealing with your reactions! It can be very difficult parenting or working with an anxious child. Make sure you manage your own reactions. Do some things for yourself (call a babysitter, run a hot bath, read a book when the kids go to bed, talk to a friend about how you’re feeling, go for a walk, or do whatever helps you keep a positive perspective). Remember the basics: eat well, get enough sleep, and exercise! Also, give yourself permission to take time off. You can't be helpful to your child if you don't take care of yourself. Occasionally check in with yourself or others to ensure you're not accidentally passing on your own fears to your children. Children look up to parents and learn from them—you are their 'blueprint' for the outside world. Whenever possible, try to present a neutral reaction to frightening situations and let your child know it's safe to explore things. If you do share or show your anxiety, be sure to follow up by talking about how you're also working on being brave and facing your fears. Be a role model!

Take risks! Anxious children need to try new things and take some risks to build confidence and develop the necessary skills for interacting with the world. Encourage your child to try some experiments, such as making a phone call, talking to an unfamiliar classmate, or asking a question to a store clerk. Remember, you can model brave behaviour by trying new things too!

Avoid avoidance! Anxious children tend to want to avoid things that cause them anxiety. Although avoiding things temporarily reduces distress, it also allows fears to grow and makes things more difficult in the future. Avoid letting your child avoid things whenever possible. Instead, encourage them to try things and take small steps toward facing fears! Help your child learn that anxiety is not the problem; avoidance is.

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Healthy habits for the home

Anxious children and teens prefer to have a sense of control in their lives. They do not cope well with a disorganized, "spontaneous" family style. They feel calmer when:

• life is predictable

• they know what is expected of them

• they know what the consequences will be

Two ways to help make life more predictable for everyone in the family are setting limits and creating routines.

Setting limits is a challenge for parents, especially when the anxious child or teen becomes upset, moody, or has a 'meltdown.' If limits are repeated and enforced, they help everyone feel more secure and, usually, a child or teen's behaviour will improve. It can be a relief to have adults in charge!

Routines also help to reduce anxiety. But anxiety tends to disrupt routines. You need to work hard to build family routines so that life is more predictable for your child. Help your child adjust to new family routines by preparing him or her in advance. Ask your child to help plan the new routine, and introduce it gradually. Work together to make a colourful and decorated schedule placed on the fridge or other family area to help provide a sense of control and predictability.

This includes bedtime routines! A bedtime routine involves doing the same things, in the same order, at the same time, just before going to bed. This ritual helps your child gradually relax and wind down. For both your child and the rest of the family, a routine that lasts anywhere from 30 to 60 minutes is best. Stimulating activities should start to wind down at least an hour or more before bed (e.g., turning computer games off).

Some activities you can include in a routine:

• small bedtime snack

• let your child choose what pajamas to wear

• read a story together (or on their own if preferred)

• with young children, you can tuck your young child in with a blanket, teddy bear or some other thing that makes them feel secure

For older children and teens, you may want to include:

• some one-on-one time to talk about the day

• listening to some relaxing music

• reading magazines together

• practicing some relaxation tools (e.g., progressive muscle relaxation)

It is important you do not get into the habit of permitting your anxious child to sleep in your bed. This becomes a habit which is hard to break. For more information on how to handle this situation, see Helping Your Child Sleep Alone or Away from Home.

Plan time for homework and projects. This needs to be a regular part of the schedule, as anxious children tend to put things off. Anxious children can easily become overwhelmed by a task. Thus, it can be helpful to:

• Break the task into small, manageable steps

• Set a specific time and place to work (not in bedroom

• Praise and rewards for each step completed

• Work on "feeling overwhelmed" with them (see below)

Often the hardest part is getting started, so ensure you’re following the "first this, then that" rule. For example, this could mean "first homework, then screen time" rather than the other way around. This can help motivate your child rather than getting into a conflict when you try to move them from a preferred activity to a non-preferred activity.

If your child is anxious about an upcoming event or project, you can adapt the Climbing My Fear Ladder form to break down the "goal" into manageable steps. Goals that work well with this activity are events that require preparation and/or performance (e.g., test, oral presentation, recital, job interview etc...).

Encourage physical activity. Whether your child is anxious or not, exercise can be beneficial in helping to reduce stress and induce relaxation. Anxious children can report feeling tired or fatigued due to exhausting themselves with worry, and then don’t feel like exercising; however, exercise can improve energy levels and at least temporarily reduce worry. Try to find something fun to do together rather than making this a chore. Ongoing participation in a physical activity program encourages self-discipline and leadership, as well as opportunities to socialize with peers. Get the whole family involved!

Talk to other parents. It's important that you not feel alone in your parenting of an anxious child. Talk with other friends, family members, or people at your child's school to see if they also struggle with parenting an anxious child. Be open to sharing your challenges and hearing theirs. Getting support from others (and providing support back) can be helpful to you as a parent for your own mental health.

Consider your own health. It's not uncommon to see anxiety run in families. Prior generations struggled even more with stigma around mental health than current generations and may have concealed their own mental health concerns with alcoholism or other substance abuse. If you or loved ones around you are concerned about your own anxiety or mental health, consider seeking help from a professional or access the adult mental health materials on Anxiety Canada's website for further help and support. Helping yourself can be a huge step in helping your child with their anxiety.

 

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