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Anxiety in Children

By Claire Marsh 4 min read

Anxiety disorders in children have grown to become the second highest mental health issue they face. How can parents recognise if their children have anxiety and what can they do about it?

Anxiety disorders are caused by a number of different factors, including family history (a genetic predisposition), environmental factors such as ongoing stressful situations, brain chemistry, personality factors, medical problems (for example, anaphylaxis creating fear around certain triggers) or a combination of these.

The growing prevalence of anxiety in children is likely a result of a faster pace of life. With globalisation and the internet, young people receive a greater amount of information about what is happening in the world, which can cause worry. Research has shown the more time we spend on the screen, the more anxious and isolated we feel. In general, children are spending more time on screens and not being exposed to as many new and different situations that require them to adapt and develop new skills.

It is common for children to have fears as they are developing and learning about dangers and threats. However, younger children often don’t have the words to let you know how they are feeling, so we have to be attuned to them and know what is normal for our own child.

Signs your child may be suffering from anxiety

Physical signs

  • Stomachaches
  • Changes in toileting habits

  • Changes in appetite

  • Difficulty sleeping

  • Appearing restless and sweaty

Behavioural signs

  • Displaying avoidance of certain situations

  • Seeking reassurance from a parent frequently

  • Refusing to do things or being irritable when asked as a way of avoidance

  • Getting easily upset over seemingly small matters or things they should be able to do

  • Not wanting to try new things, trying to get a parent to do something for them

There are two typical reactions parents have when faced with an anxious child:

Authoritarian

High in expectations and strict rules, low in warmth.

Interpret anxious behaviour as being naughty or defiant and respond with discipline.

Will not alleviate a child’s anxiety.

Permissive

Lack of limits and rules.

Step in to make the situation easier for the child by doing the task or solving the problem for them.

Can be enabling the child in their avoidance by not requiring them to go to certain places or do certain tasks because it’s distressing for them, and for the parent to see their child in a fearful state. Constantly shielding and removing obstacles for a child means they don’t get the chance to learn they are capable of coping in that situation, that perhaps the danger isn’t real but perceived or have positive experiences in that situation that will help them to feel less fearful about it in the future.

Anxiety is not something a child will necessarily just “grow out of”. Early intervention is the key and there are some practical ways parents can respond to their child’s anxiety:

Help them calm down

If you believe their reaction is indeed anxiety, some simple relaxed breathing can help them to calm down. Guide your child to breathe in slowly and deeply for three seconds, hold for three seconds, then exhale for three seconds. Repeat as necessary. Talking with them will have a greater impact when they are calmer because they are able to think and reason. While they are anxious, they are not likely to process your words, but your calm tone of voice could be calming for them.

Clear limit-setting

Anxious children respond very well to this as without it, their worry can be consuming their thoughts throughout the day. Create a space and time for your child to let their worries out, for example a “worry box” where they spend 10–15 minutes per day during their “worry time” writing or drawing what worries their mind got stuck on during the day. When the time is up, the box gets closed and put away. This gives a child reassurance and validation that their thoughts matter, but that they don’t have to listen to what their fearful mind is telling them all the time.

Build their confidence gradually

Expose them to their fear triggers in little steps. For example, if your child is afraid of the water or swimming, don’t avoid taking them to the pool, but maybe start out by having them sit and watch other children swimming, slowly building up to putting their feet in the shallow end and eventually more of their body in the water (with your support) until they can be in there on their own. This might happen over a number of weeks or even longer, so be patient.

Make plans for the future

What could they do if things don’t go according to plan? Create time and space to talk about their fears. Children may have very real fears about what’s happening in their lives and the world, for example, the death of a pet or loved one, natural disasters or car crashes. It’s important we don’t sugar-coat our explanations to minimise these fears but to validate them and explain them in a very realistic and factual way. This will help children to understand and cope better.

Challenge the “what if” thoughts

Help them counter a negative and unhelpful thought that will trigger anxiety with a thought that is equally as likely and more helpful in building courage. For example, “What if I go to school and no-one talks to me?” could become “What if I go to school today and have fun with my friends?”. The reality is we don’t know and can’t predict what will really happen.

Model

Voice your own fears and anxiety. For example, “I’m doing a presentation at work today and I’m feeling kind of scared. I’m worried I might mess it up, but I know I have prepared for it and I will give it my best shot.”

Talk to a health professional

Start with your GP who can refer you to psychology services such as counselling. Having individual attention from a trained professional with experience in evidence-based strategies can be hugely beneficial and can fast-track your child’s progress.

The idea is not to try to get rid of anxiety altogether, but to help our children gain skills to manage difficult emotions so they can lead fulfilling and functional lives.


For more resources, the Brave Program is available free and can be done at home with your child or teenager.

Claire Marsh is a registered psychologist at Sanctuary Lifestyle Clinic and the manager of Adventist Counselling Services. She is a trained facilitator of the Cool Kids anxiety program designed to help young people between the ages of seven and 17.


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