Anxiety is normal and everyone experiences anxiety at some point in time. Anxiety helps us to prepare for real danger (a bear in the woods) or performing at our best (a job interview or public speaking). Anxiety is the tense emotional state we experience when we cannot predict the outcome of a situation. When we experience anxiety, it triggers our ‘fight, flight or freeze’ response and gets our body ready to defend itself. Without it we would not survive.
Anxiety in Children and Teens
For children, the focus of anxiety changes as they develop. Infants and toddlers might be afraid of loud noises, strangers, separation and anything sudden or intense. From ages two to four, children may also start to have fears about animals, the bath, monsters and other imaginary creatures. Around ages four to six, children develop anxieties about the bigger world, for example, thunderstorms, doctors and dentists. At this age, children have difficult distinguishing between reality and fantasy, which may also add to anxiety. They may be afraid of monsters, burglars and other bad guys. For ages six to eleven their worries may include things related to school: being on time, doing work perfectly, performance and being teased or bullied. Teens may be worried about social scrutiny, safety and success in the future. The concern arises when children exaggerate the risks and underestimate their ability to cope with a given situation.
Anxiety affects our bodies, thoughts and behaviors. There are three parts to anxiety: physical symptoms (how our body responds), thoughts (what we say to ourselves), and behaviors (what we do):
- Thoughts: what if I forget what I want to say during the presentation
- Behaviors: find an excuse to get out of it
- Physical symptoms: stomachache, headache, heart racing
In children, anxiety can appear in different forms. Some children appear visibly stressed while others keep their anxiety internal and worry silently. Other kids may be angry or frustrated by their limitations. Children can display a wide variety and high number of anxiety symptoms without ever developing a disorder. It is diagnosed as a disorder if the anxiety is excessive, disruptive to normal functioning, the child is unhappy and burdened, and the duration is at least one month.
Anxiety disorder prevalence ranges from 5.7 to 17 percent of all children. Rates of anxiety disorders tend to increase slightly with age. There are several risk factors that may contribute to the development of anxiety disorders in children. These include: genetics, temperament, parenting style and environmental factors including traumatic events. Children of anxious parents are seven times more likely to develop an anxiety disorder than children of non-anxious parents. While genetics are significant (explain 30 -40 percent of all transmission), the majority of children with anxious parents do not develop an anxiety disorder.
Some of the anxiety disorders we observe children experiencing include:
- Separation Anxiety (most common in 7-9 year olds)
- Phobias: dogs, cats, snakes, storms, water, heights, blood, bridge, flying, vomit, choking, costumed characters, school and fire drills
- Social Anxiety/Excessive Shyness
- Generalized Anxiety
Strategies for Parents
Reacting and responding appropriately and in a helpful way to a child’s anxiety can be quite challenging for parents and caregivers. Some parents are able to find an approach that helps the child to overcome the anxiety, however, many find that intuitive parenting techniques don’t work and may even escalate the anxiety. As parents/caregivers try different approaches, they often wind up tired, frustrated and unsuccessful. Out of caring and concern, parents of anxious children are more likely than parents of non-anxious children to be more protective and closely involved with their child. Parents often discover that avoidance of the problems is the least aversive approach for their child. Although this might work in the short run, it does not help the child to break the cycle of anxiety.
Every child who experiences debilitating anxiety wants to fight back and be free of it. Typically, they do not just “grow out of it.” Parents can offer empathy and specific strategies (see resources below). If these interventions are not sufficient, the treatment of choice, which has been scientifically proven to help with anxiety, is cognitive-behavioral therapy (CBT). CBT is a practical, logical and effective strategy to manage anxiety and has been used successfully with children and adults. With CBT, people with anxiety learn a new way of reacting ad responding to anxiety. It is a short-term intervention with long-term results.
Childhood should be a happy time, yet more and more children are suffering from anxiety. Fortunately there are many successful interventions. If this is a concern for you, we encourage you to check out the resources below or contact your school counselor.