Also: Obsessive Compulsive Disorder (OCD)
We’re born worriers. Scientists believe that our brains have evolved a “negativity bias”, meaning we’re drawn to threats more than opportunities. We’re likely to detect negative information faster than positive information and generally have a background level of anxiety as our brain monitors the environment for possible threats. It’s in our genes. This negativity bias was helpful for our ancestors, as they lived in an extremely threatening environment. Some were prone to unnecessary worrying, and upon hearing a rustle in the bushes, might fear the worst and think something like, “Sabre-tooth tiger! Run!” As a result, they were more likely to survive and pass on their worry genes down to us (even though nine times out of 10 the noise was probably nothing more than a squirrel!). Then there were our other ancestors who didn’t worry as much, and assumed the rustling meant they’d found a squirrel for lunch. They might have got it right nine times out of 10, but the one time they got it wrong, they got it seriously wrong. So, they were less likely to pass their genes down to us than the worriers. Although the environment’s changed and we’re safer than ever before, our brains haven’t adapted and they’re still constantly on the lookout for threats and reasons to worry. Anxiety is the most common mental health problem facing children and adults in our country. As many as one in eight school children suffer from an anxiety disorder. Everyone experiences anxiety at one point or another; though it doesn’t feel good, anxiety is a response to a perceived threat that propels one to act by fleeing the threat or fighting it. In this way, anxiety is critical for survival.
Normal anxiety protects us from danger, is manageable, and limited to specific situations. With excessive anxiety, your child may be overestimating the threat of danger while underestimating her ability to deal with it. Physical symptoms of anxiety can include rapid heart-rate, muscle tension, difficulty sleeping and stomach aches. To avoid feeling anxious, your child may avoid situations that create anxiety, thus allowing her fear to control her. High anxiety is an exhausting mindset that takes a toll physically, emotionally, and mentally.
If your child is unable to control her worries, if her anxiety is out of proportion to situations, if it impairs her home, social or academic activities, if it causes physical discomfort, and has lasted one month or more, you may want to consult a psychotherapist for assessment and treatment. Many therapists utilize Cognitive Behavior Therapy (CBT) to treat anxiety. CBT focuses on the connection between thoughts, behaviors and feelings. Such treatment might teach your child how to think more realistically about her worries, to confront and not avoid anxiety provoking situations, and to use relaxation skills.
Psychotherapists can also help parents develop parenting strategies that help children develop a sense of control over their worries. Carol H. Sampson, LCSW, recommends the following Parenting Tips for Anxious Children and Teens:
- Children easily pick up subtle verbal and non-verbal clues and mirror the behavior of their parents. Think about how you respond when overwhelmed and afraid. Are you calm and confident in the face of adversity and fear or do you loose your temper and get upset? Consider what your reactions are teaching your child.
- Do you quickly rush to fix problems when your child is anxious or upset? If so, you may prevent her from learning how to tolerate difficult feelings. You may also be communicating that you don’t feel she is capable of solving problems on her own. Instead, help your child become competent and resilient by seeking her ideas on how to fix the problem.
- How do you respond when your child wants to take a healthy risk? Are you enthusiastic or hesitant? If you are tentative, your child is apt to pick up your ambivalence and fear.
- Do you constantly check with your child to see if she is okay? Are you imposing your fears on her? This may actually give your child reason to feel worried.
- Are you overly protective? Do you encourage your child to avoid anxiety provoking situations? When you give your child permission to avoid difficult situations, you are inadvertently reinforcing her worries and preventing her from acquiring the coping skills needed to face her fears.
- Do you provide your child with excessive reassurances? If so, you may strengthen her worries while making her more dependent on you. Instead, encourage self-reliance by teaching your child how to assist herself.
Instead of increasing your child’s worries, provide her with the tools she needs to face her fears. Here are a few suggestions:
- Communicate a message that indicates you understand she may be afraid, but you are confident in her ability to handle the situation. Highlight past successes. Anticipate situations in which your child may be anxious and brainstorm possible solutions together before a crisis develops.
- Teach your child to self-soothe when overly anxious or distressed. Encourage her to go to a calming place or pursue activities that can help her relax such as listening to music, deep breathing, or exercise.
- Help your child talk back to her fears. Help her understand exactly what shi is worried about and why. Ask her what are the chances it will happen? What else could happen? So what if it happens?
- Prevent stress by making sure she has down-time and opportunities to relax.
Jonathan Dalton, PhD Clinical Psychologist Director, Center for Anxiety and Behavioral Change- AMAZING presentation“Parenting a Child with Anxiety: What to Know and How to Help.” Well worth the watch..
25 Books to Help Kids Overcome Anxiety, Worry and Fear
9 Things Every Parent of an Anxious Child Should Try
Helping Your Child with Anxiety by Laura Markham of AHAparenting
49 Phrases to Calm an Anxious Child
Anxiety in Children: A Metaphor to put you in Their Shoes
When Anxiety Doesn’t Look Like Anxiety- How to Recognize and Manage Behavior when Anxiety is the Fuel
Anxiety in Children: A Metaphor to Put You In Their Shoes (and right beside them)
Anxiety in Kids and Teens: Why Anxiety Triggers Often Don’t Make Sense- And How to Turn Avoidance into Brave Behaviour
25 Books to Help Kids Overcome Anxiety, Worry and Fear
*Treating Childhood and Adolescent Anxiety: A Guide for Caregivers, by Eli R. Lebowitz, Haim Omer
*Freeing Your Child From Anxiety, by Tamar Chansky, Ph.D.
Helping Your Child WIth Selective Mutism: Steps to Overcome a Fear of Speaking, by AE McHolm, CE Cunningham, MK Cobham
Helping Your Anxious Child: A Step-by-Step Guide for Parents, by RM Rapee, A Wignall, SH Spence & V Cobham
*What to Do When You Worry Too Much, by Dawn Huebner, Ph.D. (an interactive self-help workbook for school-age children)
What to Do When Your Brain Gets Stuck, by Dawn Huebner, Ph.D (an interactive self-help book on OCD for school-age children)
More great books and articles on anxiety/OCD/phobias are on Dr. Huebner’s website:
What to Do When You Dread Your Bed
What to Do When Bad Habits Take Hold
What to Do When Your Temper Flares
What to Do When You Grumble Too Much
My Anxious Mind: A Teen’s Guide to Managing Anxiety and Panic, by MA Tomkins & KA Martinez
Anxious Kids, Anxious Parents, by Lynn Lyons
The set of 4 books below by Daniel J. Siegel, MD & Tina Payne Bryson, Ph.D. is based on a “whole brain” approach to children (teaching them to how to connect their immature, instinctual “lower brain” with the mature, logical, reasonable “upper brain”.) One of our favorite sets of parenting books:
Visit Magination Press (http://www.maginationpress.com/) for a wide variety of topic specific books recommended by the American Psychological Association.
This Go Zen Anxiety phrasebook has 72 short phrases/concepts to help your child deal with anxious thoughts- well worth the read.
American Academy of Child and Adolescent Psychiatry Guide to Medication for Anxiety.
Lurie Childrens Hospital resources for parents on OCD, separation anxiety, generalized anxiety and social anxiety:
Hey Sigmund– Australian based website with psychology research/science based advice on handling anxiety in all ages.
Check out Kidlutions: Solutions for Kids article on coping resources for anxious children: Worry Warriors: Crafty Ways to Help Kids Cope with Anxiety
WorryWiseKids website offering comprehensive, user-friendly information on the full range of anxiety disorders: how to identify symptoms, find effective treatments and prevent anxiety from taking over a child’s life.
Go Zen Web site offers animated short films on anxiety relieving techniques for kids.
Go Zen also has these two lists of techniques and phrases to help calm anxious children:
HelpGuide.org- guidance on anxiety medication and types of therapy for anxiety
youth.anxietybc.com Website with easy to understand, youth-aimed information on anxiety- causes, symptoms and treatment
https://www.anxietycanada.com Anxiety Canada™ is a leader in developing online, self-help, and evidence-based resources on anxiety and anxiety disorders and promotes understanding about anxiety and anxiety disorders through general information sessions, professional seminars and workshops, offered throughout the year. We are the developers of the free MindShift app which helps youth and young adults manage anxiety, using step-by-step strategies based on psychological treatment.
NOCD online therapy for OCD- online licensed therapists specializing in Exposure and Response Prevention (ERP)
Mindfulness and Meditation
MINDFULNESS Child psychology has directed a lot of focus on this concept in the last decade. Mindfullness is “mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations.” Teaching a child how to recognize and process their emotions is a powerful and lifelong skill.
Two really helpful mindfullness projects are: The Glitter Jar and The Calm Down Corner.
A Glitter Jar is a jar filled with water, dish soap and glitter- when shaken, the chaos is a good visual represtation of how your child’s brain is feeling during a tantrum/breakdown- having them watch the glitter settle is both calming and representative of their brain quieting as well.
In a Calm Down Corner you are designating a space where children who are having trouble regulating their emotions can go and use a variety of techniques to calm down their brains instead of acting out inappropriately. The location should be relatively small and cozy, with visuals that can help your child identify what emotion they are working through, and suggestions as to how to handle the emotion. You can have music, some pillows to punch, manipulatives to play with, signs of breathing exercises or the aforementioned glitter jar.
Movement can be another powerful way of settling a child- GoNoodle is an movement/mindfulness app that is especially useful for children w restless energy, or those who need to physically work out their emotions.
Mindfulness and Meditation Apps/Books
These resources help us learn to “turn down the worry” in our brains.
Enchanted meditations for Children 1 and 2 (young children)
The Smiling Mind (programs for children 7 – 11, 12 – 15 and for young adults
Calm (pre-teen – adult; go to guided meditations on the app)
Breathe (pre-teen through adult)
Mood meter (self-identifies feelings and teaching feeling vocabulary, offers suggestions on self calming and keeps a log)
Aura (3 minute meditations)
Insight Timer (>4,000 guided meditations from 1,000 teachers)
Mindfulness recordings from OSU: htttp://go.osu.edu/mindfulness
Sattva (includes social connections)
Simply Being (customizable length)
Stop, Breath & Think Good for kids ages 5-10, learn how to tune into feelings and choose a mission to create a force field of calm. https://www.stopbreathethink.com
Recommended Children’s Books
Breathe Like a Bear, by Kira Willey
My Magic Breath, by Nick Ortner
Angry Ninja Anxious Ninja series, by Mary Nhin
Master of Mindfulness, by Laurie Grossman
Sitting Still Like a Frog. by Eline Snel
Good Morning Yoga and Good Night Yoga, by Mariam Gates
Moody Cow Meditates, Kerry Lee MacLean
Yoga4Classrooms, by Lisa Flynn
5 Senses Mindfulness Strategy:
- 5 – acknowledge 5 things you see around you
- 4 – acknowledge 4 things/objects you can touch/feel around you
- 3 – things you can hear
- 2 – things you can smell
- 1 – thing you can “taste” (perhaps gum, perhaps recalling recent drink or food)
Calm Strips are convenient reusable sensory stickers that you can stick to your phone, laptop, desk.. almost anywhere. Touch, scratch, or trace the textured surface to regulate restless energy, increase focus, and remind yourself to just breathe.
9 Things Every Parent with an Anxious Child Should Try
As all the kids line up to go to school, your son, Timmy, turns to you and says, “I don’t want to take the bus. My stomach hurts. Please don’t make me go.” You cringe and think, Here we go again. What should be a simple morning routine explodes into a daunting challenge.
You look at Timmy and see genuine terror. You want to comfort him. You want to ease the excessive worry that’s become part and parcel of his everyday life. First, you try logic. “Timmy, we walk an extra four blocks to catch this bus because this driver has an accident-free driving record!” He doesn’t budge.
You provide reassurance. “I promise you’ll be OK. Timmy, look at me… you trust me, right?” Timmy nods. A few seconds later he whispers, “Please don’t make me go.”
You resort to anger: “Timothy Christopher, you will get on this bus RIGHT NOW, or there will be serious consequences. No iPad for one week!” He looks at you as if you’re making him walk the plank. He climbs onto the bus, defeated. You feel terrible.
If any of this sounds familiar, know you are not alone. Most parents would move mountains to ease their child’s pain. Parents of kids with anxiety would move planets and stars as well. It hurts to watch your child worry over situations that, frankly, don’t seem that scary. Here’s the thing: To your child’s mind, these situations are genuinely threatening. And even perceived threats can create a real nervous system response. We call this response anxiety and I know it well.
I’d spent the better part of my childhood covering up a persistent, overwhelming feeling of worry until, finally, in my early twenties, I decided to seek out a solution. What I’ve learned over the last two decades is that many people suffer from debilitating worry. In fact, 40 million American adults, as well as 1 in 8 children, suffer from anxiety. Many kids miss school, social activities and a good night’s rest just from the worried thoughts in their head. Many parents suffer from frustration and a feeling of helplessness when they witness their child in this state day in, day out.
What I also learned is that while there is no one-size-fits-all solution for anxiety, there are a plethora of great research-based techniques that can help manage it — many of which are simple to learn. WAIT! Why didn’t my parents know about this? Why didn’t I know about it? Why don’t they teach these skills in school?
I wish I could go back in time and teach the younger version of myself how to cope, but of course, that’s not possible. What is possible is to try to reach as many kids and parents as possible with these coping skills. What is possible is to teach kids how to go beyond just surviving to really finding meaning, purpose and happiness in their lives. To this end, I created an anxiety relief program for kids called GoZen! Here are 9 ideas straight from that program that parents of anxious children can try right away:
1. Stop Reassuring Your Child
Your child worries. You know there is nothing to worry about, so you say, “Trust me. There’s nothing to worry about.” Done and done, right? We all wish it were that simple. Why does your reassurance fall on deaf ears? It’s actually not the ears causing the issue. Your anxious child desperately wants to listen to you, but the brain won’t let it happen. During periods of anxiety, there is a rapid dump of chemicals and mental transitions executed in your body for survival. One by-product is that the prefrontal cortex — or more logical part of the brain — gets put on hold while the more automated emotional brain takes over. In other words, it is really hard for your child to think clearly, use logic or even remember how to complete basic tasks. What should you do instead of trying to rationalize the worry away? Try something I call the FEEL method:
- Freeze: pause and take some deep breaths with your child. Deep breathing can help reverse the nervous system response.
- Empathize: anxiety is scary. Your child wants to know that you get it.
- Evaluate: once your child is calm, it’s time to figure out possible solutions.
- Let Go: Let go of your guilt; you are an amazing parent giving your child the tools to manage their worry.
2. Highlight Why Worrying is Good
Remember, anxiety is tough enough without a child believing that Something is wrong with me. Many kids even develop anxiety about having anxiety. Teach your kids that worrying does, in fact, have a purpose.
When our ancestors were hunting and gathering food there was danger in the environment, and being worried helped them avoid attacks from the saber-toothed cat lurking in the bush. In modern times, we don’t have a need to run from predators, but we are left with an evolutionary imprint that protects us: worry.
Worry is a protection mechanism. Worry rings an alarm in our system and helps us survive danger. Teach your kids that worry is perfectly normal, it can help protect us, and everyone experiences it from time to time. Sometimes our system sets off false alarms, but this type of worry (anxiety) can be put in check with some simple techniques.
3. Bring Your Child’s Worry to Life
As you probably know, ignoring anxiety doesn’t help. But bringing worry to life and talking about it like a real person can. Create a worry character for your child. In GoZen we created Widdle the Worrier. Widdle personifies anxiety. Widdle lives in the old brain that is responsible for protecting us when we’re in danger. Of course, sometimes Widdle gets a little out of control and when that happens, we have to talk some sense into Widdle. You can use this same idea with a stuffed animal or even role-playing at home.
Personifying worry or creating a character has multiple benefits. It can help demystify this scary physical response children experience when they worry. It can reactivate the logical brain, and it’s a tool your children can use on their own at any time.
4. Teach Your Child to Be a Thought Detective
Remember, worry is the brain’s way of protecting us from danger. To make sure we’re really paying attention, the mind often exaggerates the object of the worry (e.g., mistaking a stick for a snake). You may have heard that teaching your children to think more positively could calm their worries. But the best remedy for distorted thinking is not positive thinking; it’s accurate thinking. Try a method we call the 3Cs:
- Catch your thoughts: Imagine every thought you have floats above your head in a bubble (like what you see in comic strips). Now, catch one of the worried thoughts like “No one at school likes me.”
- Collect evidence: Next, collect evidence to support or negate this thought. Teach your child not to make judgments about what to worry about based only on feelings. Feelings are not facts. (Supporting evidence: “I had a hard time finding someone to sit with at lunch yesterday.” Negating evidence: “Sherry and I do homework together–she’s a friend of mine.”)
- Challenge your thoughts: The best (and most entertaining) way to do this is to teach your children to have a debate within themselves.
5. Allow Them to Worry
As you know, telling your children not to worry won’t prevent them from doing so. If your children could simply shove their feelings away, they would. But allowing your children to worry openly, in limited doses, can be helpful. Create a daily ritual called “Worry Time” that lasts 10 to 15 minutes. During this ritual encourage your children to release all their worries in writing. You can make the activity fun by decorating a worry box. During worry time there are no rules on what constitutes a valid worry; anything goes. When the time is up, close the box and say good-bye to the worries for the day.
6. Help Them Go from What If to What Is
You may not know this, but humans are capable of time travel. In fact, mentally we spend a lot of time in the future. For someone experiencing anxiety, this type of mental time travel can exacerbate the worry. A typical time traveler asks what-if questions: “What if I can’t open my locker and I miss class?” “What if Suzy doesn’t talk to me today?”
Research shows that coming back to the present can help alleviate this tendency. One effective method of doing this is to practice mindfulness exercises. Mindfulness brings a child from what if to what is. To do this, help your child simply focus on their breath for a few minutes.
7. Avoid Avoiding Everything that Causes Anxiety
Do your children want to avoid social events, dogs, school, planes or basically any situation that causes anxiety? As a parent, do you help them do so? Of course! This is natural. The flight part of the flight-fight-freeze response urges your children to escape the threatening situation. Unfortunately, in the long run, avoidance makes anxiety worse.
So what’s the alternative? Try a method we call laddering. Kids who are able to manage their worry break it down into manageable chunks. Laddering uses this chunking concept and gradual exposure to reach a goal.
Let’s say your child is afraid of sitting on the swings in the park. Instead of avoiding this activity, create mini-goals to get closer to the bigger goal (e.g., go to the edge of the park, then walk into the park, go to the swings, and, finally, get on a swing). You can use each step until the exposure becomes too easy; that’s when you know it’s time to move to the next rung on the ladder.
8. Help Them Work Through a Checklist
What do trained pilots do when they face an emergency? They don’t wing it (no pun intended!); they refer to their emergency checklists. Even with years of training, every pilot works through a checklist because, when in danger, sometimes it’s hard to think clearly.
When kids face anxiety they feel the same way. Why not create a checklist so they have a step-by-step method to calm down? What do you want them to do when they first feel anxiety coming on? If breathing helps them, then the first step is to pause and breathe. Next, they can evaluate the situation. In the end, you can create a hard copy checklist for your child to refer to when they feel anxious.
9. Practice Self-Compassion
Watching your child suffer from anxiety can be painful, frustrating, and confusing. There is not one parent that hasn’t wondered at one time or another if they are the cause of their child’s anxiety. Here’s the thing, research shows that anxiety is often the result of multiple factors (i.e., genes, brain physiology, temperament, environmental factors, past traumatic events, etc.). Please keep in mind, you did not cause your child’s anxiety, but you can help them overcome it.
Toward the goal of a healthier life for the whole family, practice self-compassion. Remember, you’re not alone, and you’re not to blame. It’s time to let go of debilitating self-criticism and forgive yourself. Love yourself. You are your child’s champion.