Anxiety in childhood
Just like adults, children occasionally experience anxiety and some children are anxious more frequently or more intensely than others. Most of the time this is an understandable reaction to current circumstances and will dissipate with little need for intervention. However, sometimes professional support may be helpful. Different fears are more typical at different ages in childhood:
Two to four-year olds frequently worry about: separation from caregivers, the dark, sleeping alone, loud noises and extreme weather.
Five to seven-year olds frequently worry about: the dark, ‘bad people’, tests and medical appointments, bugs and animals.
Eight to eleven-year olds frequently worry about: ‘bad people’, supernatural monsters, school failure, peer rejection and dying.
Twelve to eighteen-year olds frequently worry about: their safety, school failure, social situations, forming their identity, adulthood and global issues.
The symptoms of anxiety in childhood are similar to those experienced by adults:
- Changes to sleeping routines including waking up during the night, finding it difficult to fall asleep or starting to wet the bed when they had previously been dry
- Changes to eating routines such as declining foods that were previously enjoyed or eating less at meal times
- Irritability and / or anger
- Difficulties concentrating and / or restlessness
- Avoidance of activities they previously enjoyed such as school or sports clubs
- A lack of confidence or hesitancy in trying something new
- Negative thoughts such as thinking they are a bad person
- Feeling worthless
- Feeling ‘on edge’, as a parent or carer you may feel on edge yourself when talking to them
- Physical symptoms such as
- More frequent headaches or stomach aches
- Tiredness or fatigue
- Feeling sick
American Academy of Pediatrics, 2018
Supporting children who are experiencing anxiety
Supporting a child who is experiencing anxiety can be really difficult and cause your own anxiety levels to increase. The following section talks through some frequently-used strategies that are less effective and explains why, then describes some strategies that lots of families find helpful. Professionals at Sunshine Counseling can support you in implementing these strategies.
Validation and things to avoid
If your child is experiencing anxiety-related symptoms it can be tempting to try to ‘fix’ their anxiety straight away. This is understandable as it can be painful to see your child struggle and their anxieties may seem ‘silly’ to our adult minds. Some strategies that parents and carers often use which are usually ineffective include:
- Offering children excessive reassurance, for example, “It’ll be ok, Mommy promises, yes, Mommy definitely promises, yes, definitely…” This tends to lead the child to seeking more and more reassurance until you (understandably!) become frustrated
- Dismissing their worries “I know that seems like a big problem now, but you’ll soon forget about it”
- Solving the problem for them “Have you tried….? Why don’t you…” This often makes children feel as though they haven’t been listened to, plus it is helpful see these experiences as an opportunity for children to develop their own problem-solving abilities
Try to avoid the above approaches as they tend to be short-term fixes that increase the child’s anxiety over time. Instead, validation is the recommended strategy for ensuring children feel listened to and understood. Good validation technique involves actively listening to your child and then reflecting back to them what you have heard, with empathy, for example:
- I hear that you felt very scared about monsters under the bed last night and struggled to get to sleep. That must have been really difficult!
- I’m noticing that the spider is really scaring you, you’re being really brave staying in the room. I’m going to stay with you and support you.
Manage, don’t avoid
It can be tempting to adapt the environment to suit your child if they are feeling anxious, however, in the long run this can cause anxiety to increase. Instead, support your child by encouraging him to challenge himself with realistic goals. For example, if he child is scared of bugs, talk about taking on this challenge step by step, perhaps starting with viewing bugs from a distance, then watching someone else hold one, before finally moving closer. This process may take many weeks, or even months, and he will need continuous support throughout. Backward steps are also not uncommon.
Breathing techniques are simple strategies that can be used to manage different intense emotions, from anger to anxiety. Such techniques should be first practiced when both you and your child are really relaxed. When you both understand the idea, it can be used to manage anxiety. One simple technique is to focus on breathing in for a count of three and then out for a count of three. Another technique for older children (and adults) is to breath deeply while focusing on specific parts of the body, starting at the toes and working up to the head.
Play ‘anxiety detective’
Help your child to notice anxious thoughts by playing ‘detectives’. You can encourage your child to hunt around their own brains for worrisome thoughts and then collect evidence that is supporting of the worry or rejecting of the worry. This strategy can be practiced with hypothetical situations first, for example, ‘Timmy is scared of dogs’ and considering together the evidence that Timmy should be afraid and evidence that he does not need to be. Encourage more negating evidence than supporting, while remaining compassionate and validating of Timmy’s feelings. You can then encourage your child to use this method to tell you about their own anxious feelings and explore together the evidence for and against this worry. Remember to validate the child’s feelings throughout this exercise.
Create a worry box
A worry box is a small decorated box and is used to store worries that children write down on pieces of paper. After explaining the idea to your child, encourage them to decorate the worry box however they would like. Whenever they feel a worry in their head they can write or draw it and place it in the box. At the end of each day you should aim to sit down together and discuss the worries, providing you with an opportunity to validate their concerns.
American Academy of Pediatrics. (2018). Anxiety fact sheet. Retrieved from: https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/resilience/Pages/Anxiety-Fact-Sheet.aspx