Anxiety in Children

It is common for children to experience anxiety, for their brain to perceive danger in the environment where no significant danger exists. This can present as fear of entering unfamiliar situations, reluctance to engage with unfamiliar people, worry about future events, or terror of a particular object or situation (clowns, spiders, heights, etc). Although many fears are part of normal development (eg separation anxiety between 12 & 18 months, fear of thunder & lightning between 2 & 4 years), childhood and adolescence are also the most common times for development of anxiety which can contribute to problems in adulthood. Children need assistance to overcome their anxiety in order to participate fully in life, engage with others, learn effectively, and be resilient (able to bounce back from disappointments and hurts).

The most effective treatment for anxiety in children is psychological therapy. For younger children, this primarily consists of parents being assisted with techniques to minimise their child’s anxiety. Older children can participate in therapy directly and be taught how to challenge their anxiety and increase their confidence. In some cases, young children detect a parent’s anxiety and their anxious behaviours are an unconscious reflection of their parent’s agitation. In these cases, it is useful for the parent to obtain his or her own therapy to reduce their anxiety so that they are better able to help their child.

Although as parents we would like to protect our children from pain, parental over-protection is more likely to make kids anxious. Children need to experience the small knocks and disappointments of daily life in order to develop skills in managing their emotions and to have faith in their own ability to resolve problems.

The following strategies can be helpful in reducing childhood anxiety but if anxiety is severe or prolonged, seek help from a child psychologist.

• Daily routines. Predictable patterns of behaviour, such as regular times for meals and bed, help reduce children’s anxiety and assist them to learn to manage their own arousal and emotions.
• Sleep. Develop a 5-7 step pre-bed routine to help your children settle to sleep. Ban electronic devices and television after the evening meal; instead encourage reading, drawing, and quiet play. Make settling to sleep a fun activity involving the reading of stories and interaction with a parent. Once the child is in bed at their designated time, avoid interaction until morning, as many children attempt to engage their parent after bedtime by talking of fears, which in turn increases anxiety.
• Feed them well. There are connections between food and anxiety. A diet high in unprocessed food (eg vegetables, fruit) and low in sugar / salt / artificial colourings / flavourings is associated with optimal mental health.
• Encourage physical activity. Exercise, in all its many forms, is associated with lower anxiety. Train your children to enjoy using their body, through structured sports and incidental activity. Encourage outdoor play and walking or cycling to get places.
• Regulate breathing. When anxious or stressed, our breathing naturally accelerates and becomes less effective. Fortunately, slowing our breathing calms us and decreases stress. Teach children to notice changes to their breathing and to respond by deliberately slowing (not deepening) their breathing. Practising when relaxed makes this easier to do. It can be helpful to introduce slow breathing to the night time routine using the guideline of breathing in for 3 seconds, hold for 3 seconds, breathe out for 3 seconds, pause for 3 seconds. There is no need to be rigid about the time; the goal is to slow the breathing. Younger children might like to count 3 hippopotamuses in their head to help slow their breathing.
• Experiment with the unfamiliar. Encourage children to attempt new activities and tastes, and to take an interest in the unfamiliar. Draw their attention to new experiences and objects. Stimulate curiosity.
• Abolish the concept of failure. Stimulate children to attempt new skills and to extend existing skills. Explain that success usually only occurs after multiple attempts.
• Celebrate achievement. Teach children to notice and celebrate when prolonged effort results in attainment of their goal, even if the outcome is of no significance to anyone else. It is more important to validate the effort than the result. Awareness of achievement despite difficulties helps children feel more equipped to learn new skills or approach unfamiliar tasks.
• Teach social skills. Expose children to a variety of situations and explicitly teach how rules vary across different settings. Children feel less anxious if they know social rules and what behaviour is expected of them. It also means that they are more likely to be accepted by their peers and to make friends.
• Give attention for non-anxious behaviour. With a highly anxious child, it’s easy for the anxiety to dominate all interactions between child and parent. Inadvertently, this feeds the anxiety as the child learns that s/he obtains more of the parent’s attention if anxious. Reverse this process by interacting with the child when s/he is playing happily and respond to any anxiety in a calm, matter-of-fact manner.
• Show confidence in the child. When children are fearful or agitated about a situation, it can be empowering for an adult to stay calm and suggest that they have confidence in the child’s ability to deal with the situation. Comments such as ‘Wow, that sounds tough. What do you think you’ll do about it?’ acknowledge the child’s experience and give the message that the child has the skills to come up with a solution, while also suggesting that the adult is happy to talk it through with them if required.

Don’t label the child as ‘shy’. Children define themselves in the terms they hear others use about them. If described as shy or anxious, children take on that attribute as part of their core identity. Instead, focus on behaviours and attributes that you want to see more of and that will be helpful for the child, eg brave, confident, funny, helpful, friendly, etc.