A Parent's Guide to Childhood Anxiety

It is estimated that about 1 in 8 children experience some form of an anxiety disorder. Anxiety can be mild, and very temporary, as in simply being nervous about an upcoming event, to more severe and long lasting forms such as panic attacks, obsessiveness and traumatic stress responses. Symptoms of anxiety can range from low-level physiological responses such as headaches, upset stomach or irritability to intense nausea, sweating and an overwhelming incapacity to function. Anxiety may be generalized and manifest itself in a variety of surroundings and situations or it may be specific such as test anxiety. One of the more common types of anxiety for children is separation anxiety and parents can often see this exhibited when they leave a child such as going to work in the morning or taking the child to day-care.

Separation anxiety can be a phase. However, if it is not approached properly it can develop into other forms of anxiety such as social anxiety, phobias or trauma. Regardless of the type of anxiety a child experiences, treatment is available. In some cases, simple, supportive communication from a parent or significant adult can alleviate the anxiety. In other cases, professional intervention may be required. Because parents exert such a strong influence over their children, and because children mostly trust and rely upon their parents, and because going to a professional therapist introduces a stranger, parental intervention can be very effective when done properly.

One of the big mistakes parents often make in responding to a child exhibiting anxiety is to discount the child's experience. For example, if a child is exhibiting symptoms of anxiety and says they are afraid of going into their bedroom because a monster is there, to say "don't be silly there is no monster in your room" essentially tells the child they are lying. To the child's mind, there may be a "monster" in the room, in whatever form it may take. A much better approach is to accept the child's experience and lead the child to a more rational view. For example, the parent could say something like "oh, really, how do you know a monster is in your room?" If the child says "I saw it there" the parent can ask the child to elaborate on what it looked like, when it is there, what it does there and then lead the discussion to possible strategies to deal with this problem by emphasizing the various strengths and supports the child has at his or her disposal. It is far more important to help the child learn to deal with these kinds of situations than the actual removal of the monster. In that regard, anxiety becomes an opportunity to develop certain psychological skills that can be very useful throughout life.

The same kind of approach can be used for more intense forms of anxiety. In almost every case, anxiety is generated by internal dialogue, referred to as "self talk" and subconscious mental imagery. Because children are not well developed linguistically, many of their anxieties are produced from subconscious mental pictures. For example, the child above is likely not saying internally that there is a monster in the room; they are probably imagining a monster in the room. The same kind of imaginings can be at the root of social anxiety in which the child is imagining any number of unpleasant, negative and "bad" scenarios in social settings, all of which may not be realistic. Test or performance anxiety is often generated by subconscious mental imagery of failure and, perhaps, punishment resulting from that failure.

Because children have such a high need for safety and protection, most all anxiety can be relieved when the child's sense of safety and protection is bolstered. Exactly how that is accomplished will depend a lot on what the child says in response to questions about the situation. For example, a parent can ask a child who thinks a monster is in their room what they need to feel safe in their room. If the child says the monster has to go away, the parent can collaborate with the child in figuring out what needs to happen to get the monster to leave. It is important that the child participate in the strategies to remove the monster. It may not be enough that the parent goes into the room, comes out and says the monster is gone.

More intense forms of childhood anxiety, such as ongoing and intense phobias, panic attacks, obsessive-compulsive disorders or posttraumatic stress responses would likely require professional intervention. However, even in those situations, parents can help reduce the symptoms of anxiety by respecting and acknowledging the child's experience, listening with an open mind, asking appropriate questions, in a supportive and inquisitive manner and letting the child know, in a way the child can easily understand, which may require not just words, but behaviors as well, that they are loved, cared for, and, above all else, safe.