How to help a child cope with anxiety

Children's Health

by Johelin De Freitas Hernandez, MD

Dec 17, 2020

Is your child feeling anxious, sad or worried? As a parent, it’s only natural to be concerned, but these feelings are all part of a child’s normal development.

However, if your child does not outgrow these fears and worries, it can lead to problems at home and school. When these anxieties persist, or when there are so many fears and worries that they interfere with daily activities, it may lead to a diagnosis of an anxiety disorder. 

Types of anxiety disorders

Anxiety disorders are one of the most common psychiatry conditions that start during childhood, affecting one in eight children. Anxiety disorders cause extreme fear and worry, and changes in a child’s behavior, sleep, eating or mood. When the condition is left untreated, children with anxiety often perform poorly at school and miss important social experiences. 

Generalized anxiety disorder (GAD)

Generalized anxiety disorder causes a child to worry almost every day over a variety of things. For many kids, this includes normal worries like homework and tests, just on a more extreme level as compared to their peers. 

Generalized anxiety disorder may also cause your child to worry about things you may not expect — “fun” activities like recess, parties and lunchtime, as well as serious topics like war, the future, illness, etc.

Separation anxiety disorder (SAD)

Separation anxiety — the fear of being apart from their primary caregiver — is a normal milestone for babies and young kids. This typically starts at age 6-8 months and disappears by 2-3 years of age, when kids start to get used to being with babysitters, grandparents or daycare. 

However, if your kid does not outgrow the fear of being apart from you, he or she can develop a separation anxiety disorder. Kids with separation anxiety feel anxious being away from their parent or away from home and may refuse to go to school, sleep or do other activities alone.

Selective mutism

Selective mutism is when the child talks at home and with others close to them but refuses to talk at school, with friends or at new places.

Social phobia (social anxiety disorder)

When a child experiences social phobia, he or she feels afraid of being the center of attention for fear of what others will say or think. They may try to avoid school or social activities, and group projects or class presentations may cause extreme fear or anxiety.

Specific phobia

Everyone faces some fears during childhood. Many children are afraid of things like loud noises, the dark or monsters. However, a phobia is more extreme — it is a more intense and longer lasting fear of a specific thing. When a child has a specific phobia, he or she may avoid going places where they think they might encounter the thing they fear. 

Signs of anxiety in children

Though symptoms vary depending on the specific anxiety disorder, a child with anxiety may: 

  • Cling to a parent 
  • Cry when parted from parents or caregivers
  • Have prolonged or excessive tantrums
  • Sleep poorly or have trouble falling asleep alone
  • Have recurrent complaints of nausea, headache or stomachaches
  • Refuse to go to school or other activities without you
  • Have problems concentrating or sudden academic struggles
  • Act scared or refuse to talk

Older kids and teens can also experience symptoms like feeling shaky or jittery, shortness of breath or a racing heart. These are symptoms of the “fight or flight” response, the body’s normal response to a perceived threat.

How you can help your child with anxiety

If your child is experiencing any of these symptoms in a recurrent or persistent manner, there are some things you can do to help.

  • Talk to your child about their fears and worries. Encourage them and acknowledge their feelings.
  • Stay calm during any episodes of anxiety since the child can also sense the parent’s anxiety.
  • Routines are always reassuring. Try to stick to regular routines when possible.
  • Find books or films that will help them to understand their feelings.
  • Talk to your child about new upcoming events or changes. For example, starting in a new school or moving to a new house. Prepare your child for doctor’s appointments and similar activities by letting them know what to expect.
  • In younger kids, distraction can be helpful. Teaching relaxation techniques, breathing exercises or yoga can help older kids learn what methods work for them.
  • Don’t avoid events or things that trigger anxiety. It is better to take small steps so kids can learn to work through their fears. For example, if your child is shy talking in public or at school, gradual exposure to those moments help their brain adapt and survive anxious moments. Let your child order their own ice cream or other treat when you order out to help grow his or her confidence. 

If you are worried about your child’s anxious symptoms, talk to your pediatrician or family medicine doctor. They may recommend you see a trained therapist for diagnosis and treatment.

Coping with anxiety during COVID-19

Anxiety can develop for a number of reasons. It may be that your child is more prone to anxiety because of their genetics, brain chemistry, temperament or learned coping strategies. Environmental factors (like the COVID-19 pandemic, for instance) can also play a role in causing your child’s anxiety symptoms. 

Children are equally impacted by the uncertainties and social isolation brought on by the COVID-19 pandemic. Routines have drastically changed, holidays and family activities have been impacted, and parents may also pass down some of their own anxiety to their kids. 

Related: How to help your kids cope with coronavirus changes

Model for your kids an example of how to cope and react in stressful situations. Avoid sharing all your worries and fears about this crisis with your children, as your own anxiety will only compound theirs. Try to adjust routines and enjoy the moments when your family is playing, studying and working together. 

Occasional anxiety is normal, but talk to your pediatrician if it becomes excessive or begins to limit your child’s activities.

Subscribe to the Scrubbing In newsletter for more ways to keep your family well.

About the Author

Johelin De Freitas Hernandez, MD, is a pediatrician on the medical staff Baylor Scott & White Clinic – Round Rock 425 University. Schedule an appointment with Dr. De Freitas today.

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