How to relieve anxiety in a child

Anxiety in children - NHS

Just like adults, children and young people feel worried and anxious at times.

But if your child's anxiety is starting to affect their wellbeing, they may need some help.

What makes children anxious?

Children can feel anxious about different things at different ages. Many of these worries are a normal part of growing up.

From the age of around 6 months to 3 years it's very common for young children to have separation anxiety. They may become clingy and cry when separated from their parents or carers. This is a normal stage in a child's development and should stop at around age 2 to 3.

It's also common for preschool-age children to develop specific fears or phobias. Common fears in early childhood include animals, insects, storms, heights, water, blood and the dark. These fears usually go away gradually on their own.

There may also be other times in a child's life when they feel anxious. For example, many children feel anxious when going to a new school or before tests and exams. Some children feel shy in social situations and may need support with this.

When is anxiety a problem for children?

Anxiety becomes a problem for children when it starts to get in the way of their everyday life.

If you go into any school at exam time, all the children will be anxious, but some may be so anxious that they do not manage to get to school that morning.

Severe anxiety like this can harm children's mental and emotional wellbeing, affecting their self-esteem and confidence. They may become withdrawn and go to great lengths to avoid things or situations that make them feel anxious.

What are the signs of anxiety in children?

When young children feel anxious, they cannot always understand or express what they are feeling. You may notice that they:

become irritable, tearful or clingy
have difficulty sleeping
wake in the night
start wetting the bed
have bad dreams

In older children you may notice that they:

lack confidence to try new things or seem unable to face simple, everyday challenges
find it hard to concentrate
have problems with sleeping or eating
have angry outbursts
have a lot of negative thoughts, or keep thinking that bad things are going to happen
start avoiding everyday activities, such as seeing friends, going out in public or going to school

Find out more about the symptoms of anxiety on our page about anxiety disorders in children.

Why is my child anxious?

Some children are more likely to have worries and anxiety than others.

Children often find change difficult and may become anxious following a house move or when starting a new school.

Children who have had a distressing or traumatic experience, such as a car accident or house fire, may have anxiety afterwards.

Family arguments and conflict can also make children feel insecure and anxious.

Teenagers are more likely to have social anxiety than other age groups, avoiding social gatherings or making excuses to get out of them.

Find out more about social anxiety.

How to help an anxious child

If a child is experiencing anxiety, there are things that parents and carers can do to help.

First and foremost, it's important to talk to your child about their anxiety or worries. Reassure them and show them you understand how they feel.

If your child is old enough, it may help to explain what anxiety is and the physical effects it has on our bodies. It may be helpful to describe anxiety as being like a wave that builds up and then ebbs away again.

As well as talking to your child about their worries and anxiety, it's important to help them find solutions.

For example, if your child is worried about going to a sleepover, it is natural to want to tell them not to go. However, this could mean your child feels that their anxiety will stop them from doing things.

It's better to recognise their anxiety and suggest solutions to help them, so they can go to the sleepover with a plan in place.

Other ways to ease anxiety in children

teach your child to recognise signs of anxiety in themselves
encourage your child to manage their anxiety and ask for help when they need it
children of all ages find routines reassuring, so try to stick to regular daily routines where possible
if your child is anxious because of distressing events, such as a bereavement or separation, look for books or films that will help them to understand their feelings
if you know a change, such as a house move, is coming up, prepare your child by talking to them about what is going to happen and why
try not to become overprotective or anxious yourself
practise simple relaxation techniques with your child, such as taking 3 deep, slow breaths, breathing in for a count of 3 and out for 3.
distraction can be helpful for young children. For example, if they are anxious about going to nursery, play games on the way there, such as seeing who can spot the most red cars
turn an empty tissue box into a "worry" box. Get your child to write about or draw their worries and "post" them into the box. Then you can sort through the box together at the end of the day or week

Find out more

Young Minds: supporting your child with anxiety
Health for Teens: practical advice about dealing with anxiety

When should we get help?

If your child's anxiety is severe, persists and interferes with their everyday life, it's a good idea to get some help.

A visit to a GP is a good place to start. If your child's anxiety is affecting their school life, it's a good idea to talk to their school as well.

Parents and carers can get help and advice about children's mental health from Young Minds' free parent helpline on 0808 802 5544, from Monday to Friday, 9.30am to 4pm.

Find out more about treatments on our page about anxiety disorders in children.

Helping children manage anxiety - Mayo Clinic Health System

Speaking of Health

Tuesday, August 31, 2021

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Children's Health (Pediatrics)
Pediatric Medicine

Everyone is born with the ability to experience anxiety. The American Psychological Association defines anxiety as an emotion characterized by feelings of tension, worried thoughts and physical changes, such as increased blood pressure and heart rate.

Anxiety is normal and will occur at various times throughout life. It is important to experience anxiety, as it helps recognize and respond to threats of danger and motivate the completion of tasks. For example, having anxiety while driving in a snowstorm is helpful because it leads to altered driving behaviors to safely arrive at the destination. Also, having anxiety before an important test is helpful because it motivates you to study. However, some people's experiences of anxiety can become excessive, ongoing and overwhelming, and lead to significant difficulty functioning in daily life. These are signs of an anxiety disorder.

Signs and symptoms of anxiety

Children and teenagers may have similar worries to adults, but also they may have excessive worries about performance at school or sporting events, fitting in, social experiences, safety, being on time, their future, natural disasters or other catastrophic events. Some signs of significant anxiety include fatigue; changes in sleep habits, such as sleeping too much or too little; irritability; anger; difficulties with concentration; lack of confidence; reassurance seeking; avoidance; and decreased grades.

The most common physical symptoms present in children and teenagers who experience significant anxiety include stomachaches and headaches. They also can experience increased heart rate, rapid breathing, restlessness or jitteriness, trembling or feeling "twitchy," dizziness, diarrhea, nausea and chest tightness or pain.

For many children, anxiety can develop as a paired association, which means the anxious symptoms become associated with something that does not typically elicit anxiety, such as a situation, event or object. For example, imagine a child being at school and experiencing a panic attack for the first time, which is the sudden onset of intense anxiety or fear that often includes a strong body response, such as increased heart rate, rapid breathing, feelings of going crazy or losing control. On this day, the child was stressed about a large presentation, but because of this panic attack, the child's brain may start to associate school with intense anxiety, especially if the child experience's another panic attack at school. Therefore, whenever the child goes to school or even thinks about going to school, the brain can perceive it as a threatening situation, which can trigger ongoing anxiety or frequent panic attacks.

Do's and don'ts to ease anxiety

Many tools can help your children work through anxiety. These are strategies licensed mental health clinicians use with people in therapy, and research has found these strategies to be beneficial in treating and managing anxiety.

If you feel confident you can use these tools with your child — excellent. However, if you do not feel confident or want more support, consider talking with your child's primary care physician who may connect you with a mental health clinician for assistance. If needed, physicians or clinicians can use additional tools not listed here.

Do:

1. Identify triggers.

A helpful first step is for you and your children to become aware of and recognize what causes them to feel intense anxiety. Once those triggers are identified, you can implement many of the tips below.

2. Validate and empathize.

Children's thoughts, emotions and experiences are real to them. No matter how you think or feel about their experiences, it is important for your children to feel heard, validated and understood. Empathize with your children, imagine what it is like to be in their shoes, and recognize and affirm that their thoughts, feelings and experiences are valid and important.

3. Challenge unhelpful thinking.

Ask your children to talk you through the thoughts they are experiencing that are unhelpful and causing them distress, such as "I am going to fail my test and then fail my class." Once you know what thoughts your children are telling themselves, you can work with them to identify more realistic, helpful thoughts. Ask questions to get them thinking about their situation differently and decrease their buy-in into their unhelpful thoughts, such as "Have you ever failed a test or class before" or "What have you done in the past to pass a test? Have you done those things now?"

These questions allow children to think through all the evidence and come to conclusions independently. Self-realization is much more powerful than parents, teachers or peers telling children they will not fail. Once your child's unhelpful thoughts have been challenged, encourage them to develop a more realistic, helpful thought, such as "Although I feel like I may fail, I have prepared for this test and will perform my best" or "Even if I fail this test, that does not mean I will fail the class." Exaggerated ideas, such as "I will for sure pass and will do amazing," are unnecessary and typically not helpful, as most children do not buy in to these unrealistic notions.

4. Practice deep breathing.

Deep belly breathing is a tool to help calm down, refocus and think clearer. It increases oxygen levels in the bloodstream and decreases heart rate, breathing rate, muscle tension and stress level. Instruct your children to place their hands on their belly and chest. Tell them the goal is to take deep breaths with their bellies, which will lead to the hand on their belly moving up and down as air enters and leaves their bodies. When the hands on their chests are moving more, that means they are breathing with their chest. Encourage them to use their bellies to breath. Instruct them to take deep breaths slowly in through the nose, hold and then out slowly through their mouth. Repeat this several times. A fun way to guide this exercise includes pretending to smell a flower, and then blow bubbles or blow out birthday candles.

5. Break down tasks.

Break down tasks into smaller steps so the overall process feels less daunting. For younger children, have random rewards throughout the process to positively reinforce their behavior. For older children, provide positive praise and encourage them to reward themselves.

6. Role-play.

If your children are worried about specific situations, role-play those feared situations to help them prepare. Examples could include ordering at a restaurant, buying a movie ticket, asking a teacher for help or inviting friends over.

7. Build overall confidence.

Have your children perform tasks around the house to contribute to the family and build confidence. Offer your children opportunities to face challenges. It is important to praise their efforts and focus less on results. If they get stuck, ask your children about skills they used to overcome similar obstacles in the past.

Don't:

8. Label emotions as bad.

Stay away from labeling their thoughts, emotions and experiences as good or bad. For example, do not say "It is bad to think you will fail." When children hear that, their thoughts are bad, they often then internalize this and think "I am bad."

9. Minimize anxiety.

Do not minimize your children's experiences and tell them to "Just do it" or "Suck it up." Their feelings of anxiety are real, and they are suffering. Although it is healthy to face things that cause anxiety, meeting children with empathy, compassion and kindness is more helpful and effective when facing feared things.

Remember, you are not alone. You and your children do not have to navigate this alone. Your child's primary care physician wants to help all children thrive.

Deirdre Paulson, Ph.D., is a psychologist in Family Medicine in Eau Claire, Wisconsin.

Topics in this Post

Family Medicine
Children's Health (Pediatrics)
Pediatric Medicine

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5 useful tips from a psychologist that will save a child from anxiety

A shot from the animated series "South Park"

Anxiety and worry can completely destroy a child's self-confidence. Especially when it comes to the first trip to school after a long vacation or adaptation in a new team. Psychologist Ellen Hendricksen has compiled a list of five simple yet important tips to help you deal with childhood anxiety.

Childhood is a continuous experience: with whom to sit at a desk, how to write a test, how to walk past a barking dog. Seeing your child excruciatingly worried about something is very painful. It's hard to see how he moves away from his peers, not letting you out of kindergarten, crying at birthday parties and refusing to participate in school activities. Sometimes children's anxiety, caused by absolutely irrational things, only irritates. But in this situation, the child can and should be helped.

1. Make a game plan

Sometimes children forget that they have the ability to cope with any task. Help your child realize that he is capable of solving any age-appropriate problem on his own (or with a little help from outside). If the child expresses his concern and addresses you with this concern, answer: "It seems that you are very worried about A" or "I see that you are very worried about B. " This makes it possible to give a name to the emotions experienced and avoid the impasse that occurs after the phrases “there is nothing to be afraid of” or “just relax”.

Help the child make a plan. “If something scares you, what can you do to deal with the situation? If you need help, who can you turn to? If Anya stops being friends with you, what will you do? If you get lost in a mall, who do you turn to? What happens if you feel nauseous during a lesson? What will you do?". Helping with planning achieves two goals at once: firstly, it helps the child move from a problem to its solution, which reduces uncertainty, namely, it is a source of anxiety. Secondly, it tells the child that you believe in him. You believe that he is capable of handling any task appropriate to his age.

2. Teach your child to respond to their anxiety

Sometimes children don't realize that anxiety is just one side of the conversation. They may respond to their anxiety in order to feel more confident. To do this, invite your child to choose a name for their anxiety. For example, "restless Lisa_Anya_Misha" or even draw a character sitting on a child's shoulder. This helps to personalize anxiety, thereby, as it were, separating it from the child. Constantly encourage dialogue with this character. Old enough children can write ready-made remarks in their diary: "I can handle any anxiety", "It's okay to make mistakes or do stupid things." Younger children who can already read can carry a reminder or business card in their pocket with the same helpful messages: “I am stronger than my anxiety. It's okay to not be perfect." If the child is embarrassed to carry a note with him, you can get yourself a talisman that will remind you of a certain fixed answer. For example, let the owl sticker mean "I can handle any obstacle." The child can put this sticker in a pencil case, a folder and a backpack.

3. Explain that any storm will sooner or later subside.

Excitement entails unpleasant physical sensations - increased heartbeat, emptiness in the head, rumbling in the stomach. Such feelings can exacerbate an initially stressful situation (for example, solving math problems at the blackboard, having lunch in a canteen, or just an unexpected survey during a lesson). Unpleasant sensations can make the child think "I'm going to vomit" or "something is wrong with me." If physical sensations make the child think that something is wrong with him, do a little training. Specifically evoke specific symptoms so that the child gets used to them. You can run up the stairs together to make your heart beat harder, spin on a swing to make you feel a little dizzy. Ask the child to focus on these sensations. 30 seconds or a minute is enough. Then draw his attention to how quickly he returned to normal: as a rule, it takes no more than two minutes. The child may come to his senses even before you. He / she can answer: “Yes, it was not scary - it's just a swing!”. But there is an answer to this - “Yes, but you experience the same thing when you are called to the board, and this is caused by your anxiety. Did you notice how quickly you came / came to yourself after the swing? In the same way, you will quickly come to your senses after being called to the board. In general, teach your child not to be afraid of these physical sensations. Yes, they bring discomfort, but this is just anxiety (and nothing more.) It should recede quickly enough.

4. Rid your child of useless rituals

If your child has a number of strange traditions, say he can only brush his teeth by turning the water on/off exactly four times, then it's time to experiment. Invite the child to find out what will happen if the “ritual” is not observed. Of course, he will take this offer as if you offered him to put on a jacket inside out. But continue to gently insist, call for curiosity.

You must admit that giving up the "ritual" can be painful. But if the child insists that tapping the table exactly seven times with a pencil is the only way to put the world in order, offer to test this theory. If you yourself are part of a strange "ritual", for example, a child asks you to fold a blanket strictly symmetrically, then gather your strength and firmly refuse. Why? By participating in the ritual, you are sending a signal that something bad is bound to happen otherwise. Thus, every day you seem to be saying that the child will not be able to cope without outside support. Get ready for tears. Be strict, but at the same time support the child, because the “ritual” is extremely important and valuable for him. But still, in the long term, it is much more important to convey to the child that safety does not depend in any way on wishing “good night” in the right tone or in exactly three hugs in front of the school door.

5. Let the child talk

For at least a few minutes a day, give as little direction as possible, as little advice as possible. Sometimes parents ask how this can help a child. You are definitely not to blame for your child's anxiety, but changing certain behaviors can really help.

Pay attention to how you talk to your child. A huge percentage of our communications with a child are directions and advice. For a child prone to anxiety, all this is like criticism. And this "criticism" appears in quite unexpected places.

Sometimes the questions “would you like to start doing your homework?”, “why not add red cubes to your tower?” taken as criticism. Even some everyday educational moments look like an exam: “Can you read this inscription? What is color?" Sometimes even a compliment is like criticism: “Good work, you are moving forward, although there is still a lot of work ahead.”

The solution is not to give the child complete freedom. You still need to be sure that everything is in order at home and that your homework is done. But at least for a few minutes a day, bite your tongue and let the child be the main one in the conversation. As little pressure as possible, as few indications as possible, as little intensity as possible in phrases. Just show that you are really listening to him. Remember that now the child is the main one in the conversation.

"I'm glad you told me about your day" is different from "What did you learn at school today?" For at least a few minutes a day, do not arrange a test out of the conversation

Instead of giving advice or solving a problem for the child, think over everything that he has told you. “You seem to be very nervous before school tomorrow” will be much better than a phrase like “There is nothing to worry about here.” This is how you show that you perfectly understand the feelings of the child. As a rule, anxiety is accompanied by a feeling of helplessness. When you stop giving advice or direction, children will begin to feel in a position of power, they will understand that now they have more control over the situation.

Anxiety is always a sign of uncertainty, inability to answer the question “can I do it?”. Working through situations and preparing to deal with your fears is the best way to give your child a sense of self-confidence. Result? A self-confident child and, as a result, a self-confident adult.

Anxiety in children - causes, symptoms and treatment

Definition and explanation of anxiety
What is the danger of increased anxiety
Types
Causes of
Diagnostics
What to do: advice to parents

Among all the problems in child psychology, increased anxiety in a child stands out. More often than not, only behavioral disorders occur. In general, clinical signs of anxiety can be detected in almost 10% of children of preschool and school age, and the numbers are steadily increasing.

Anxiety is typical for children of both sexes, but there is a difference in the intensity of its experience and the scope of possible factors. So, if we are talking about preschoolers and elementary school, boys are more anxious, and in secondary school and puberty, girls are more likely to be anxious. For boys, the most disturbing areas are violence and the possibility of punishment, for girls - relationships with relatives and strangers. Source:
I.I. Khaprenkov. The problem of studying anxiety in children from the point of view of developmental psychology // Eurasian Scientific Journal, 2016, pp. 302-303.

In adolescence, anxiety can have a mobilizing effect, motivate to certain activities. But for preschoolers or children in elementary school, increased anxiety only affects negatively. If children are constantly afraid of mistakes, trying to control themselves, this leads to problems in daily activities. In addition, constant anxiety and anxiety in children can significantly affect the level of self-esteem, underestimating it. Often, the child's constant anxiety may indicate difficulties with emotional adjustment, an adequate response to certain social situations. This provokes uncertainty in their strengths and capabilities.

Definition and explanation of anxiety in children

We all experience fear from time to time - both quite real and irrational, associated with our thoughts and feelings. This is one of the mechanisms for the survival of man as a species. Children at different ages are dominated by certain fears associated with the stages of their psychological development and the acquired experience of socialization. So, at an early age, fears of pain, darkness or objects, sounds predominate in children, at preschool age there is often a fear of death, younger students are typically afraid that they will lose the respect and appreciation of their parents and others. For adolescents, the fear of loneliness, enclosed spaces, and crowds is typical. But it is important to determine where ordinary fears and anxieties turn into pathology . Episodic fears and anxiety are the norm, they are always tied to specific circumstances. But the pathological level of anxiety in a child is a stable condition with clinical symptoms, which is not tied to specific circumstances and real threats to life and health. That is, a child with pathological anxiety is always worried, even when there are no reasons for this, he cannot relax, he is always tense.

Why increased anxiety is dangerous

Excessive anxiety of children leads to overwork, reduced performance, reduces the chances of revealing all the talents of the child. The resources of the body are spent on the suppression of emotions and fears, and not on productive activity . If the problem is not solved, it can result in neurosis, depression and personality changes. In addition, full communication with others - peers and adults - suffers. Such children are more likely to become dependent on leaders, they can become members of not the best companies.

Types of anxiety

It is important for a psychologist to identify the type of anxiety in children. There is situational anxiety - an emotional state caused by external factors. The second type is personal anxiety, a stable trait, an individual feature. It manifests itself as a tendency to excessive, frequent and strong experiences, anxiety due to various circumstances.

Moderate anxiety in certain situations is necessary and useful, but if it goes beyond rational boundaries, this is already a maladjustment reaction that disrupts the organization of the child's behavior and activities.

Causes of anxiety in a child

The condition can be provoked by serious events in a child's life: the death of loved ones, the divorce of parents, failures in school. The risk of anxiety is especially high if these events influence together, burdening each other. But often the problem of children's anxiety lies in the parents themselves or adults who constantly communicate with the child, in the methods of education, the anxiety of the parents themselves, who express it with the baby.

Types of parents who can provoke problems for children:

Nesting parents. They try to protect children from any problems and dangers. Due to hyper-guardianship, children cannot be independent, feel defenseless before the world and cannot achieve success on their own.
Parents-projectors, who themselves have not achieved much success in life, are trying to realize them in their child. Or another option - people with a high position in society require their offspring to comply with the status. The desire to adjust the child to ideals leads to anxiety, the baby is afraid to disappoint his parents and not justify their hopes.
Spartan parents. They want by hook or by crook to educate character and will, too "tightening the screws." They ignore or ridicule the problems of children, which leads to the fact that the child feels like a failure. Source:
O.A. Andrienko. Fears and anxiety in children of primary school age // Humanitarian Balkan Research, 2019, vol. 3, No. 2 (4), pp. 63-65

There are also mixed types of parents, as well as grandparents, older brothers and sisters who influence the child. It is also worth highlighting three types of special requirements that can lead to internal conflicts in the child's personality, which serves as a provocateur of increased anxiety:

Requirements that contradict each other. When parents cannot agree among themselves, or when the wishes of the parents go against the school rules.
Requirements that are too high or inadequate for the age and abilities of the child. For example, if a child is not capable of sports achievements due to anatomy and physiology, and parents certainly want to make him a sports star.
Negative (or negative) demands that humiliate the honor and dignity of the baby, emphasizing his dependence on the decisions of adults. For example, male fathers demand to stop being capricious, otherwise they will not buy toys for the child or will not take it with them.

Anxiety diagnostics

In order to start overcoming anxiety in children, it is important to correctly and timely recognize the problem. Most children do not tell their parents about problems, and teenagers deny any trouble at all. Therefore, along with changes in mood and behavior, it is important to note external symptoms in a child: chills or hot flashes, sweating, hand tremors, increased heart rate, shortness of breath, muscle tension. Children may complain of chest pain, numbness in the limbs, headache, dizziness, or lightheadedness.

To diagnose anxiety, you can use the Lavrenteva and Titarenko scale, as well as the CMAS criteria. They involve a number of questions. Each affirmative answer is 1 point. Questions relate to the child's behavior, his emotions, communication with peers, statements. If, after completing the survey, almost the maximum scores (up to 15-20) are scored, the child has increased anxiety. With an average score (up to 7-14), the degree of severity is average, up to 6 points - the risks are low.

What to do: tips for parents

Having learned about the problem, there is no need to worry and panic, especially with a child. It is necessary to systematically work with children to reduce anxiety. As you grow older, the problem gradually weakens, but you should not wait for everything to go away on its own. Otherwise, by an older age, this can result in depressive disorders, motivation and life success will decrease.

There are a number of tips for relieving anxiety in children that parents should keep in mind.

First of all:

You can not threaten the child, including physical punishment or unrealistic actions ("I will give you to strangers if you do not obey," etc.). Children take their parents' words seriously.
Give up screaming, swearing at the child, especially in front of other people.
You can not use derogatory expressions and insults, they reduce the self-esteem of children.
It is worth abandoning the practice of comparing a child with other children, no matter how this comparison is (positive or negative).
You should not constantly criticize the child, it is better to translate it into the category of advice (but in moderation) or instructions.
There is no need to make excessive demands on the child, you always need to take into account his individuality.
Give up the practice of apologizing for any wrongdoing. It is important that children honestly explain the reasons for their behavior.
There is no need to demand courage, children need to get used to the new environment or people.
It is not necessary to force the child to compete with others, especially in those areas where he is not strong.
You can not question the authority of other people (coach, teacher at school), demanding that the child listen only to you.

To help eliminate anxiety, parents need to make an effort to connect with the child and change their own behavior. It is important to address the baby by name, look into the eyes when talking, increase the volume of affectionate touches - all this increases the level of trust. Discuss the successes of the child with other family members more often, look for reasons for praise, even in small things.

It is important to allow the child to communicate with friends in his home, to arrange holidays with them. This is extremely important for socialization.

In punishments and rewards, one must be consistent, if one thing was promised, one cannot do something completely different on another day.