ADOLESCENT CHILD SPECIALTY SERVICES

8336 Office Park Drive, Douglasville

404-310-1161

by Rebecca S. Blakeman, Ph.D. Licensed Psychologist

CHILDHOOD ANXIETY

Although it may seem that children should have nothing to worry about, the truth is many children are living a life consumed with anxiety. The good news is, anxiety is very treatable...and parents can make a huge difference!

Recognizing Anxiety

In order to help their child cope with anxiety, parents must first recognize when their child is experiencing anxiety beyond what is typical for children their age.  Your child might be anxious if he/she experiences the following  problems:

• He worries nearly every day about several different topics (e.g., school performance, parental approval, getting hurt or having someone close to him get hurt).
• She does not seem able to stop the worrying...it happens automatically and there doesn't seem to be anything she can do to control it.
• He becomes overwhelmed about situations that should be pleasurable (e.g., playing with friends, going to school).
• She becomes so upset in certain situations that no one can enjoy themselves (e.g., parents going out to dinner while she stays with a babysitter).
• He finds it extremely difficult to spend time away from his parents. 
• Her school work is suffering.  She cannot concentrate.
• He complains of headaches or stomache aches before school.
• She is having trouble sleeping.
• He has become very irritable.
• She is spending less and less time with friends, and more and more time at home.
• He has panic attacks in which he seems to literally 'panic' about a situation and tries desparately to remove himself from the situation.

These symptoms are related to anxiety in general.  There are some anxiety disorders with slightly varied symptoms.  For example, in selective mutism, children are unable to talk in certain situations (e.g., school, church, playgroup), even though they can talk easily at home.  In obsessive compulsive disorder, children experience obsessive thoughts  and exhibit compulsive behaviors (e.g., hand washing, counting, repeating behaviors a certain number of times, etc.) that they connot control.  In posttraumatic stress disorder, children have been traumatized by an event (e.g., car accident, abuse) and experience flashbacks and nightmares of the event.  Finally, children can exhibit specific phobias that are exaggerated fears to everyday objects or events (e.g., dogs, public toilets, etc.).

What Can Parents Do?

If your child is exhibiting these types of behavior, or if you think he/she might be struggling with anxiety, please know that treatment can often result in relatively quick improvement.

First and foremost, do not become angry at your child for the anxiety symptoms.  These behaviors can be very frustrating (e.g., a child refusing to go downstairs in his own house, or a child who insists that Mom hug her and say "I love you" exactly 9 times before she is able to go to sleep).  But parental anger will only serve to increase the anxiety in a situation where the child is already incapable of coping.  As best as you can, stay calm and pleasant.

Offer reasurance, but don't overdo it.  This is a very fine line to walk.  If parents offer no reassurance, their child feels unsupported and possibly abandoned.  If they offer to much, they can actually cause the anxiety to worsen.  Too much comfort in the face of unrealistic fears gives the impression that there really IS something to fear...so children can become even more anxious.

With love and support, help your child to face the very situations that are causing distress.  This is where professional help can be especially important, as it is sometimes difficult for parents to know how far to "push" an anxious child.  Certainly pushing too fast and too hard can be detrimental...but not pushing enough can make the anxiety worse.  The longer we avoid situations that make is anxious, the more anxious we will be in that situation when we do have to face it.  A child who experiences anxiety at a level of 7 out of 10 (10 being the most anxious) when he goes to school will likely experience anxiety at a level of 10 out of 10 if he is allowed to miss 3-4 days of school.  The old saying is true...the best way to beat a fear, is to face a fear and do exactly that which we are most afraid of.

It is extremely important for children to develop healthy coping skills for managing their anxiety.  These are often best learned with the help of a professional who can assess your child's strengths and weaknesses, as well as his/her personality traits in order to choose which strategies will be most effective for your child.  These strategies include relaxation, pleasant imagery, and cognitive restructuring.

Cognitive Restructuring is a fancy way of saying 'changing the way one thinks about situations.'  A child who is anxious will think very negatively about a situation (e.g., "I'm going to fail this test.  It will prove I'm stupid").  These thoughts are likely to significantly increase a child's anxiety.   To understand the potential impact of these thoughts, picture an adult standing beside the child saying these things to him/her.  Any parent would be horrified if someone said that to their child, because they know how damaging those statements can be.  Anxious children need to learn to identify their negative thoughts, recognize that they are not usually true (i.e., "I usually pass my tests").  Then he/she must learn to create more positive, and accurate thoughts.  In our example, these thoughts could be:   "Even if I failed this test, it wouldn't prove I'm stupid.  Just last week I figured out how to fix the computer, when Dad couldn't." 

For some anxious children, medication will be a necessary part of treatment.  Medications can help control the physiological aspects of anxiety (i.e., rapid heart rate, feeling sick to the stomach, etc.) so that the child is better able to implement the coping strategies he/she is learning.  Medication is usually short-term.

If you think your child maybe suffering anxiety, please call today to schedule a consultative appointment to see if treatment may be beneficial (404-310-1161).