Anxiety is one of the most common mental health problems in children and adolescents. Anxious children in most cases are quiet, well-behaved and overly diligent. Therefore, they often go unnoticed by teachers and educators. Others may be more active and disruptive, thus being labeled as suffering from attention deficit hyperactivity disorder. Both scenarios result in children often not getting the help they desperately need. Unfortunately, anxiety that is not addressed can lead to missed opportunities in development and relationships in the future and to a reduced quality of life. (Poppleton, Ramkission, Ali, 2019)
Anxiety is a natural human reaction and serves an important biological function: it is an "alarm system" that is activated when we sense danger or threat. When the body and mind react, we can experience a variety of physical discomforts such as dizziness, palpitations, difficulty breathing, sweaty or trembling limbs, abdominal pain, headaches, and more. These sensations are caused by a sudden influx of adrenaline and other stress hormones that prepare the body to quickly escape or escape from danger, the so-called "fight or flight" response.
Parents often report that from a very early age they sensed that there was something different about their child, but did not immediately recognize it as an anxiety problem. Some wait for their child to "outgrow this period", not knowing that anxiety can deepen. Other parents see anxiety as something natural because they, too, felt the same way in their own childhood. As a result, parents of anxious children and teens are often confused, frustrated, discouraged, and overwhelmed.
The good news is that there is a lot of literature on the topic of anxiety, as well as many professionals who have extensive experience with anxiety conditions. In this text you will find some basic explanations about anxiety in children. The first step is to learn more about anxiety—what it looks like, how it works, and how to recognize if your child has a problem.
What can trigger anxiety in children?
- Separation from a close adult - from about 6 months to 3 years of age, separation anxiety is very common in young children. Children may become clingy and cry inconsolably when separated from their parents or caretaker (e.g. grandmother). This is a normal stage of child development and should subside by around 2 to 3 years of age if adults respond to these sections with both understanding and assertiveness.
- Change - every child reacts differently to life changes. Some children are more prone to anxiety and worry than others. Moving to a new home or school is an example of such a life change. It is also common for preschoolers to develop specific fears. The most common early childhood fears are of beasts, insects, storms, sirens, heights, water, blood, injections, and the dark. (Muris, 2001)
- Trauma – children who have experienced a distressing or traumatic experience such as a car accident or natural disaster may suffer from high anxiety afterwards.
- Family situation - family misunderstandings and conflict situations can also make children feel insecure and anxious. Tension between parents can often increase anxiety in children. Divorce or parental separations, accompanied by misunderstanding and unclear boundaries, contributes to anxiety in children.
- Social anxiety – this difficulty is often seen in teenagers. It is expressed in avoiding social gatherings or making excuses to get out of them. At this age, children tend to communicate more freely in the virtual world, as there is less social threat.
When is anxiety a problem for children?
Anxiety becomes a problem for children when it starts to interfere with their daily life. Many children would feel a little tense before exams or in the first days at a new school, but most manage to quell this tension and adapt. It is possible that more anxious children may not be able to approach the challenging situation at all because of the physical discomfort caused by the anxiety. They feel insecure and worried more than other children of a similar age. Anxiety stops them from participating in activities at school or in other social settings. Their fears and worries seem out of proportion to the problems in their lives.
Such conditions can harm children's mental and emotional well-being, having a negative effect on their self-esteem and confidence. They may become distant and go to great lengths to avoid things or situations that make them feel tense.
What are the signs of anxiety in children?(Aichinger&Holl, 2010)
When young children feel anxious, they may not always understand or express what they are feeling. They may become irritable, upset or clingy. Difficulty sleeping may occur, such as multiple awakenings during the night, sporadic or constant incontinence during sleep, nightmares. Physical complaints and/or symptoms on the part of anxious children are also characteristic - abdominal pain, loss of appetite or excessive appetite, nausea, constipation or diarrhea, headache, low tone, sweating of the limbs, tremors, palpitations, various tics.
In older children, a lack of confidence is noticeable. Some may refuse to try new things. Others may seem unable to cope with simple everyday challenges. They may also have difficulty concentrating, have angry outbursts, have a lot of negative thoughts or premonitions of something bad to come. In such cases, children begin to avoid basic daily activities - for example, seeing friends, going out to public places or going to school.
How can we help an anxious child?
If a child is experiencing anxiety, there are ways parents and carers can help:
- Conversations - it is most important to talk to the child about their anxiety or worries. It needs to be reassured that its feelings are significant and heard. To reassure does not always mean to agree. His fears should not be downplayed, but neither should they be amplified. It is good to show him that he is heard, that the adult empathizes with him, that he is helped to understand what he is worried about, and that he is encouraged to feel that he can face his fears. The message we're sending him is, “I know you're scared, and that's normal. I'm here to help you get through this.''
- Open-ended questions - it is useful to encourage the child to talk about his feelings, but not to ask closed leading questions - "Are you worried about the test tomorrow?" Asking open-ended questions helps avoid feeding the cycle of anxiety - "How do you feel about the test tomorrow?"
- Learning about anxiety - if the child is old enough, it can be explained to him what anxiety is and what its physical effects are on our bodies. Other ways to relieve anxiety in children is to teach them to independently recognize the signs of anxiety in themselves. It is good for them to know that they can seek help from adults when they need it. They can be helped to find, together with the adult, solutions and strategies for dealing with anxiety in different situations.
- A daily rhythm – for all children it is soothing, so it is good to have it and for the parent and child to stick to it wherever and whenever possible.
- Awareness - if a child has developed anxiety due to traumatic events such as losing a loved one or a separation, you can look for age-appropriate books or movies to help them understand their feelings. These resources would have the most positive effect if you read the book or watch the movie together and then talk about the topic.
- Think one step ahead – if you know a change is coming, prepare the child by talking to them about what will happen and why the change is needed. Newly created situations and what is to come alongside them need to be explained to children. The calmness of the adult, but also his sincerity about his own feelings, inspires security and confidence in children.
- Play – distraction from the distressing situation can be helpful for young children. For example, if the child is worried about going to nursery or kindergarten, the way there can be varied with games and fantasies. (Cohen, 2012)
When should we seek help?
If the child's anxiety is high, lasts for a long time and interferes with his daily life, it is advisable to seek help from a specialist in the form of a child psychologist and psychotherapist.