As I have said before, anxiety has replaced infectious diseases as one of the most frequent disorders pediatricians see regularly. Not all anxious feelings are destructive however. Being anxious about grades motivates kids to do their homework and study for tests. Or, being anxious about their parents being mad, motivates teens not to stay out too late or call home to let their parents know where they are. But sometimes anxiety and worry, tip a child into an unhealthy state where their worry is destructive to their health. Here’s a Doc Smo pearl for you to ponder- Anxiety that doesn’t lead to an action and ultimate resolution is destructive. I see this cycle almost everyday so I thought it might be useful to talk about what measures parents can take to help their children, should they be anxious and need help. Let’s explore anxiety in today’s edition of Portable Practical Pediatrics.
What are the common presenting symptoms of anxiety in a child?
There are lot of different presentations of anxiety and worry in children. In today’s world, pediatricians have become experts at recognizing the physical symptoms of worry that manifest in children. We were actually trained at detecting meningitis, pneumonia, and diabetes but we have morphed into experts in psychosomatic illness. Here is a list of the most common physical symptoms that I see in my patients that are often rooted in anxiety:
- The child with recurrent headaches or stomachaches,
- The child who starts having sleep problems such as difficulty separating from their parents, frequent nightmares, or bedwetting that returns after it had disappeared.
- The child who complains of being chronically tired when no physical cause can be found.
- The child who complains of shortness of breath without the child having a cough or exercise intolerance.
This is by no means a complete list but these are the presentations I see most commonly in very anxious children. If your child exhibits some of these symptoms, consider anxiety as a possible root cause.
Now for some of the behavioral manifestations that might signal excessive worry in your kids:
- If your child lacks the confidence to try new things or seem unable to face simple, everyday challenges
- If your child chronically finds it hard to concentrate
- If your child has excessive emotion about food and eating
- If your older child is prone to angry outbursts that happen too frequently
- If your child is stuck on negative feelings or is repeatedly thinking that bad things are going to happen
- If your child is developing unnecessary rituals to keep bad things from happening
- If your child is beginning to avoid everyday activities, such as seeing friends, going out in public or attending school because of some excessive worry
- If your child is acting much younger than their actual age. In other words, their behavior has not progressed or even has regressed compared to children of their age.
I think all of these symptoms require action on the part of parents so let’s talk a little more about what you, the parent, can do to help should you have a anxious child.
Once you have determined that your child suffers from anxiety, what do you do next?
Start with an assessment of what is wrong, what is causing your child to be anxious? A lot of parents forget this step and it can be the most important. Make sure you consider all aspects of your child’s life when doing this evaluation including recent unsettling events, changes in your child’s family situation, any serious mood problems among family members, any recent traumatic events in your child’s life, or the possibility that your child is being bullied. Additionally, consider if your child is getting too much media consumption, or has academic problems at school.
Doc Smo’s advise to parents of an anxious child.
- Talk, talk, talk and this is probably the most important step -especially when your child is open to this kind of conversation like at the end of the day when they want to avoid bed, after they have been upset and need to calm down, or when they want something from you. The main point here is that you need to try and hear what your child’s fears are and not blow these worries off but rather, emotionally connect to their feelings. Listen and try and understand. You may even be able to impart some of your wisdom after listening to their concerns. Tell them stories of how you handle your own anxious situations and overcame your own anxieties when you were young. Oh, and make sure you recognize and try and correct their misconceptions about their life situation. Misconceptions like, if parents fight it means they don’t love their kids, or if a child has trouble with math at school that it means they are stupid. This is what psychologists call cognitive behavioral therapy or CBT. We have talked about this before on Portable Practical Pediatrics and you might want to check out one of these pedcasts- https://www.docsmo.com/accidental-psychotherapy-pedcast/ Give them your version of CBT. It can be very helpful. And finally, focus on solutions. Teach your anxious child strategies that can help them overcome the anxiety. Get your child to get out of the “What if” mentality and into the “What is” frame of mind. This can be very helpful.
- Make sure your child has enough down time, free play, and exercise. Unstructured play with plenty of exercise is one of the most effective stress relievers known. It’s hard to put a lot of energy into being anxious if you are physically tired, wouldn’t you say?
- Make sure your child has routines, a schedule that is predictable and constant. Children need structure and predictability. Meals should not be missed, schedules should be adhered to, and parents should tell their kids what to expect as the day unfolds. Routines make them feel secure.
- Here is an important tip–Turn off the TV and limit screen time. Some of what is considered “Entertainment” is very disturbing to young children, even some of that kiddy programming. Even Disney can step over the line for some children at times.
- Make sure you take a some time to assess all facets of your child’s life and look for sources of stress.Maybe they are trying to do too much or you are somehow putting too much pressure on them to learn to play the piano or perfect their backhand on the tennis court. As a parent, try not to become too anxious yourself and react to your child’s anxiety by becoming overprotective or controlling.
- Consult your child’s pediatrician or a mental health professional. They can be extremely helpful in helping sort out minor anxiety for more serious problems. They also have some tools at their disposal that can be extremely helpful like cognitive behavioral therapy and medications that can relieve anxiety.
I hope those tips give you a starting point if you have an overly anxious child in your house. Don’t forget to consult your child’s pediatrician to get their insights. They probably know your child fairly well and can be very helpful. Well that’s today’s installment of Portable Practical Pediatrics. If you enjoy learning about child health issues with pedcasts, take a moment to write a review on iTunes and of course, subscribe to my blog at www. docsmo.com. Fresh content will be coming at you regularly, I promise. My goal is to give you accurate insightful information that you can use in your parenting journey. Thanks for joining me today. This is your host, Dr. Paul Smolen, you know, Doc Smo hoping if you have a anxious little one, trying these tips may help a ton. Until next time.
- How to Help your Anxious Child-Huffington Post
2.National Health Service- Your Health, Your Choices