Author: Dr. Melanie Badali
My daughter has struggled with anxiety since a very early age. When I first set out to find help, I had no idea of where to start. I didn’t know of any other families with anxious children and no one seemed to be struggling like we were – and if they were, no one talked about it. Fast-forward to a few years later and my network of parents of anxious children has grown. As soon as I started talking about anxiety, I found that other parents with similar issues came out of the woodwork. The more I talked about it, the more I was connected through friends – and friends of friends – to parents of children with anxiety.
When I meet a parent of an anxious child, there are three common things I usually hear. ONE – it took a while to pinpoint anxiety as the culprit. TWO – they kick themselves for not doing something sooner, and THREE -they didn’t know where to start. In my case, all three applied.
Now when I look back, it seems obvious that anxiety was what my daughter was struggling with, but at the beginning, it wasn’t so obvious to me. Friends and family would repeatedly tell me that my daughter would “grow out of it.” I believed it and did nothing for quite a while. I don’t think I’m the only parent who feels guilty that I didn’t seek help earlier. If you are a parent who has been in this situation, you know that it can be extremely difficult to pinpoint what is exactly going on with your child and what is the best way that you can help them.
Managing an Anxious Child – Where to Start
In this three-part blog series, we will cover tips for parents who may be new to managing their anxious child. In our first blog, we will cover common symptoms of children who may be struggling with anxiety.
What does anxiety look like?
Anxiety is one of the most common mental health concerns for children and adults; one in four Canadians (25%) will have at least one anxiety disorder in their lifetime. In some children, it may be more obvious, but in others, it may take a bit longer to determine that they are dealing with anxiety. In my situation, I knew that something was different with my daughter when she was a toddler, but didn’t recognize that it was in fact anxiety and kept hoping that she would grow out of it. As her symptoms persisted and became worse, eventually it became clear that she was struggling with anxiety.
What are the symptoms of Anxiety?
Anxiety can have an impact in several different ways – it can affect your child emotionally and cause the child to worry about things, and it can also impact them physically, causing your son or daughter to complain of stomach aches. It can impact your child’s behavior, and cause him/her to avoid situations, constantly seek reassurance, and become overly dependent on you the parent. Anxiety is a problem when it becomes excessive and extreme, relative to the situation. In fact, anxiety can impact us in six ways:
- Affect: Emotionally and physically
- Behaviorally: Avoiding or seeking reassurance
- Cognitive: Worrisome thoughts
- Dependence: Relying on parents
- Excess and Extreme: Excessive and extreme in relation to the situation
- Functioning: Impacting how your child manages each day
With my daughter, it started when she was very young. Lights, dogs, bees, clothing, and large family gatherings set her off, even before she couldn’t communicate with us, and then in kindergarten, the separation anxiety kicked in, which later led to stomach aches and school refusal. Sometimes it’s not as obvious to spot. Anxious youth are often quiet and well behaved, and thus frequently go unnoticed by their parents, teachers, and coaches.
In some instances, a child may complain of stomach issues, and after seeing a doctor, the family will find out that it is in fact, anxiety. When my daughter’s anxiety was at its worse, she would complain of stomach issues each night before bed. Some examples of physical symptoms that a child with anxiety may exhibit include:
- Chest pain or discomfort
- Discomfort or pain in the stomach, nausea
- Dizzy, lightheaded, or unsteady feelings
- Feeling foggy, or like things are unreal or a feeling of being detached from oneself
- Feeling very hot or cold
- Feelings of a lump in the throat or choking
- Numbness or tingling
- Rapid heart rate
- Rapid breathing (hyperventilating), feelings of shortness of breath, or breath holding
- Trembling or shaking
If your child starts avoiding activities that s/he once enjoyed, or has started to refuse to go places, for example, refusing to go to school, your child may be struggling with anxiety. In situations where there is no real danger, avoidance prevents children from learning to cope with a challenging situation or from engaging in activities. Common examples of behavioural changes caused by anxiety include:
- Not participating in class because s/he is afraid to speak up or raise a hand
- Excessive fear of making mistakes, or desire to be “perfect” in appearance and work projects
- Refusing routine injections (shots) or dental work
- Refusing to hang out with other kids or having few friends because of social fears
- Not sleeping in his or her own bedroom or refusing to attend sleepovers
- Refusing to go to school for any number of reasons (e.g., an exam, performances, a bully, social situation, etc.)
- Refusing to participate in sports, dance, or other performance-related activities
In my experience, my daughter was terrified of lunch hour and would do everything in her power to get me to pick her up at lunch. She would complain of a stomach ache, refuse to go to school and cry as soon as the bell rang in the morning when she had to go into the classroom. As soon as I told her that I would come pick her up at lunch, everything stopped, and she was fine. Unfortunately, this may seem like a quick fix; however, avoidance doesn’t help long-term. She had to find ways to cope with her fear of lunch hour and work through it. I’m happy to report that lunch hour is going more smoothly now.
I found from a very young age, my daughter worried about things that wouldn’t concern most children.
Since kindergarten, I haven’t once forgotten to pick her up from school, but for about two years, she worried about this every day. She would ask me at night, as well as in the morning if I was going to remember to pick her up from school. She would even leave me post-it notes as a reminder. I’d find these notes while she was at school. Unbeknownst to me, she would also set my alarm on my iPhone to remind me. Some other common examples of worry in anxious children include:
- I’ll fail my exam
- My Mom might forget to pick me up after school
- My teacher will yell at me and the kids will laugh
- That dog might bite me!
- What if I fall off my bike and everyone laughs?
- What if I throw up at school?
- What if my Mom or Dad dies?
I noticed that my child was more dependent on me than other children were with their parents. She had difficulty separating from me and wanted me everywhere with her – at activities, school, and birthday parties. The need to seek reassurance for everyday things was also quite common. Some examples of dependence that you can look for, include:
- Asking “Are you sure I won’t get sick?”
- Asking “Are you sure you will be on time to pick me up?”
- Asking parents to talk to teachers to request extra time on an assignment or to manage other academic needs
- Making the parents give them a complete change of clothes when they go to the movies in case the child gets sick.
- Not wanting to be away from home unless they have a cell phone
- Only going to a party if a parent comes with them
- Seeking ongoing reassurance about something (e.g. skin irritation is not cancer)
Excessive and Extreme Symptoms
Anxious children may worry in excess and to an extreme. When my daughter was five, I can recall her checking the locked doors at night to make sure that the “bad guys” couldn’t get in. Sadly, she would also hide things on Christmas Eve, for fear that Santa Claus would steal something from her. Some other examples of excessive and extreme worrying include:
- Expecting the worst to happen, all the time
- Generating extreme conclusions from vague information
- Having trouble falling asleep due to excessive worries about daily events, getting enough sleep, or staying asleep
- Making extreme predictions with catastrophic outcomes
- Viewing themselves as incompetent, unlovable, worthless, ugly, etc.
- Worrying for hours rather than minutes about talking to a peer, a girl/boyfriend, or teacher
Unfortunately, anxiety has impacted our daily lives and has made everyday activities such as attending school, after-school recreational activities, and birthday parties extremely difficult. Some common examples of how anxiety can impact your daily life include:
- Being unable to do routine tasks without crying, tantrums or having continual reminders
- Believing, “I can’t cope” or “It’s safer to stay home”
- Not getting enough sleep or nutrition
- Over time, academic struggles, and/or social withdrawal
- Struggling to balance reasonable demands such as doing homework and playing a sport
Determining whether your child has anxiety can be overwhelming. If any of the symptoms above look familiar to you, it is best to discuss them with your family doctor. In the next blog, we will cover the resources that are available to help manage an anxious child. It’s also important for you, as a parent, to learn more about anxiety.
Explore our site to learn more information on parenting children with anxiety.