When Your Child's Anxiety Is Worth Worrying About — and How to Help
Published on in Health Tip of the Week
Published on in Health Tip of the Week
We all have anxious moments — and it’s normal and healthy for kids to have some age-appropriate worries about how they’ll do on tomorrow’s test or why they weren’t invited to the party their other friends were. Learning coping skills for those moments is a key life skill.
Sometimes, those worries cross the line into something a little more serious: anxiety. Especially in the wake of all the changes wrought by COVID-19, anxiety among children and adults has skyrocketed. Fortunately, if your child has anxiety, there are numerous ways to help them learn to manage it.
The first step in helping your child is identifying the issue. Children often can’t articulate when (or why) they feel anxious; anxiety in children can look different from adults — and kids at different ages will have different indicators as well.
Some things to watch for that could indicate a younger child is having anxious thoughts include:
Older kids are more likely to be able express when/why they feel anxious, but you could still see some indicators of anxiety, such as irritability, physical symptoms, shakiness or having trouble concentrating — which can be mistaken for ADHD.
Changes to a child’s schedule — even “good” things like going on vacation or moving up to the next grade — can create some anxiety for kids.
If you think your child is showing signs of anxiety, you’ll want to learn more about what they’re thinking and feeling. For younger kids, it can be helpful to use words like “being worried” or “scared” that will be more meaningful to them and are more likely to garner useful information about what’s bothering them.
If anything, noted Consuelo C. Cagande, MD, of CHOP’s Department of Child and Adolescent Psychiatry and Behavioral Sciences, it might be a little easier now to talk to kids about anxiety. “We virtually all had anxiety together during the pandemic,” she noted. “It’s almost become the new normal to talk about. We’re all a little more vigilant about it, but you also don’t want to hover over them or ask them if they feel this or that after a stressful situation. Just be aware and monitor your child and any changes.”
For lower level, more “everyday” anxiety, parents and caregivers have a lot of options for helping children learn to recognize their anxiety and find their own ways to calm themselves. Naline Lai, MD, a pediatrician at CHOP Primary Care, Doylestown, and John Grove, LCSW, therapist with CHOP Healthy Minds Healthy Kids Program, offered the following techniques to share with kids.
Another version of self-calming, called grounding is particularly helpful if your child is prone to panic. One effective and easy-to-remember grounding method is to have a child name five things they can see, four things they can touch, three things they hear, two things they can smell and one thing they can taste. The process of focusing on their sensations helps center children and reduce their immediate anxiety.
Anxiety can be a normal reaction to certain circumstances. An acute moment of anxiety in one stressful situation isn’t something to be concerned about. And your child might not have anxious symptoms even during more chronically stressful times.
But sometimes common, everyday anxiety becomes something a little more troublesome. “When it impairs their functioning, we start to be concerned,” says Dr. Cagande. For children, that could mean frequently missing school, failing grades, avoiding social activities or not wanting to leave the house, etc. “Taking a ‘mental health day’ from school isn’t impairment — missing two weeks without a medical reason would be,” Dr. Cagande said.
She advised that if parents see this kind of behavior in a child that goes on for even a few weeks, it may be time to see a mental health professional. A good first step is to see your child’s primary care pediatrician to rule out any medical issues that might be affecting their mental health and, if needed, to get a recommendation for a therapist.
For many children with anxiety, the symptoms are relatively mild, and they may benefit from therapy alone. For children who are more severely impaired by their anxiety, medication combined with therapy is the best option.
Let’s face it: Not all parents love the idea of seeking mental health care for their kids. They may worry about being stigmatized or have concerns about taking medication. It’s a typical concern, but one that Dr. Cagande said was based on misconceptions.
“One idea we promote is that mental health is health. It’s part of routine care to ask about it,” says Dr. Cagande. “Mental illness is common, especially in kids, and the pandemic has only amplified this. Anxiety and other mental health issues are illnesses that can be treated with medications or lifestyle changes just like asthma or diabetes.”
For your child’s overall good health, helping them take care of their mind and body are equally important.
Categories: Health Tip of the Week