Understanding & Managing Childhood Anxiety

WHAT DOES ANXIETY LOOK LIKE IN KIDS?

Anxiety is the most common issue I work with in families. Anxiety is a shape-shifter. It can mask as anger, opposition, perfectionism, or withdrawal from friends and activities.

 Anxiety might look like this in your child:

  • Can’t fall asleep at night; child’s mind is stuck in overdrive

  • Won’t try anything new 

  • Overreacts to everything

  • Can’t stand it if there is not a clear plan

  • Can’t make up their mind, hates making decisions

  • Seems grumpy all the time; tantrums easily

  • Flies into a panic easily

  • Acts interested - but won’t follow through (playdates, parties, etc)

  • Always thinks 10 steps ahead

  • Asks many “what if” questions 

  • Needs a lot of reassurance

Anxiety can look different for different children. Children who are extremely confident in some ways can also have significant anxiety in others. We can think about a child’s functioning in four separate domains, and how anxiety impacts each domain in different ways:

Body

Your child’s physical experience and functioning, such as a pounding heart, blushing, trembling, or crying. These symptoms are part of our healthy, normal “fight or flight” response. 

Thoughts

How your child is feeling has a strong effect on how they understand and think about the world. Anxious children tend to have very vivid imaginations about the many ways things can go wrong. We can’t stop our thoughts but we can learn to notice our thoughts and to respond differently to them. 

Behavior

Anxiety’s job is to keep us safe from harm. When a child is anxious they will likely avoid the thing that made them anxious. Over time, “avoidance creep” means that your child’s world is getting smaller. Sometimes it is easy to spot the link between anxiety and certain behaviors (for example, your child sees a dark cloud and won’t play outside because she’s afraid of storms). But sometimes it is not so easy to see the connection (for example, when anxiety causes changes in your child’s mood, sleep, or appetite).

Feelings

High levels of anxiety increase the frequency of emotions such as fear and anger, and decrease the frequency of emotions such as happiness, curiosity, calm, and excitement. An anxious brain is in defense mode, prioritizing safety over exploration, connection, fun. The overlap between anxiety and depression is high because there simply isn’t as much room for positive emotions when a child is anxious. 

*Source: Eli Lebowitz, Breaking Free of Child Anxiety and OCD

How I treat anxiety:

I use evidence-based practices for effectively treating anxiety.

  • Cognitive Behavioral Therapy (CBT)

  • Supportive Parenting for Anxious Childhood Emotions (SPACE)

You and your child will learn:

  • How anxiety works

  • How to notice and challenge anxious thoughts

  • How to approach versus avoid anxiety-provoking situations (exposure)

  • How to turn off your alarm bells (practice relaxation)

  • How to manage and tolerate feelings

  • Healthy habits and routines for supporting positive moods and relationships