Anxiety in Children - How To Help A Child With Worries
What is Worry?
The definition of worrying is to cause anxiety by dwelling on difficulties.
When children worry, they repetitively think about the negative aspects of a problem.
Kids may do this because they are already feeling anxious or are under stress at school or socially.
Then the worrying can make kids feel more anxious because they may feel that they can’t control their worries. Then they feel anxious about feeling anxious. It’s a vicious cycle that could lead to symptoms of a panic attack.
Worrying is a normal part of life. It’s a signal that something could be wrong. It helps us solve problems. It prepares us for potential future problems.
Worrying can also be a sign of an anxiety disorder if the worries are excessive and the resulting anxiety interferes with your child’s daily activities.
What are the symptoms of worrying?
Repetitive or uncontrollable negative thoughts or images
Restlessness or feeling on edge
Fatigue
Difficulty concentrating or mind going blank
Muscle tension or muscle soreness
Poor sleep
What is Generalized Anxiety Disorder (GAD)?
GAD is the most common diagnosis for individuals with excessive worry and anxiety.
Symptoms include:
Persistent worry and apprehension that is out of proportion to what would actually happen
Difficulty controlling worried thoughts
Worries over routine daily activities and experiences (Job, health, finances, family, household chores, being late)
Difficulty making decisions
The worry and apprehension goes well beyond normal daily worries and is associated with significant physical symptoms of:
Restlessness or feeling on edge
Trembling, twitching
Fatigue
Difficulty concentrating or mind going blank
Feeling irritable
Muscle tension or muscle soreness
Poor sleep
Frequent urination and/or diarrhea
Sweating
Nausea
What do children worry about?
Children typically experience worry about their competence or performance with school or sports.
Children’s worries usually shift from one concern to another. They may seek more reassurance and approval from parents.
Children may also conform more and lack confidence. Children will usually have more physical complaints such as stomach aches or feeling ill and may avoid going to school.
The type of worry tends to be related to the age of the child. As kids become more aware of the world around them, they become more aware of their vulnerabilities.
Younger children may worry more about being away from their parents, worry about strangers, and worry about storms.
Preteens and teenagers may worry more about grades, tests, sports performance, body changes, fitting in, and being bullied. Kids can also worry about societal issues such as terrorism, social injustices, and even presidential elections.
Worry Center of the Brain
Brain imaging studies have identified that a small almond shaped structure in the brain called the amygdala is associated with worry (Elizabeth I. Martin, PhD, Kerry J. Ressler et al. 2009). They found an increase in activity in the amygdala and in the left prefrontal cortex of adolescents diagnosed with Generalized Anxiety Disorder (GAD).
Researchers Pine and LeDoux have suggested that the amygdala sounds the alarm but the thoughts in your prefrontal cortex are responsible for labeling the anxiety and fear (Joseph E. LeDoux, Ph.D., Daniel S. Pine, M.D., 2016).
Your prefrontal cortex is responsible for planning, attention and focus, making decisions, and regulating social behavior (called executive functioning).
This part of your brain decides if the worry or fear is real or not real.
Your amygdala will respond to the decisions coming from your prefrontal cortex. Your amygdala picks up cues from your thoughts and behavior. Learning how to communicate with your amygdala differently, has the power to over-ride the fear response and decrease anxiety.
When we worry, we continually spin around between our left prefrontal cortex and amygdala. This can become a vicious cycle because your thoughts are focused on danger, your amygdala then triggers the anxiety alarm, causing you to have more thoughts of danger, and causing your amygdala to keep sounding the alarm.
Another brain imaging study at UCLA also discovered that when people were shown a photograph of an angry or fearful face, they had increased activity in the amygdala (Matthew D. Lieberman et. al. 2007).
But when the people attached the feeling word “Angry,” there was decreased activity in the amygdala. They discovered that only “feeling words” caused a decrease in the amygdala and an increase in the right prefrontal cortex. Attaching a name like “Harry” did not have the same effect.
So worry causes a vicious cycle between your amygdala and your left prefrontal cortex.
Labeling your emotions turns on your right prefrontal cortex and shuts off your amygdala.
This suggests that labelling your negative emotions helps to reduce them.
How Parents Can Help a Child with Worries
The goal is to get your child to start talking about the worry, to label their feelings, and to learn how a worry is just a thought that causes anxiety.
Talking about the worry helps your child shift out of silent worry mode and activates other parts of their brain responsible for speech, hearing, and abstract reasoning. This helps increase your child’s brains resources to solve problems.
1. Ask Questions
To identify possible worries ask open ended questions of “what, how, who, and when” to find out what is on their minds and what is going on during their day.
“How was your day today?” “What happened at school?” “What do you think about that?” “How does that make you feel?” “Who did you talk to or play with today?”
Try not to ask yes or no questions.
2. Listen Without Judgement
Remember that your child’s worries may seem insignificant in comparison to your adult worries but your child’s worries can be very troublesome to her. So it’s important how you respond when your child lets you in on their worries.
Your intent may be to provide reassurance that what your child is worrying about is an issue that can easily be solved but this could also invalidate your child’s feeling of how big, important, and difficult it is for them.
Repeat what your child says to make sure you got it right and to show that you are listening. “You are worried that everyone will laugh at you if you tell the teacher the wrong answer after being called on in class?”
If your child is too fearful to talk, try having your child color while talking. This help your child to talk about her worries with less fear and anxiety.
3. Deal with your own anxiety effectively
As parents, we need to be mindful of not imposing our own anxieties and fear onto our kids by limiting their exploration and experiences, such as helping them to avoid scary situations.
It is also important not to over-react to your child’s worries or to show your own anxiety about their worry. You may feel anxious on the inside but you can still model how to stay calm.
Our kids will learn how to deal with anxiety by watching us and how we deal with our own anxiety.
4. Provide empathy and reassurance
Tell your child that you know how scary things can feel. Sometimes it’s helpful to tell your child about a worry or fear you had when you were their age and how you conquered that fear.
Confidently tell your child “It’s going to be OK, you will get through this, and I am going to help you.”
Tell your child that worries are a normal part of life.
5. Do not Accommodate Your Child’s Worries
Kids will normally want to avoid even talking about their worries or what they fear. Avoiding only provides temporary relief.
Avoidance falsely confirms that the worry is dangerous and should be feared. Avoidance ultimately maintains the worry and causes more anxiety.
Don’t avoid dealing with your child’s fear by making accommodations such as not going places that may trigger the worries and fears or enforcing that other family members change their behavior.
6. Label the worry
Help your child label the feeling that the worry is causing, “How does that worry make you feel?”
Remember that research has discovered that labeling the feelings caused by worry helps to turn off the worry cycle between the left prefrontal cortex and the amygdala.
Instead of focusing on the content of the worry, such as “What if the teacher calls on me and I say the wrong thing in class, everyone will laugh at me,” have your child call it “The thought that causes me to feel afraid.”
7. Write It Down
Writing a worry down allows your child to stop mentally spinning about it. If it is written down, then your child doesn’t have to ruminate about it. It gets the worry out of their head and onto the paper.
This can also be helpful if your child is afraid or uncomfortable talking about the worry.
Your child can then allow you to read the worry or your child can put the worry somewhere.
My wife created a worry jar for our kids to put their worries into. You can use a jar, a box, or anything that can be closed. You can then get rid of the worries by putting them in the trash, tearing them up, or throwing them in a fireplace.
The best time to write down the worries can be at the end of the day right before bed or in the morning before the start of the day.
Writing down worries helps with problem-solving. By writing down her worries, your child will move from her subjective fear of the worry to being able to look at it more objectively.
To help problem-solve the worry, have your child write down the worry, the feeling your has, what your child fears will happen, what your child wants to happen instead of the fear, and then some possible solutions:
I am worried about .
Because of this worry I feel .
I am afraid will happen.
What I want to happen is .
Possible ways to make this happen are .
8. Change the Ending
Have your child write down the worry as a story and have your child change the ending.
“The little girl worried so much that the teacher would call on her and if the girl did not know the answer, all the kids would laugh at her and think she was dumb. The day came when the teacher called on the little girl, and to her surprise, she proudly knew the answer.” Or “……the little girl did not know the answer, and to her surprise, the other kids did not laugh because they did not know the answer either.”
9. Refocus
Now that your child has confronted the worried thoughts and labeled them, it’s time to move on to the next task.
Have your child focus on what’s going on around them. Ask your child to talk about the things that they have control over and are grateful for.
Help your child get out of worry part of their brain and shift over to another part of their brain by coloring, listening to music, exercising, or other enjoyable tasks that require their mental attention.
10. Seek Help from a Mental Health Professional
If you believe your child’s worries are severe, it will be helpful and important to seek consultation with a mental health professional to assess for possible anxiety related disorders and to provide appropriate treatment.
