Supporting an Anxious Child: Anxiety Disorders in Children
Wondering if children can have anxiety disorders? Do you want to know how to support an anxious child? Anxiety disorders in children are becoming more and more prevalent, especially due to some of the changing ways we consume media and the unique pressures of today.
Now, anxious kids certainly existed long before Instagram and TikTok. Still, many parents may not realize how much the relentless comparisons with peers contribute to anxiety disorders in children and teens. Other factors contribute to anxiety disorders in children as well, as we'll explore here.
If you suspect your child might be suffering from anxiety, here's how to support an anxious child and help get them through this challenge. For many children, supportive counseling and psychotherapy can offer them a safe space to explore these feelings. Contact us today to learn more about our counseling services for kids.
Anxiety Becomes a Vicious Cycle
Recently, I worked with a middle school girl, whom we'll call Rachel. Rachel was suffering from debilitating anxiety. Her parents brought her to me for treatment, and her mother reported that she was terrified of sleeping in her own room. In fact, she wouldn't even go up to the second floor of the house unless someone was with her.
She would also refuse to go to school from time to time, curling up in a fetal position on the floor and becoming emotionally distraught. Her parents didn’t know what they could do “better” to support their anxious child. They brought Rachel to our offices to see if we could offer her some coping skills to help her manage the anxiety she was experiencing.
The family was from an affluent suburb, where Rachel attended a rigorous middle school. She was anxious and perfectionistic. She often felt that she wasn't measuring up, like she wasn't good enough. She struggled with social relationships and worried that other students were judging her. Her social relationships suffered, as did her grades.
She felt unrelenting pressure with one more activity to attend, one more hurdle to jump, or one more task to accomplish. She suffered from migraine-like headaches and stomach upset. Rarely did a day go by when she didn't visit the nurse's office or text her mother to pick her up. But it became a vicious cycle—the more she missed school, the more anxious she became about missing school.
Her parents' first step was to take her to visit her primary care doctor, who prescribed an antidepressant. She had side effects and didn’t feel as though the medication helped. As time went on, she became more hopeless and depressed. When Rachel came to us, her parents were highly concerned about the anxiety that seemed to be consuming their beautiful teenage daughter.
Why Kids Experience Anxiety, Now More than Ever
Anxiety seems to have become quite prevalent in today’s society. In recent years we've seen an increasing trend of anxiety disorders in children and adolescents. Some of it has to do with outside forces—social unrest and news cycles highlighting frightening disasters.
But another major contributor to adolescent anxiety comes from our highly connected lifestyles with social media and electronic entertainment. Kids compare themselves to what they see online. Their experiences on the internet feel very "real" to them, and they may view media and feel they don't measure up to what they see on the screen.
Similarly, there’s a desire to appeal to as many people as possible through their social media posts and shares. Kids overshare and get caught up in how many views or likes they have. They haven’t yet developed their ability to discern private interactions from public ones, and so they can quickly find themselves in trouble.
These social media relationships can get in the way of and undermine genuine, meaningful in-person relationships. It can lead to bullying, name-calling, and abuse. It can also lead to a profound sense of loneliness and isolation. Just because a kid has a Snapchat streak of 20 people doesn't mean they're engaged in intimate connections. They're exchanging goofy pictures, trying to outdo or outrank others. Social media becomes an impediment to developing meaningful and trusting in-person relationships. “Likes” feel good, but it’s fleeting—it offers a temporary boost that’s quickly gone.
With social media, there's an immediacy factor. Kids are highly connected to their phones (as any parent of a teen or tween can confirm). Kids may agonize over a comment or wonder why a friend is "ignoring them" if they don't receive an immediate response. They may struggle with the delay of gratification, and when their needs aren't immediately met, they experience anxiety.
High-Achieving Kids and Anxiety Disorders in Children
As we saw with my patient Rachel, high-achieving kids can experience a lot of anxiety as well. Kids who live in very achievement-oriented communities and environments face incredible pressure to succeed in all domains—academic, extracurricular, social activities, and more.
Many kids face a constant flurry of activity. There's no downtime or slow time. The pressure is on to meet high academic expectations, participate in extracurricular activities, face constant social stimuli, and achieve.
Kids today don't have the downtime to get creative and imaginative. Parents are concerned about boredom, but the reality is that boredom offers kids a chance to come up with something new to entertain themselves. Having “think time” helps kids avoid the culture of instant gratification. Whereas electronics—video games, phones, television—feed into the idea of constantly needing to be entertained and busy at all times.
Even the pace of today's television has changed. Look at kids' educational programming from the 1970s and 1980s—it was slow, quiet, informational. It gave kids a chance to process the information and ponder what they were learning. Today's media is much faster with higher stimulus. The lights, the rapid images, the noise all leads to kids feeling a draw toward constant entertainment.
The idea of louder, faster entertainment may also contribute to feelings of anxiety in children. There's a discomfort with simply "being" or finding pockets of mindfulness and reflection. Kids are unable to tolerate boredom and quickly become frustrated and anxious in quiet situations.
So a child slows down a bit. Maybe they don't fit in that extracurricular activity. Maybe they spend time reading, doing a puzzle, playing a board game, or pretending outside. Will missing out hold them back? While many parents may fear that if kids don't get straight A’s, participate in after-school sports, engage in extracurricular activities, and have robust social lives, they won't get into college or succeed; this perception is false. Most kids I've seen get into a four-year school somewhere, if that’s what they want. Kids don’t need to be perfect achievers and attend an elite school to be successful later on.
The toll of constant pressure to perform leads kids to crack under pressure, like my patient Rachel. They become terrified of failing and struggle with the ability to relax. Pressure from parents, peers, and teachers compounds the stress, and as kids feel unable to cope, the feelings of failure increase too.
Lack of Independence and Self-Efficacy
Self-efficacy is the belief that one can handle a given situation. When kids are subject to “helicopter parenting” or lack independence, their self-efficacy suffers.
We live in a society where kids' activities are very planned out and structured. They aren't faced with many opportunities for on-demand problem-solving. They aren't put in places where they can mess up and fail. But failure is critical to building self-efficacy, confidence, and grit.
Kids go to school, then to extracurricular activities, then they go home and do homework. They don’t have much time for unstructured downtime or simple “play.” I work with many children who have never gone alone to a park in their neighborhood. Parents may believe that they’re protecting their kids from dangers, and they may indeed be, but they’re also robbing them of the opportunity to make independent choices.
Decades ago, when I was a kid, we would go out with friends for hours. We played in the woods, we explored, we navigated social relationships, and learned independence. Yes, there were chances to get hurt and other dangers, but there was also an opportunity to learn and build emotional resilience.
When we don’t give room for kids to be independent and make mistakes, they don’t know how to handle failure. It feels catastrophic. Parents may try to intervene—to contact teachers, "help" with homework, or involve themselves in social dilemmas. Still, the damage they're doing to their child's sense of self-efficacy is causing more significant pressure and anxiety.
Resolving Rachel’s Anxiety: How to Support An Anxious Child
So how do we help our children through these feelings of stress and anxiety? How can we help them build those critical skills like independence, grit, creativity, and problem-solving? How can parents support an anxious child?
One of the first, most critical steps is to allow your child space to simply be. If you notice that your child is frequently worried, or displaying perfectionist tendencies, let them have some space to make mistakes and learn. Avoid the urge to intervene and “rescue” your child from missteps.
Another essential suggestion we offer to all parents is to insist their child unhook from social media—at least at night, if not altogether. Anxiously comparing oneself to peers is almost uniformly distressing for kids. Round-the-clock responding to texts, posting to social media, obsessively following Instagram and Facebook exploits of friends contributes to self-consciousness, anxiety, and fear of failure.
When anxiety starts to affect any part of daily functioning, it's the tipping point. Worry is part of our human experience. Fear and concern can be helpful, like studying for an important test or crossing a busy road. But when anxiety starts to impact daily routines or manifests itself with physical symptoms like stomach and headaches, it’s likely time to seek the advice of a professional.
Red flags for anxiety in children include:
- Interference in school attendance.
- Problems paying attention in the classroom.
- Social isolation and avoiding friends.
- Physical symptoms like headaches and stomach aches.
- Anger, frustration, or lashing out (particularly displayed in boys).
- Tearfulness, sadness, or a flat affect.
- Inability to sleep, eat, or focus on activities.
- A sudden drop in grades.
We follow the guideline that if a child experiences physical symptoms and a doctor can't find a medical reason, if they're missing school, concentration, sleep, or appetite is diminished, or if the symptoms last longer than two weeks, they need attention. When kids (or adults) display catastrophic thinking, all-or-nothing thinking, or the idea that things will "always be like this," it's time to seek professional assistance.
With our patient, Rachel, we focused on therapeutic exercises to help her tolerate distress and imperfection. She had such high ideals and expectations of herself that it took several weeks of practice to challenge her thinking. In her sessions, we used role-playing, homework activities, and talk therapy to help her explore her feelings; our goal was to help her overcome her fears and spend the whole day at school.
When treating anxiety disorders in children, we often focus on methods that help build resiliency—to give the client ways to stop feeding the anxiety monster and stand up to it. Usually, this requires retraining the brain to tolerate uncomfortable situations. We have to create the message, "I can do this! It's okay to be outside of my comfort zone and to still be myself."
Parents must remember that kids build resiliency from experiencing failure. Anxiety is all about avoiding uncertainty and discomfort, but when kids experience uncomfortable situations, they learn how to navigate them with greater ease and confidence. When parents protect kids from facing the sources of their anxiety, we’re getting in the way of those critical coping and problem-solving skills.
If you're concerned that your child may be suffering from anxiety, please reach out. Our trained staff is well-versed in treating all forms of anxiety in children and adults, including OCD, PTSD, Generalized Anxiety Disorder, and Panic Disorder. Kids and parents don't need to navigate this difficult situation alone. We're here to help.