Kids Worried Sick

Breaking down the anxiety epidemic facing today’s kids



Like many active 10-year-olds, Ava* is involved in competitive cheerleading, enjoys playing the flute in her school’s band and loves spending time with her group of five close-knit friends. But daily life is a struggle for this fifth grader, who is haunted by debilitating worries about her personal safety, her health and being alone.

            “She’s always had issues with being alone in the house,” her mom says. “If I’m doing laundry, she’s in the laundry room with me. She still sleeps in our bed at night. I make her go to bed in her bed every night, and I sit in her room until she falls asleep. But, by about 1:00, she comes and gets in our bed.”

            Ever since Ava broke her arm last year during a cheer practice, her anxiety has worsened steadily.

            “She thinks she’s having heart attacks, and she’ll go to the school nurse saying she can’t breathe and her face is numb,” her mom says. “Before that, she’d never been to the school nurse in the six years she’s been in elementary school.”

            Ava isn’t alone. Mental health experts say that anxiety is now the number one most common mental health challenge among children. The National Institute of Mental Health estimates that 31 percent of adolescents, ages 13 to 18, suffer from an anxiety disorder of some kind, with girls at a slightly higher risk.

            Thanks to increased awareness and understanding of the disorder among health care practitioners, more children receive the treatment they need at an earlier age.

            “I’m seeing kids who in the past would have just white-knuckled their way through life until it got to the point where they couldn’t do it anymore,” says Dr. Jane Sosland, child and adolescent psychologist, University of Kansas Medical Center. “The stigma of mental health is slowly, slowly being chipped away, and that’s a good thing.”

 What is anxiety?

            From your heart slamming against your rib cage before standing up to speak in front of an audience to sweaty palms during a job interview, we’ve all experienced anxiety. Anxiety becomes a problem when it affects quality of life and interferes with the activities you normally enjoy.

            Some symptoms of anxiety disorder include panic attacks, sleep problems, heart palpitations, chest pain, muscle tension, unexplained uneasiness, dizziness and cold, sweaty, numb or tingling hands or feet.

            “Usually, anxiety can start in the very young years, but then it can rear its ugly head in the teenage years,” Sosland says. “It’s something probably to do with hormones and puberty and a time in kids’ lives where they are starting to feel more self-conscious.”

            Left untreated, anxiety can cause kids to miss out on important social experiences and lead to poor performance in school, substance abuse, physical illnesses, depression, self-harm and suicide.

Causes of anxiety

            Anxiety can be a product of genetic wiring or a result of a specific stressful or traumatic event. The condition also can be triggered by a combination of factors, ranging from marital and economic distress in the family to overwhelming school pressures, social media and intense news stories.

            Some experts also worry that helicopter-style parenting can exacerbate anxiety. So-called helicopter parents go to great lengths to protect their children from failure or struggles, resulting in emotionally-fragile young adults who lack the confidence to solve their own problems independently.

            Without a sense of resilience, trying to manage life’s inevitable ups and downs becomes exceptionally stressful.

            “Resilience is built by working through adversity and difficult situations. It is difficult to pick yourself up and brush yourself off if you never fall down,” says Dr. Zafar Mahmood, a child and adolescent psychiatrist, HCA Research Psychiatric Center, Kansas City, MO.

Parenting anxious kids

            Although you should maintain the same expectations for your anxious child as you would another child, it’s okay to adjust those expectations during stressful moments. Plan ahead for transitions to ease anxiety and praise small accomplishments, like when your child tries something new.

            “An anxious child is very difficult to parent sometimes. On the one hand, they’re usually very well-behaved, very much follow the rules, do well in school, but they also can be challenging for a parent because they really want a lot of reassurance,” Sosland says. “However, they can’t get it enough.”

            Suppose your child repeatedly asks you, “Do you think I did okay in the concert?”

            The more you reassure him with statements like, “Yes, you did great! Everybody thought you were awesome!” the more you unintentionally reinforce your child’s belief that maybe he isn’t okay.

            Instead of trying to make a child feel better through reassurances, Sosland recommends acknowledging your child’s worries and then asking how he can best manage his thoughts.

            For example:

            Parent: “It sounds like you are pretty worried about your performance. What can you say to yourself to cope with your worry?”

            Child: “That was hard for me, but I did my best. I’m proud of myself for hitting that note I’ve been practicing all week. I’ll be okay.”

            By guiding your child to reframe how he thinks about a situation, you send the positive message that you believe he has the resolve to cope with his feelings, and he doesn’t need to rely on external evaluations to feel good about himself.

            Because parenting a child with anxiety can be stressful, surround yourself with a strong support network for when you need a break or a compassionate shoulder to lean on.

Coping with anxiety

            Help your child identify healthy coping mechanisms for when she is anxious.

            “Having someone who they feel like is actually listening to them is a huge piece of learning how to feel better,” Sosland says. (See sidebar for additional coping ideas.)

            As parents, we often think we need to help our kids solve their problems. Sosland has another suggestion called the 80/20 rule.

            “Eighty percent of the time kids just want their parent to listen. They don’t want you to fix the problem,” she says. “We are quick to come in and tell them what to do or tell them they shouldn’t feel the way they do. That doesn’t usually make them feel better. It just makes them feel like they’re not being heard.”

            The other 20 percent of the time kids do want your help. Usually, they will ask you directly for advice about how they can solve a problem.

Rising social anxiety            

Our hyperconnected children can’t imagine life without technology. Studies are beginning to suggest that too much screen time could correlate to increasing rates of anxiety, depression and loneliness.

            In her book iGen, psychologist Jean Twenge studies trends among children born between 1995 and 2012. Through her research, she discovered disturbing patterns indicating that as smartphones became more commonplace among teens, depression and unhappiness also began to rise.

            “They are on the forefront of the worst mental health crisis in decades,” Twenge writes.

            Kids today spend about an hour less per day with their friends than teens did in decades past, preferring online interactions. But the more time they spend online, the less happy they feel.

            “Eighth graders who spend 10 or more hours a week on social media sites are 56 percent more likely to be unhappy than those who spend less time,” Twenge writes. “There’s not a single exception: All screen activities are linked to less happiness and all non-screen activities are linked to more happiness.”

            Why? Biologically, we are designed to spend time with friends face-to-face. When we socialize with friends, our brains release a host of neurochemicals and hormones that reward us with an overall sense of wellbeing, helping us to better manage stress and even buffer us from illness. The brain doesn’t respond in the same way to computer-mediated communication.

            Over-reliance on screen interactions can interfere with a teen’s ability to develop crucial social skills that help her pick up on emotional cues, manage conflict or build confidence in social situations.

            “Without developing interpersonal skills and discipline, kids may experience feelings of anxiety anytime they step out of the house and interact with others,” Mahmood says.

            Social media also can give kids the impression that everyone else’s world is hunky-dory and that they’re alone in their struggles. And with unhindered 24/7 social media access and multiple messaging platforms, there’s no break from the rest of the world for quiet reflection or relaxing time alone.

            “In days past, you could leave the bully on the bus. Now bullying follows kids into their bedrooms when it is time to go to sleep,” Mahmood says.

            Foster resilience to challenge anxiety

            We’d all prefer to avoid situations that make us uncomfortable. The trouble is if we don’t participate in activities because we’re scared of failing or because they make us nervous, we can’t grow more self-confident and resilient.

            According to the Anxiety and Depression Association of America (ADAA), when we avoid stressful situations, we reinforce anxiety and end up feeling more demoralized.

            Knowing how far to push children can be tricky and depends on the intensity of their anxiety.

            “If you have an anxious child, what you don’t want to do is push them too far and too fast out of their comfort zone,” Sosland says. “On the flip side, you don’t want to be overly protective and never expose them to those things that make them anxious.”

            Instead, she recommends taking baby steps to increase self-confidence. Also, tap into the activities your kiddo is already passionate about. Self-confidence in one area can increase self-confidence in other areas of a youngster’s life.

            “If your child is really anxious in school, but they love to go horseback riding, then let’s do that horseback riding because they feel really good about that. They can learn lessons from that which they can transfer over into school,” Sosland says.

            Seek experiences that gently push your child to try new things in a supportive, collaborative atmosphere. Acknowledge and praise those moments when she accomplishes something despite the initial uneasiness and discomfort it caused, whether that’s pushing through a mile at cross country, going to her first sleep-away camp with a friend or trying out for a part in the school play.   

            Day-to-day, look for opportunities where your child can advocate for herself. For example, instead of emailing your child’s teacher about a grade your child felt was unfair, encourage her to talk to the teacher about it. If he’s struggling in a particular subject, suggest he ask his teacher for extra help. If your child complains about a playground disagreement with a classmate, listen to the problem and, if requested, offer ideas for possible ways to manage the situation.

            “Let them face adversity,” Mahmood advises. “Everyone will face disappointment and adversity in their lifetime. Those who succeed are those who have developed the skills and discovered the resources to deal with it.”

            Anxiety is highly treatable. If your child continues to struggle, please consult your family physician.

 

*Name changed.

 

Did You Know? A parent with anxiety is seven times more likely to have a child with anxiety.
Source: Dr. Jane Sosland

 

Coping Ideas for Anxious Kids

  • Journal.
  • Listen to music.
  • Reframe negative thoughts with positive.
  • Paint, draw or collage.
  • Pet an animal.
  • Blow bubbles.
  • Ride a bike.
  • Rest.
  • Watch a funny video.
  • Breathe deeply.
  • Volunteer for a favorite cause.

 

Stress-Relief Ideas for Parents

  • Take a power nap.
  • Squeeze a stress ball.
  • Listen to soothing music.
  • Walk with a friend.
  • Blow bubbles with your child.
  • Listen to a calming meditation app with your child.
  • Collage.
  • Garden.

 

Additional Resources

  • WorryWiseKids.org
  • Freeing Your Child from Anxiety by Tamar E. Chansky, Ph.D.
  • Anxious Kids, Anxious Parents: 7 Ways to Stop the Worry Cycle and Raise Courageous and Independent Children by Reid Wilson, Ph.D.

Freelance journalist Christa Melnyk Hines and her husband reside in Olathe with their two children, ages 10 and 12. Christa is the author of Happy, Healthy & Hyperconnected: Raise a Thoughtful Communicator in a Digital World.

 

As always, please consult your health care provider with any questions or concerns.

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