We all get anxious, but it becomes a “disorder” when it prevents a person from normal functioning. Anxiety and panic are very real, whether triggered by life in general or certain things such as phobias. Take it serious–it’s not something an extremely anxious child can “get over”. Willpower alone does not work.
Anxiety disorders are also one of the most common psychiatric conditions in children and adolescents, but often go undetected and untreated. Early, effective treatment can reduce the negative impacts on academic and social functioning.
Excessive worry or anxiety about multiple issues, which lingers six months or more, can indicate an anxiety disorder.
- Anxious mood: excessive worry, anticipating the worst
- Tension: startles or cries easily, restlessness, trembling
- Phobias: fear of the dark, fear of strangers, fear of being alone, fear of animals, etc.
- Insomnia: difficulty falling asleep or staying asleep, nightmares
- Intellectual difficulties: poor concentration, memory impairment
- Depression: decreased interest in activities, inability to feel happy
- Somatic complaints (muscular): muscle aches or pains, teeth grinding
- Somatic complaints (sensory): ringing in the ears, blurred vision
- Cardiovascular symptoms: tachycardia, palpitations, chest pain, feeling faint
- Respiratory symptoms: chest pressure, choking sensation, shortness of breath
- Gastrointestinal symptoms: difficulty swallowing, nausea or vomiting, constipation, weight loss, abdominal fullness
- Genitourinary symptoms: frequent or urgent urination, painful menstruation
- Autonomic symptoms: dry mouth, flushing, pallor, sweating
- Physical behavior: fidgeting, tremors, pacing
- Other: risk of abusing alcohol in adolescence, cutting and other self-injury (not suicidal)
Physical pain reduces psychological pain by shocking a person’s attention into the here-and-now. Like a glass of water thrown into someone’s face when they are upset, the shock overrides inner turmoil, and releases adrenalin and endorphins. It’s stimulating, even energizing. According to statistics from research, cutting becomes addictive after about 14 episodes.
True story: Laurel, age 14, cut herself regularly on her fingers, preferring to cut under her fingernails. She hid the cuts and scabs with nail polish. Her father eventually learned about this and asked her why: “I feel more calm because the sting feels good and distracts me.” A therapist recommended that Laurel draw “cuts” on herself with a red pen instead of a knife, and also wear a rubber band on her wrist or fingers and snap it when she wanted to feel a sting.
It is common for cutters to hide their scars or scabs under clothing if they think you will try to stop them, or they will cut in a place you won’t see unless they are unclothed. They may also make an excuse about an injury if you do see visible cuts. You can look for unexplained blood on clothing. Don’t be afraid to ask if they are cutting; many young people have freely ‘confessed’ when asked.
Treatment for anxiety
A child or teen will often be diagnosed with more than one type of anxiety disorder, in addition to a psychiatric disorder–30% of all anxiety cases include a diagnosis of depression and attention-deficit/hyperactivity disorder.
Cognitive behavioral therapy (CBT), in combination with antidepressant medications “have consistently shown efficacy for anxiety disorders in children and adolescents.” Many anti-anxiety medications on the market are addictive, so a doctor or psychiatrist will be very cautious about prescribing them except on an as-needed basis. Treatment must also include parent involvement, especially if the parents are also anxious. In the case of cutting, allow your child to cause themselves pain that is harmless, for example: hold tightly onto ice as long as they can, smell vinegar, taste hot pepper. These may sound strange, but they are effective techniques used in Dialectical Behavior Therapy (DBT) to help an anxious person tolerate stress. You find out more about CBT and DBT here: Therapy types explained – DBT, CBT, CPS, and others
How you can help
- Validate or affirm your child’s feelings. If he or she is worried, fearful, upset, or distraught, don’t insist they should not have their feelings, regardless of the reason. You can let your child know that feelings are normal and it’s OK to have a little fear at times.
- Reduce their dependence on you. Help them learn to cope by offering less reassurance, which can undermine their commitment and skills for coping. Messages that “everything will turn out OK” teaches them that you will help them through all fears, but they need to learn that they can get through fear on their own.
- Avoid helping too much. If you try to protect your child from all harm, it prevents them from becoming independent and keeps them socially immature; traits they need to learn in their teens. Learning and maturing require that kids handle challenges on their own by confronting small anxiety hurdles along the way.
- Model how to cope*. A parent’s anxiety greatly aggravates their child’s anxiety. If you are anxious, tell your child how you plan to cope with it. For example, “Sometimes I feel nervous when I have to climb a ladder, but I just need to take a deep breath, be careful, and do it. If I get too nervous, I can always climb back down, and try it again later.”
* Charles H. Elliott, Ph.D. “Anxiety: Three Messages to Avoid Giving Kids”
If your child is in a situation where they are experiencing severe distress, always have an escape plan or an “out” so your child can leave the situation as quickly as possible. Prepare yourself ahead of time so you won’t feel inconvenienced when it happens, and accept this as part of their treatment needs.
- This reduces anticipatory anxiety when they are exposed to stress, and teaches them how they can manage themselves on their own. This is also a teachable moment when you reinforce self-calming skills.
- This builds trust in you and a willingness to listen to your guidance. (When I did this consistently, my child grew more comfortable in similar stressful situations.)
Don’t forget to take care of YOU and your foundation
If you’ve found ways to reduce your child’s anxiety, share them in the Comments section for others to consider.
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