How to help an anxious child

In an era where anxiety rates in children are on the increase, it's important to understand what anxiety is. Then, we can learn how to manage it. Dr Jodi Richardson shares her best tips to help parents understand anxiety and help their kids learn to manage it.

What's happening to our kids?

These days there are few more perennial sources of parental anxiety than the seemingly skyrocketing rates of anxiety among our kids. Every day another article flits across our social media feeds, warning us of a catastrophic rise in the number of anxious kids filling our schools, taxing the resources of parents and teachers alike. We look at our own child and wonder whether their hesitance over going to school or trying new foods is a harbinger of things to come.

“I first started working in schools in the late 1990s,” says Dr Jodi Richardson, an educator and co-author of Anxious Kids, a manual for parents dealing with a child’s anxiety disorder. “Anxiety wasn’t on the radar back then. I didn’t even know it existed. Now, everywhere I go, parents and teachers are talking to me about this huge increase in visible symptoms and diagnoses.” 

According to the wide-ranging 2015 Young Minds Matter survey, at any given time 7 per cent of Australian kids under the age of eleven have an anxiety disorder of some description. That’s approximately 140,000 children. While this represented a significant increase in the rate of diagnosed mental illness among Australian children, it was also the first time that anxiety disorders had been included in the study, making it difficult to discern a meaningful trend. 

Is it a case of overdiagnosis?

Perhaps what we’re actually witnessing is simply an overdue acknowledgement of a long dormant issue. For years, the collage of symptoms we now recognise as anxiety have been written off as nervousness or immaturity. (This gels with Richardson’s experience: “I’ve had anxiety since I was four, but my parents just called me a worry wart.”) But now that we’re able to identify the disorder, we can suddenly see how prevalent it is. America’s Child Mind Institute estimates there’s been a 17 per cent increase in clinical diagnoses over the past decade.

As with most mental illnesses, anxiety disorders can be traced to a combination of biological and environmental factors. It’s been estimated that genetic make-up accounts for around one-third of a child’s susceptibility to anxiety. The remainder is believed to be tied to their surroundings; lower levels of family education, wellbeing and income are major risk factors. An anxious parent can also produce an anxious child. As Richardson explains: “Anxiety is contagious. An anxious child can trigger anxiety in a parent and vice versa. That’s part of the reason why it’s so important to manage the symptoms.”

Anxiety is a normal emotion

At a basic level, Richardson says, it’s important to remember that anxiety is an absolutely normal emotion. “It’s part of what makes us human,” she tells me. “Anxiety is intimately tied into our fight-or-flight response.” More neurotypical kids might feel a sense of anxiety when they have to do something new or scary, like give a presentation in front of the class. “But that will fade as soon as the stressor has passed. In kids with anxiety disorders, the feeling can hang around”, leading to a perpetual state of hyper-wariness.

Our anxiety response comes from the amygdala, the part of our brain responsible for attaching emotional significance to events—in particular, fear. A small, almond-shaped cluster located in the deepest reaches of our brain, the amygdala is one of the most primordial parts of our neural architecture. We share it with almost every other vertebrate species. It’s how we learn to assess danger and how our bodies know they need to be prepared to run. 

When is it a disorder?

Anxiety disorders are a consequence of meshing this primitive technology with the higher order processes in the upper sections of the brain. When our sense of self emerges around the age of four, we begin to ruminate on our actions and place them within a broader system of cause and effect. However, if our amygdala becomes overactive, it starts attaching a feeling of fear to an excessively wide set of circumstances. Then, when we’re faced with analogous events, we trigger the amygdala again and again, generating a semi-permanent anxiety response. While an overactive amygdala is typically a response to immersion in a stressful environment, the cause can be biological, too. In 2013, researchers at Stanford University showed that larger amygdalas in children were linked
to increased feelings of anxiety.   

Anxiety attacks explained

When you’re in the midst of an anxiety attack, your amygdala goes into overdrive, unleashing a wave of physiological changes on your body. Your heart-rate increases, shunting extra fuel to your extremities. You take deeper, faster breaths to get more oxygen into your bloodstream. Adrenaline dumps into your system, heightening your senses, reflexes and focus. Blood is re-routed from the stomach to the large muscle groups in your arms and legs, causing a surge of nausea. You start sweating as your body pre-emptively acts to cool you during your escape.

“It’s all about powering up the body, so that it’s ready to respond to the threat at hand,” says Richardson. But in children with anxiety disorders, the brain begins manifesting threats where there are none. Like buying an ice-cream for themselves; going to a sleepover; answering a question in class. “Rather than springing into action, the most common outcome from anxiety is to stay frozen in place.”

How to help an anxious child

When a child is experiencing anxiety, the first thing for parents to do is simply recognise that the child is feeling anxious, says Richardson. “We usually want to tell them, ‘It’s okay, there’s nothing to worry about,’ but all that does is send a message to kids that, as a parent, you just don’t understand.” Instead, she suggests validating their feelings by saying, “I can see that you’re really worried about this. Let’s work it out.”

Richardson also stresses the importance of bringing children out of their minds and back into their bodies. “Start with deep breaths, with an equal emphasis on both in- and exhalation,” she says. “This helps to bring the parasympathetic nervous system back online, slowing down the body’s processes.” Once the child’s breathing is under control, re-orient them in the present using simple mindfulness exercises. “Anxiety is usually about things happening in the future or past, so by anchoring kids in the present moment you can break free of those worry loops. Ask kids to use their senses: what are five things you can see, four things you can hear, three things you can feel?” 

How to deal with sources of anxiety

Anxiety puts parents in a bind because our natural instinct is to keep our child away from whatever it is that’s causing such a deep and adverse reaction. Yet if we keep them constantly protected, they’ll never build an awareness of their own capacity to overcome and survive these situations. A significant body of research has emerged around the idea of ‘stepladdering’, where intimidating tasks are broken down into smaller, more manageable chunks. According to Richardson, there’s no step too small. “It’s just about doing something to get away from that paralysis," she says. "If you were anxious about a presentation, it could be doing another rehearsal, or making cue cards or reading your notes. If that’s too much, just go for a walk or play with the dog.” 

As a parent, your role isn’t necessarily to cure your child’s anxiety. It’s to help them recognise when anxiety symptoms are coming on and to teach them how to manage it. “There are some parents who are afraid to even give it a name,” says Richardson. “But kids need honest information so that they can learn how to stop anxiety from getting in the way of their lives.” 

Frame it the right way, though, and Richardson believes that combating anxiety can be a positive, resilience-building journey for a child. “Every time they take a step towards achieving their goals, it’s such a win for that child. And the more it happens, the more they’ll realise they don’t need to have all their ducks in a row before taking a step into the unknown. We want to raise kids who can feel uncomfortable feelings, recognise them for what they are, express them and regulate them, and actually still do the stuff that matters. That’s the path to a meaningful life.”

Tips for dealing with an anxious child:

1. Avoid reassurance.

   Our first instinct is to tell our child that there’s nothing to worry about. Meanwhile, their brain is telling them that it’s a life-or-death situation. Saying “don’t worry, it’s going to be okay” simply tells our child that we don’t understand what they’re feeling. Validate their anxiety and then set about solving it together.

2. Normalise worry.

   An anxious child has enough going on without also thinking that they’re behaving weirdly. Explain to your child that worry is a totally normal feeling that serves a very useful purpose: protecting us from danger. However, sometimes we get false alarms and we need to learn how to shut them off.

3. Forget positivity.

   Embrace accuracy instead. Get your child to identify something that’s making them anxious. Then help them set out factual statements both in support of and against the proposition. Once they see the evidence arrayed in front of them, they’ll be better able to make the positive conclusion themselves.

4. Allow them to worry.

   Telling your child not to worry is a sure-fire way to make them hide the scale of their concerns. Instead, set out some time each day when they’re allowed to worry about whatever they want. Have them write their feelings down and then, when worry time is over, they say good-bye to their worries for the rest of the day.

5. Embrace the body.

   If your child feels an anxiety attack coming on, teach them some simple mindfulness routines. Get them to focus on their breathing for a couple of minutes, taking deep, even breaths, in and out. Ask them to name things they can see, touch or smell. By focusing on the body, they’ll come out of their minds and into the present.
   

6. Start stepladdering.

   It’s vitally important not to wholly shield your child from the sources of their anxiety. By the same token, simply throwing them in the deep end can be a recipe for disaster. Instead, try a technique called ‘stepladdering.’ This is where you take an anxiety-inducing task and break it down into smaller, more manageable chunks.
   

7. Be kind to yourself.

   When you’re watching your child struggle with anxiety it’s all too easy to play the self-blame game. But the causes of anxiety are deep and multi-layered. The only thing that can be said for certain is that you yourself are not the cause. So, cut yourself some slack, embrace forgiveness and remember that you are your child’s greatest champion.

///

Written by Luke Ryan and illustrated by Sakuya Higuchi for Lunch Lady Magazine Issue 17