Kids and anxiety: When they need help and when it's just kid stuff
Parents know their children are under a lot of stress these days. There's a great deal of high-stakes testing in schools, more homework and even more demands on their time socially, with social media playing a huge role in their lives. But we also know that it's possible to have a bad day or a bad few days that create worry — and we shouldn't always equate that with levels of anxiety that may require intervention.
The problem is: how can you tell whether your child is temporarily stressed out or in need of help to deal with the kind of anxiety that threatens to disrupt their life? And then what exactly should you do to help if they realize this feeling isn't going away for them?
Crystal Rice, a therapeutic relationship consultant at Insieme Consulting, says parents sometimes make the mistake of looking only for negative responses from their children as proof that something is wrong — when, in fact, we need to remember that we all respond differently to intense anxiety.
"Think of behavioral signs like poker," Rice says. "Not everyone has the same 'tell.' As such, parents really should be looking for any change to 'normal' behavior — ANY. Parents often notice behavior that looks and feels 'negative,' such as a child who all of a sudden doesn't want to go to school or who shows signs of extreme fatigue earlier in the day than usual. However, children can also indicate they're facing extreme levels of anxiety by behaving in 'positive' ways, such as being more diligent about keeping their room clean (often a sign they're looking to establish order in chaos) or by seeming oddly 'calm' (when in actuality the child is dissociating or 'tuning out')."
The "magic answer" when it comes to figuring out whether your child's anxiety is abnormal has everything to do with his or her level of functioning, says Dr. Vanessa Lapointe, child psychologist, founder of the Wishing Star Developmental Clinic, and author of Discipline Without Damage: How to Get Your Kids to Behave Without Messing Them Up.
"When it has interfered with a level of functioning on a daily basis — that’s the time we would expedite our response," Lapointe says. Sleep is often the first clue, Lapointe says — trouble getting to sleep, trouble getting enough sleep, getting up too early or going to bed too late. Other telltale signs she points to include irritability, struggling with mood, meltdowns and being unable to focus on work — the last of which often results in a number of children with anxiety being erroneously mislabeled as having ADHD.
The age at which anxiety most often appears differs from child to child and depends on circumstances that include major life events like divorce, a new baby or a death in the family. But there are also spikes in anxiety levels at specific ages and stages of development, Lapointe says: age 2, ages 6-8, and just as puberty hits (give or take a year), when our bodies and lives are experiencing myriad changes.
"Really big changes in life or a traumatic life event (serious car accident, natural disaster) can push it, but there is a lot to do with a genetic link and the temperament of a child plays a role," Lapointe says. "There are kids and people who just are 'chill' and on the other end, which is also normal, are people who are more intensely aware of life." In fact, it isn't uncommon for very intelligent children to experience high levels of anxiety because of their very nature. "One of the things that makes you very intelligent is that you absorb a lot of information, but one of the things that makes you anxious is that you absorb a lot of information," Lapointe says.
If you suspect your child is experiencing a high level of stress, Rice says the first thing you should do as a parent is attempt to engage him or her in a frank talk about their feelings — a discussion that will take on different forms, depending on your child's age.
"The trick is to keep trying things until you see a sliver of something," Rice says. "It might involve talking to a child during dinner or at bed time (e.g., 'We noticed you've been quiet at dinner the past few days. Do you want to talk about why?'), or for younger children, it might require talking about the problem through play (e.g., have the child make up a new superhero and find out what problem the superhero would fix)."
Once you understand what is causing the anxiety, Rice says the next step is to validate the child.
"This is by far the most skipped step from all the parents I work with, because our natural inclination is to try to immediately FIX the problem," Rice says. "But validating the child's feelings is imperative, because we risk them shutting us out if they feel we just don't understand. Even with small children, it's important here to validate that the child has anxiety so they can learn to trust and identify the feelings that they have. We need to let the children know that the feeling they're having is understandable, normal and could be very frightening to them."
The third step is to help them try to resolve their anxiety by helping them process it. "This might be through challenging their cognitive thoughts (such as pointing out instances where their anxiety might be untrue), empowering them within the situation that is causing them anxiety (such as encouraging an 8-year-old to tell the bus driver when she sees something that breaks the rules) or through play, where alternative scenarios and outcomes might be presented," Rice says.
Parents tend to get worried when their kids are getting worried, but beware, as this only exacerbates their anxiety. "The child is scanning for a parent’s safety — if their alarm system is up and they’re looking for safety and see their parents acting crazy, they can’t find that safety," Lapointe says. "Parents have to contain it and take charge." For a lot of us, that might just mean: Fake it until you make it.
But there are times when a parent may not feel she or he is equipped to help a child deal with their problems and stress. Rice says parents should be aware of these three signs that they may be in over their heads and should consider contacting a professional therapist or psychologist:
You can't figure out the root cause of their anxiety
"This happens most often with parents of teens (who can become very secretive about their concerns) and of young children who don't always have the mental prowess to accurately name their fears (in these cases, it's often 'why...' followed by an 'I don't know')," Rice says.
If there's no progress after six weeks
If you've tried several times to figure out why your child is stressed but aren't getting anywhere or seeing progress back to "normal" behavior within six weeks.
You have conflicting issues
Your child is your priority, of course, but that doesn't mean there aren't times when you can't devote the time required to help your child work through anxiety without any outside help. "People often don't want to take their child to a therapist because the child isn't 'diagnosably' ill, but therapy is there to help people process life in any situation," Rice says. "It is not rare for a parent(s) to be in a time when there are a lot of conflicting priorities (such as during financially stressful periods) when they simply cannot devote adequate time and energy to help their child process through whatever situation they are going through. This is a great time (and sadly, a very underutilized one) to reach out to a therapist who can assist."
In addition to helping a child process their anxiety, a trained therapist or psychologist will also work closely with parents to provide them with the support and skills they need to help their children deal more effectively with their problems. Any conversation about medication and whether it could help should only take place after all other avenues of therapy and assessment have been explored.