The Anxious Child

Of all the liars in the world, sometimes the worst are your own fears.”

                                                                 -Rudyard Kipling

Anxiety is pervasive in our culture. The news, movies, tv, and Internet perpetuate a culture of fear. Parents no longer have ultimate control over what their children are exposed to everyday. Other sociocultural factors such as divorce, economic hardship, and overcrowded schools also play a pivotal role in the proliferation of anxiety. Three types of anxiety have been steadily rising in childhood: Separation Anxiety, Social Anxiety, and Generalized Anxiety. 

Separation anxiety is a reaction caused by having to leave family, loved ones, and/or familiar surroundings. Events such as divorce, death, or abuse can trigger separation anxiety; however, temperamental characteristics and the parent/child relationship are more common culprits.  Children experiencing this type of anxiety may express unrealistic worry that something will happen to a caregiver, or themselves, when separated. This can manifest itself in school refusal, resistance to extracurricular activities, stomachaches, headaches, or lethargy.  Behavioral interventions tend to be most successful. Basic examples include creating clear routines, setting time limits, preparing for transitions, consistent “good byes”, and rewarding separation. All children go through clingy phases, but if this is a persistent, chronic pattern of behavior, consider seeking additional intervention. 

Social anxiety is defined as discomfort or fear when placed in social situations where there is perceived  judgment or evaluation by others.  There are a multitude of factors that influence the development of social anxiety, such as shy temperament, stressful life events,  and inadvertent rewarding of fearful behavior.  Cognitive behavioral interventions have proven to be most successful.  It is important to be proactive by setting goals to increase exposure to social situations, preferably in a comfortable space, like your home, or structured class.  Being able to create these opportunities is often an ideal first step.  You can assist by learning about the audience, preparing conversation starters, and identifying a safe person within the designated environment. By providing continuous, positive, reinforcement for appropriate social behavior you will help your child gain confidence to build upon these initial experiences.

Generalized Anxiety is characterized by excessive worry about many things in life. Children may appear on edge, distracted, express somatic complaints, and have difficulty sleeping.  Perfectionism, unreasonably high expectations, and misperceptions of minor setbacks, greatly influence the intensity of anxiety.  Again, cognitive behavioral approaches are typically the most successful interventions.  Creating routines, like sleeping and waking at the same time, exercising, and eating healthy help manage the physical symptoms of anxiety.  It is imperative that children change their thought patterns, and self-talk, while being gradually exposed to anxiety provoking events.  Setting aside “worry time” prior to these situations, if structured and limited, can be a helpful outlet. These children tend to be very sensitive to praise and criticism, so be sure to reinforce the non-anxious behaviors, rather then the situational outcome. 

Experiencing brief periods of anxiety is a natural part of childhood. Chronic anxiety, that prevents your child from participating in activities or finding success at school, is not typical. Talking with parents, a pediatrician, school personnel, or mental health provider can empower you with knowledge and support.