How to tell if your child has anxiety

With one in four Aussie children suffering from anxiety, it can be hard for parents to know what to do or how to help. A new book offers expert tips on how to help your child turn their anxiety into resilience.

Jack has been anxious but has managed to overcome it with a lot of help. Picture: Lawrence Pinder

With one in four Aussie children suffering from anxiety, it can be hard for parents to know what to do or how to help. Here are expert tips of how to assist your child with turning their anxiety into resilience.

READ MORE:

ANXIETY EPIDEMIC HAS AUSSIE KIDS IN ITS GRIP

THE 5 BEST APPS TO HELP WITH ANXIETY

HOW STUDENTS CAN MANAGE STRESS

Jack has been anxious but has managed to overcome it with help. Picture: Lawrence Pinder

SIGNS AND SYMPTOMS OF ANXIETY

Many symptoms indicate anxiety; however, having those symptoms doesn’t mean a child has an anxiety disorder.

Pay attention to how often your child is experiencing any signs of anxiety, the severity of their symptoms and over what period of time you’ve noticed these changes.

We recommend that you keep notes over time to track your child’s signs and symptoms so that when you’re with your health professional, you can accurately relay what’s been happening.

It’s natural to feel worried and upset asking questions of your health professional about your child’s mental health.

Having a record of what’s been going on helps you to paint a clear picture for a more accurate assessment of your child.

EMOTIONALLY AND PHYSICALLY

It’s common for anxiety symptoms to be physical given the changes that happen in the body when the fight-or-flight response is triggered. These can be worrying for kids.

Many anxious kids worry that there’s something physically ‘wrong’ with them that hasn’t been identified. Teaching anxious kids what’s happening in their brains and their bodies helps them to make sense of their symptoms and feelings.

Signs and symptoms of anxiety include:

• Chest pain or discomfort

• Discomfort or pain in the stomach; nausea, dizziness, light-headedness, or unsteady feelings

• Feeling foggy or detached from yourself

• Feeling hot or cold

• Feeling a lump in the throat or choking

• Sleeplessness

• Seeing spots

• Headaches

• Numbness or tingling

• Diarrhoea

• Tiredness

• Rapid heart rate

• Rapid breathing, shortness of breath, or breath holding

• Sweating

• Trembling or shaking

• Regularly crying over small problems

• Angry outbursts

• Often appearing nervous.

BEHAVIOUR

It’s hard for anxious kids to concentrate when they’re feeling worried. It’s equally challenging to concentrate when their body feels revved up like a race car that is stuck in the pits.

Be mindful that some anxious kids can also be quiet and shy, while others may try to never put a foot out of line. It’s easy to overlook anxiety in these kids. Behaviours indicating anxiety include:

• Not participating in class, or being afraid to speak up or raise a hand

• Excessive fear of making mistakes

• Wanting to be ‘perfect’ in appearance and schoolwork

• Refusing routine injections or visits to the dentist refusing to hang out with other kids or having few friends because of social fears

• Not sleeping in their own bedroom or refusing to attend sleepovers • refusing to go to school for any number of reasons

• Refusing to participate in sports, dance or other performance related activities

• Disliking taking risks or trying anything new

• Avoiding situations they feel worried or scared about.

Christy and Sam with their children Jack and Mia. Jack had anxiety but has improved with help. Picture: Lawrence Pinder

THINKING

As the minds of anxious children are often on the lookout for threats and danger, they’re thinking all the time: reflecting on events of the past, analysing situations and reactions from every angle, wondering what’s going to happen next and worrying.

If there was a ‘Worrying Olympics’, anxious kids would be gold medallists. Worrying and overthinking is a sign of anxiety.

While it’s normal for all kids to worry, the minds of anxious kids generate worries that can overtake their thinking. Most of their worries seem irrational and inconsequential to the people who love and care for them, but in their minds the threats feel real. Examples include:

• I’m going to fail the test

• I might get it wrong

• Mum might forget to pick me up after school

• My teacher will yell at me and the kids will laugh

• That dog might bite me

• I could fall off my bike and embarrass myself

• I’ll embarrass myself in front of my friends

• I’ll get into trouble

• I could be sick at school

• Mum or Dad might die.

DEPENDENCE

Anxious kids often seek reassurance. Their fight-or-flight response is triggered much of the time, causing them to feel threatened. Naturally, they want someone they trust to soothe them and reassure them they’re okay. This dependence is part of the anxiety dance. Anxious children may:

• Ask for help with tasks they can do for themselves

• Won’t go to sleep without you nearby

• Asks, ‘Will you do it for me?’ or ‘Will you tell them for me?’

• Sees the dangerous or negative side of situations

• Asks, ‘Are you sure I won’t get sick?’

• Asks, ‘Are you sure you’ll be on time to pick me up?’

• Asks parents to talk to teachers instead of doing so themselves

• Doesn’t want to be away from home for long or at all

• Wants a parent to accompany them to parties and stay

• Seeks ongoing reassurance about a worry

• Frequently shares thoughts and worries

• Shows dependent behaviour, including clinginess.

Under any of these anxious circumstances, deep, slow breathing will help your child. In the meantime, avoid trying to use logic to persuade your child that their concerns are unfounded as this is unlikely to be helpful.

EXCESS OR EXTREME

Anxious children can blow issues out of proportion, turning everyday occurrences into overwhelming problems. Examples include:

• Scared of the dark/dogs/being alone/tests

• Expects the worst outcome

• Has a knack for arriving at extreme conclusions from vague information

• Has trouble falling asleep due to excessive worries about daily events, getting enough sleep, or staying asleep

• Catastrophises a situation.

FUNCTIONING

Children’s anxiety can be a source of frustration for many parents. When kids feel anxious they want to avoid the source of the anxiety.

They can also feel anxious for one reason and then generally want to avoid anything that takes them out of their comfort zone. Anxious kids don’t have to wait until they feel perfectly calm to do what’s important and function well.

They can learn to turn down the volume on their anxiety and take it along for the ride. How anxiety impacts children’s functioning:

• Prefers to watch others rather than have a go

• Doesn’t want to get ready for school

• Visits the school nurse often

• Misses school

• Finds it difficult or is unable to sit still for extended periods

• Difficulty concentrating

• Resists doing schoolwork

• Is performing poorly at school

• Experiences problems with friends

• Is unable to do routine tasks without crying, tantrums or having continual reminders

• Believes they can’t cope or that it’s safer to stay home

• Doesn’t get enough sleep or nutrition

• Struggles academically

• Withdraws socially.

• Struggles to balance reasonable demands such as homework or playing a sport

After reading the ways anxiety impacts on children, you may be considering the possibility that your child is indeed anxious. Alternatively, the examples might have confirmed what you already know: that your child is anxious.

It’s natural for either alternative to cause some parents stress. Let us reassure you that if your child is diagnosed with an anxiety disorder, they’re already on the pathway to the help and support they need to manage it.

TYPES OF ANXIETY

GENERALISED ANXIETY DISORDER

The anxiety, constant worry and fears that a child with generalised anxiety disorder regularly feels can make it hard for them to meet the needs of their day.

Avoidance is common to minimise feelings of anxiety that come with uncertainty or doing something new.

Generalised anxiety disorder makes it hard for children to see situations and events for what they are; their thoughts usually focus on negative possibilities and outcomes. They’ll seek comfort in the reassurance from a parent that they’re okay, that what they’re worried about isn’t cause for concern and that the catastrophes they predict won’t happen.

SEPARATION ANXIETY DISORDER

Separation anxiety disorder is developmentally normal between a child’s first birthday and around eighteen months to two years of age.

Anxious Kids: How Children Can Turn Their Anxiety Into Resilience By Michael Grose and Dr Jodi Richardson

Many children will experience difficulty separating from their parent (sometimes one parent more than the other) at the start of kinder or even at the beginning of primary school.

Most of these difficulties resolve quickly, but separation anxiety can become an ongoing challenge for some families. Some children fear that something awful will happen to them or someone they love, usually their parent, while they’re separated.

Younger children can struggle to understand why their parent is leaving them at all and if they’ll ever return. These fears underlie separation anxiety disorder.

Children experiencing anxiety of this type feel distressed at being separated and so it makes sense that they’ll avoid it at all costs. Hence the tears, the pleading, the clinginess and the unwillingness to say farewell.

Separation anxiety disorder can be diagnosed when distress on separation does not naturally reduce after around two years of age. The anxiety can extend to not wanting to go to school, complaining of tummy aches and sickness to avoid a separation, distress at staying overnight at a friend’s house or worry about going on school camp.

PHOBIAS

We’ve all experienced fear. It’s natural to feel fear when our safety is threatened. Sometimes we deliberately put ourselves in a situation that makes us scared and anxious, like bungee jumping or skydiving.

We can experience fear in these situations and yet make a conscious choice to go ahead and jump, knowing deep down that the chances of us getting seriously hurt are small and are outweighed by the thrill of the experience. Kids do the same; they might experience fear under but take the ‘leap’ anyway.

Phobias are different. When a kid has a phobia, their aversion to a particular type of activity, animal or situation is exaggerated and irrational. They hold a genuine belief that what they’re scared of poses a genuine and serious threat to their safety. In anticipation of the specific object, animal or situation, kids with phobias experience extreme anxiety and will avoid exposure as if their life depended on it.

Common children’s phobias include:

• Animals such as dogs or birds

• Insects or spiders

• The dark

• Loud noises

• Storms

• Clowns, masks or unusual-looking people

• Blood

• Illness

• Injections.

SOCIAL ANXIETY DISORDER

Kids diagnosed with social anxiety disorder struggle with social situations of any kind. Avoidance is central to the behaviour patterns in children with this diagnosis.

When kids with social anxiety disorder are around other people, their thoughts turn to questions about how they’re being seen or judged. They’re afraid of embarrassing themselves, being rejected and/or being thought of as stupid, ugly or strange.

It’s difficult for children with social anxiety disorder to see situations for what they are: a time to relax and enjoy themselves. They want to, but their anxiety makes hanging out with friends difficult, let alone meeting new people, being the centre of attention or performing in a public setting.

Kids with social anxiety disorder deal with their anxiety by staying in their comfort zone whenever possible. The signs and symptoms of this type of anxiety are related to avoiding other people and feeling distressed when they unavoidably find themselves in a social setting.

Their distress at presenting in front of their class or meeting new people is out of proportion to what other children are typically experiencing.

Michael Grose and Dr Jodi Richardson, authors of the book Anxious Kids - How Children Can Turn Their Anxiety Into Resilience.

OBSESSIVE-COMPULSIVE DISORDER (OCD)

Have you ever double or triple checked you’ve turned off the iron, heater or stove? Perhaps you’ve rechecked the doors are locked before heading off to bed at night, knowing you’ve already locked everything up only minutes before?

Many of us have done one or all of these at some time or another. We get a nagging feeling that makes us uncomfortable and an extra check is all we need to feel reassured everything is in order.

Compulsions including checking and rechecking, ordering items and handwashing are examples of symptoms of obsessive compulsive disorder. OCD has symptoms falling into two categories: obsessions and compulsions.

Obsessions are defined as recurrent and persistent thoughts, urges or impulses that are intrusive and unwanted, causing distress. Compulsions conform to rigid rules and include behaviours and mental acts such as repetitive handwashing, ordering, checking, counting, praying, repeating words silently or repeatedly telling a parent something.

Compulsions are performed to counteract the obsession, relieving the feelings of anxiety.

Common obsessions in young people include:

• Fear of germs

• Violent thoughts

• Imagining frightening or rude mental pictures

• Fear of doing something wrong in the future

• Fear of having already done something wrong

• Self-doubt

• The need for items to be orderly, even or symmetrical.

Common compulsions include:

• Checking

• Counting

• Washing hands

• Doing work all over again to ensure it’s ‘perfect’

• Making steps, clicks of a light switch, turns of a handle or other actions ‘even’

• Asking questions for reassurance

• Confessing thoughts

• Collecting or hoarding items

• Touching items in a particular sequence or a certain number of times

• Keeping to a strict routine.

Hoarding is a common sign of OCD in children, more so for girls than boys. Children can also hear an inner voice ordering them to perform rituals and other compulsions.

They can be indecisive, unusually slow in everyday activities and feel greatly relieved when a compulsion has been completed.

OCD is diagnosed when obsessions and compulsions:

• Cause unhappiness and distress

• Get in the way of daily functioning and participation in normal activities

• Take up a great deal of time

• Interfere with normal everyday routines

• Affect family relationships.

WHAT DOES ANXIETY LOOK LIKE AT SCHOOL?

Anxious kids frequently find school difficult. Symptoms can become more frequent and more distressing during the school term compared with how they appear during school holiday breaks.

Some signs to look out for at school:

• Having difficulty concentrating

• Making frequent visits to the school nurse

• Often being distracted

• Being a perfectionist

• Making careless mistakes

• Being impulsive

• Being unable to sit still

• Reducing their involvement in class

• Having excess energy

• Being fidgety

• Loving details

• Avoiding the spotlight

• Freezing when called upon to answer a question.

School timetables and routines offer a degree of certainty for anxious kids but much about a school day is unpredictable.

Within their classroom, an anxious child can be challenged by a variety of influences including the actions of their peers, impromptu questions from their teacher, the complexity of their work and/or their environment.

Heavily decorated classrooms can affect attention and learning and increase anxiety for some children. Outside of the classroom, uncertainty abounds. Anxious children can be affected by crowds of students, noise and the unpredictability of social interactions, to name a few variables.

Anxious Kids, How children can turn their anxiety into resilience — by Michael Grose and Dr Jodi Richardson, Penguin Life, RRP: $34.99 (available May 7)