How to help children cope with anxiety

Olivia Lee* would not get on the bus. The fourth-grader stood with her arms
crossed staring down the vehicle as if it were a yellow behemoth. Her mother’s urging turned
to pleading. As the clock ticked and the other children looked on, Vivien Lee* fairly begged her
recalcitrant child to board the bus. Olivia flatly refused. As parental pressure mounted, the normally
cooperative child’s sober defiance became almost violent; she began yelling at her mother, flailing
her arms. And then, as if a plug had been pulled, Olivia stopped. Her eyes welled up with tears and,
deflated, she sank to the ground with sobs wracking her little body.

“I’m too scared, I’m too scared,” Olivia repeated, over and over.

“Scared of what?” asked her baffled mother.

“I’m scared I might get car sick and barf and you won’t be there and all the kids will laugh at me.”

Olivia had always been what her mother called a worrywart – she worried that it might rain on
picture day, she feared for Daddy if he was driving in a snowstorm. But this was the fi rst time Olivia’s
fears had overcome her. When Olivia’s “worries” began to interfere with her ability to live life, to
meet the demands of school and family, she crossed over from normal worry to worrisome worry.
Anxiety disorders are a group of conditions characterized by excessive worry that’s persistent and
difficult to control, and that impedes a sufferer’s ability to live life.

Sadly, Olivia isn’t the only one to be gripped by “worry dragons”, as Dr. Jane Garland, clinical
director of the mood and anxiety clinic at the British Columbia Children’s Hospital, calls them.
According to the Mood Disorders Association of Ontario, 12 percent of Canadians suffer anxiety
disorders, making it the most prevalent of mental illnesses. And it seems kids are becoming
increasingly affected. They hear the adults around them talking about their stresses, they are
bombarded by bad news and sinister images from multiple mediums and, adds parent educator and
author Alyson Schafer, they’re simply less equipped to deal with it all. “Let’s face it,” she says, “kids
are more vulnerable. They’re smaller, they’re less experienced, they haven’t had the time to develop
the tools and competencies that adults have. So they feel more helpless, more out of control.”

Loss of control is a common theme in
childhood anxiety. So is humiliation. Whether
it’s fear of vomiting, blood, needles, new
situations or crowds (some of the most
common sources of anxiety), the underlying
issue is a heightened concern from a child that
he or she will either lose control or lose face.
And that makes sense, says Alyson, because
feeling competent and feeling connected
are two of the most primal human needs,
so anything that the child believes might
sabotage either will trigger fear.

It doesn’t really matter what we parents
think. Our nattering about how unlikely it is
that a short bus ride will lead to a barf-fest, or
that a scraped knee will become a blood bath
requiring hospitalization, is inconsequential.
It’s the child’s belief system that counts and if
we want to help them manage their anxieties,
we need to get inside their heads.

What’s inside those heads is revealing.
Often, children with anxiety disorders
can recount a singular moment of trauma
(remember, it was traumatic for them even if
it wasn’t for you). Maybe they were in class
and the boy next to them threw up and started
crying. Or maybe they were in the waiting
room at the doctor’s office listening to the
shrieks of a child being given an injection.
Whatever the precipitating event, the anxious
child concludes – whether rightly or wrongly
– “I’ll never let that happen to me.” And so
they begin to construct a world in which they
will be safe. They build their symptoms to
insulate themselves from their fears.

Everyone has fears. And that’s a good thing.
Fear is a valuable emotion – it raises red
flags in situations where caution is required.
Fear served a crucial evolutionary role; if
our ancestors didn’t listen to their fears our
species would have been subsumed by the
woolly mammoth.

And if your anxious kid doesn’t know
that, tell her. There’s nothing to fear from,
well, fear. Those feelings tell us we have an
alarm system that’s armed and ready. The
trick is to control your alarm system and
not let it control you. And that’s tough for
kids with anxiety disorders. Why? Because
it appears that they have an alarm system
that’s super-charged and ultra sensitive. It
makes kids blow common concerns way out
of proportion.

There is some evidence of a genetic
component to anxiety disorders; the highly
sensitized fear button may be hardwired, which explains why it often pops up in family
trees along with other mood disorders. So
if Grandma is mildly obsessive about hand
washing, Dad is a bit reclusive at big parties,
or Aunt Lucy sometimes struggles with the
blues, there’s a good chance that this will
affect the genetic programming of your child’s
emotion centre.

But there are other clues. Dr. Garland
says symptoms of anxiety disorder show up
in three areas: body, mind and behaviour.
As a parent, you’re looking for things like
headaches or stomach aches, accelerated heart
rate and muscle tension, as well as negative
thoughts, excessive worry and emotional
fragility. Finally, watch for behavioural signs
such as irritability, tantrums (especially when
being pushed to do something that provokes
the anxiety) and, importantly, avoidance (of
situations that trigger the anxiety).

Avoidance is a particularly worrisome
byproduct of anxiety, warns Dr. Garland,
because children who sidestep stressful
situations may fail to achieve key
developmental tasks, which could jeopardize
their futures.

Moms Lynn and Lisa* know all too
well the hazards inherent in an anxious
child’s avoidance strategy. Their daughter
Sophie is so terrified of vomiting that she
once refused treatment for hugely infected
bug bites because she was convinced the
antibiotics would make her throw up. “She
had overheard the pharmacist say that a rare
side effect of penicillin is nausea,” says Lynn.
“So she simply refused treatment. It was a
battle worthy of Napoleon to get her to take
the drugs.”

Ultimately, though, the key to building
confidence is encouragement. Pointing out
a child’s successes – however small – will
nudge an anxious child along the road to
resilience. Positively reinforcing a child’s
efforts at overcoming an obstacle has a ripple
effect farther reaching than the dreaded
school bus, or the much-feared first day of
school. Learning that you can solve life’s
problems is a gift, it’s the building block of an
“I can” attitude. “No life is exempt from sticky
situations,” says Alyson, “but the child who
has courage manages those situations because
they have learned to be resourceful, they’ve
learned one of life’s most essential lessons: I
can count on me.”

What you can do

Leaving an anxiety
condition untreated can
have serious consequences
(medically, emotionally
and developmentally).
But here’s the good news:
treatment is highly
effective. Ask your
pediatrician or family
doctor to recommend a
therapist (cognitive
behavioural therapy has
proved to be particularly
useful); meanwhile, here
are some strategies to
employ at home.

Listen. Curb the urge to lecture your child about how irrational
their anxieties are. Sure, a crippling fear of, say, Halloween masks
may seem unreasonable to you, but for your child the fear is all too
real. Honouring their perspective, a child may be willing to reveal
more about their fears; the more you know the better.

Reframe. Your child already feels fragile. Don’t fan the flame of
their inadequacy by focusing solely on the negative. Highlight the
positive and help your child befriend their alarm system. “Your
body is doing a really good job of protecting you. No one has a
better alarm system than you do!” Or, “You know I just love how intune
you are with your feelings. Being aware of feelings is a really
useful tool.”

Teach. Give your child some tools to help curb excessive worry.
“I tell anxious kids that thoughts come first and feelings follow,”
says Alyson. “So if you can learn to control your thoughts, you
can control your feelings.” There are many methods to manage
self-talk. Your child could endeavour to push in one empowering
thought for every fearful one, for example. Or, Alyson has
kids practice thought blocking with bubbles and a wand; every
time her young clients burst a bubble they are whacking a fearful
thought, refusing to listen to negative or anxious self-talk.

*The names in this article were changed.

Liza Finlay is a Toronto-based writer and master’s of
psychology candidate. When she’s not authoring articles
for this magazine and others, she is speaking to
moms’ groups about marriage and motherhood and
corralling her own two young sons.

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