Understanding Childhood Anxiety: Part 1
In the new Pixar movie Inside Out 2, our tween protagonist Riley is introduced to a range of new emotions. At their forefront is Anxiety, a talkative orange being with immediate ideas, some of which are less grounded than others. Inside Out 2 ultimately did a fantastic job demonstrating the way that anxiety can take hold of our brains, but if there’s one critique I have as a therapist who works with children, it’s this: the lore of Inside Out suggests that anxiety does not enter our consciousness until we enter our preteen years. However, as I am sure many parents will agree, anxiety often makes its appearance well before puberty.
Childhood anxiety is the term used to describe children's excessive worry, fear, or nervousness that can have a negative impact on their everyday lives and general wellbeing. The key term here is excessive- as Inside Out 2 showed us, anxiety itself is a core emotion that can serve a useful purpose. Issues arise when anxiety takes the wheel and does not let go. Although anxiety is a normal response to stressful events, it turns into a disorder when it prevents a child from handling day-to-day situations or makes them avoid activities that other children their age find enjoyable. In simple terms, it prevents them from being as happy as they can be.
As adults, we (typically) can identify anxiety in ourselves or our adult peers. For children, however, identifying anxiety can be a lot trickier. Young children, and even adolescents, often lack the language to understand their internal experiences or describe what they are feeling. Instead, anxiety may present itself through a range of emotional, physical, or behavioral symptoms, such as the following:
Avoidance: Kids who experience anxiety may steer clear of particular events or activities. This can entail staying away from social gatherings, schools, or certain individuals or locations.
Sleep Difficulties: Anxiety can interfere with sleep, making it harder to fall asleep, creating nightmares, or waking up a lot at night.
Clinginess: Children that are anxious may act clingy, asking parents or other caregivers for comfort and reassurance all the time, often over and over.
Perfectionism: A fear of making mistakes leading to anxiety may cause some children with anxiety disorders to strive for perfection in their schooling, extracurricular activities, or social relationships.
Tantrums or Irritability: Younger children may exhibit tantrums, impatience, or emotional outbursts to express their anxieties in response to stimuli. Teenagers and preteens can also showed increased irritability, seemingly out of nowhere.
Withdrawal: Anxiety can cause someone to isolate themselves from friends and past interests in hobbies as well as withdraw from social engagements.
Simply put, children will rarely say “I’m feeling really worried”- which can leave parents scrambling to understand when their child’s behavior is a result of excessive anxiety, typical development, or something else. So, when should you seek out additional help?
If you are concerned, it is always a good idea to consult with your pediatrician or another doctor who knows your child well. In addition, the following signs may indicate that your child is experiencing excessive anxiety, or another mental health challenge:
Change in behavior: If your child’s behavior changes relatively rapidly, anxiety may be the cause. For example, if your typically social child suddenly refuses to attend birthday parties for no apparent reason, anxiety may play a role. Similarly, if your child (or teenager) is more irritated over time with no obvious trigger, it may be good to investigate if anxiety is playing a role.
Changing sleep patterns: As noted above, anxiety can negatively impact sleep. A child may be experiencing anxiety which keeps them up at night and prevents good sleep, or they may be sleeping more as an additional method of avoidance.
Reassurance seeking: Some anxious children struggle to trust themselves, or even their own thought processes. They may ask loved ones for reassurance- “Is this okay? Am I okay? Is everything going to be ok? When are you going to be home?” repeatedly, but never seem fully satisfied by the reassuring answer. Children may also ask their parents to “accommodate” their anxiety, through specific rituals, check-ins, or other avoidant strategies.
Of course, the above is not an exhaustive list, and the above signs can also be indicative of things beyond anxiety. However, when it appears that a child’s anxiety is negatively impacting their ability to be as happy as they can be, that is when additional help may be indicated.
In our article next week, we will talk about how to find the appropriate therapist for your child, as well as strategies to effectively support your child- rather than their anxiety.
