Do’s and Don’ts when you notice anxiety in children.

It’s important to start this topic by first understanding the concepts of fear, anxiety, and anxiety disorders and then moving onto the dos and don’ts of what one needs to do when we notice that a child is feeling anxious.

Children experience a wide range of emotions, some of them that are positive and some of them that are negative. Among the negative emotions, the most common ones are fear, anxiety, and shyness.

How can we distinguish fear from anxiety?

Fear can be defined as emotion that is caused by a known or understood threat, while anxiety is comes from unknown, anticipatory or a threat that is poorly defined. Evolutionary theories suggest that fear as an emotion has evolved in order to keep any species safe and protected which ultimately ensured the survival of the species. Anxiety on the other hand, protects a species from the possibility of an impending danger.

What are anxiety disorders?

Anxiety Disorders are defined as those psychiatric disorders in which a child experiences excessive and pathological levels of fear, which is disproportionate to the challenge or stressor faced by the child and which leads to significant distress and impairment (in biological, social, and academic functioning).

What are the main anxiety disorders that are found in children?

According to studies by Costello, Egger & Angold (2004) and Krain et al., (2007) the common anxiety disorders found in the Paediatric population are

1. Specific Phobia
2. Social Phobia
3. Generalized Anxiety Disorder (GAD)
4. Separation Anxiety Disorder
5. Agoraphobia
6. Post-traumatic stress disorder
7. OCD

What are the common causes of anxiety in children?

Some of the common causes of anxiety in the Paediatric population are

1. Genetic factors- anxiety disorder in parents or any first-degree relatives
2. Environmental Factors (excessive parental control, parenting styles any type of abuse)
3. Negative Cognitive Bias
4. Academic difficulties
5. Concerns about body image
6. Interpersonal difficulties with peers leading to a lesser number of friends
7. Sibling Rivalry (being treated differently than compared to the sibling)
8. Lack of intimacy with parents (lack of parental warmth and neglect)

As parents and caregivers, here are some important points to keep in mind when you notice anxiety in children.

Do’s

1. If the child is meeting criteria for an anxiety disorder, it is absolutely necessary to seek professional help for the intervention of the anxiety which may include pharmacological and psychotherapeutic intervention.
2. Encouraging exposure to the anxiety provoking stimuli, in a graded manner rather than avoidance- Parents and significant others have to help children understand that anxiety can be over come only if they get their child to gradually face the anxiety-provoking stimuli, in a graded and hierarchical manner as this would lead to the habituation of anxiety rather than incubation of anxiety.
3. Having discussions about the various types of positive and negative emotions one experiences and helping the child label and identify the emotion of fear or anxiety
4. Helping the child identify the various physiological responses that occur as a result of anxiety (e.g., increased heart rate, sweaty palms, difficulty breathing, tremors)
5. Teaching the child simple grounding techniques
6. Encouraging the child to learn some basic breathing techniques (Box breathing)
7. Reinforcing (giving positive reinforcement or rewarding) any efforts made by the child, when the child attempts to face some of the triggers of his/her anxiety.
8. Helping children establish the connect between triggers, thoughts/cognitions, emotions and physiological responses.
9. Role modelling and regulating our anxiety levels in the presence of the child, as most of the learning in children occurs through observation of parents and significant others.

Don’ts

1. Engaging in family accommodation- family accommodation refers to any kind of behaviors that family members or significant others engage in wherein they either participate in rituals related to anxiety symptoms or facilitate avoidance. This prevents an individual from fully experiencing the anxiety symptoms and leads to the maintenance of the symptoms of anxiety. In the long run family accommodation negatively impacts treatment outcomes as well.
2. Forcing the child to pre-maturely face their most anxiety-provoking stimuli first, rather than in graded manner and without teaching them relaxation techniques (systematic desensitization) as this leads to flooding and can demotivate children from facing their fears altogether.
3. Invalidating a child’s anxious response to a trigger and refraining from making such statements “This is ridiculous. This is not a big deal at all!”. “If you don’t think about it, it will go away!”, “Stop exaggerating it!”, “Its all in your head!”. Instead say something like "I understand and know that you are feeling uncomfortable at the moment. I know these things are scary for you, I am here if you need me. It is probably the worry part of the brain that’s taking over”.
4. Studies have shown that parental anxiety has been linked to anxiety in children. Therefore, it is important that parents themselves undergo some form of intervention for their own anxiety as untreated anxiety in a parent can cause the parent to adopt a parenting style characterized by punitiveness, neglect or indulgence which are highly correlated to anxiety in children. Lack of parental warmth and high degree of parental control by parents can also lead to anxiety in children. Hence it is necessary for parents to undergo parent-management training in order for them to learn to adopt a parenting style that would reduce anxiety in children.

Also read,

How to motivate a special child? Find a child therapist or child psychiatrist in Mumbai

Depression due to learning disabilities. Find the best child therapist or developmental therapist near you.