for Children & Teens
Are you concerned with your child’s or teen’s anxiety behaviors?
Are you concerned with your child or teen and that they could be suffering from anxiety? Maybe they you’ve noticed them withdrawing trying to avoid school or social situations? Perhaps they become easily overwhelmed or frustrated with even the simplest tasks or everyday situations?
Have you noticed your child or teen procrastinating or delaying starting or completing school work for fear of failing? Does your child study and seem prepared, however, they freeze or forget what they studied during a test? Do they repeatedly experience unexplained digestive or sleep issues. Maybe they become overly fearful in new or unfamiliar surroundings? Perhaps you’ve noticed your child unable to relax or do they avoid situations in order to lessen stress or anxiety?
All these may be signs of an anxiety disorder. It is certainly normal for your child or teenager to feel anxious or nervous from time to time, and a certain level of anxiety is not only is helpful and motivational, but it can provide a catalyst for accomplishment. However, for some children and adolescents, anxiety has become a frequent and debilitating occurrence, which completely takes over their lives.
Anxiety is More Common Than Most People Realize
According to a National Institutes of Health study, anxiety disorders affect 31% of children between 13 and 18 years old. Research shows that untreated children with anxiety disorders are at higher risk to perform poorly in school, miss out on important social experiences, and engage in substance abuse. There is no single cause for an anxiety disorder, however, studies suggest working in concert are genetic, environmental and physiological components.
Types of Anxiety Disorders
There are several different types of anxiety disorders including panic disorders, agoraphobia, selective mutism (rare), social phobias, other specific phobias, separation anxiety and generalized anxiety disorder.
Does your child appear to worry about life, daily activities, themselves or others, or worry about things before they happen?
If so, your child may be experiencing Generalized Anxiety Disorder (GAD). According to the Anxiety and Depression Association of America (ADAA) this disorder affects 6.8 million adults and the highest risk of onset is between childhood and middle age. Symptoms include but are not limited to difficulty in controlling worry, being quickly worn out due to that worry, irritability, easily startled, restlessness, difficulty concentrating or mind going blank. Physical manifestations may include digestive issues, migraines, or a feeling like there is a pit in their stomach or lump in their throat, muscle aches or tension, and sleep problems. These symptoms are observed to take place most days for at least 6 months.
Generalized Anxiety Disorder symptoms can have debilitating effects on the early life of a young person whether elementary, middle or high school aged. It is important to seek expert help in evaluating your child’s symptoms. Notably untreated long term GAD may put your child/teen at increased risk of suicidality. The Pediatric Academic Societies Meeting in San Francisco in 2017 reported that the number of children and adolescents (5-18 years old) admitted to children’s hospitals for thoughts of suicide or self-harm has more than doubled during the last decade.
Similarly, symptoms of anxiety have now become the leading cause for college students to visit their school counseling centers, overtaking depression in 2015-16 academic year, according to a survey of over five hundred counseling centers by the Association for University and College Counseling Center Directors. Many of these students report high anxiety either throughout or starting in the last years of high school.
In working with middle schoolers or teenagers, I typically hear common anxiety complaints such as difficulty in concentrating on studying due to worry, or after having studied going blank in a test. Students also express concerns about not being able to keep up with school work or with peers and as a result feel overwhelmed with school life and social pressures. This leads them to under-function, become demotivated or otherwise feels incapable. I have observed fourth through sixth graders who develop a sudden unwillingness to attend school or children as young as second grade not completing activities for fear of “messing up” or refusing to speak with their teachers for the same reason.
Does your adolescent fear speaking, playing sports, or eating in front of others? Does your child or teenager exhibit physical distress in public or social situations? Does your child or adolescent demonstrate excessive avoidance or fear behaviors in anticipation of encountering a specific object or situation?
Social Anxiety (Phobia) include significant fears of being judged or scrutinized by others in social or performance situations, sometimes resulting in crying, being excessively timid or embarrassed, or refusal to participate. Meanwhile Specific Phobia is indicated by marked anxiety triggered by exposure to a feared situation or object – e.g. fear of spiders, blood, heights, flying on a plane, or driving through tunnels, etc.
Numerous studies demonstrate that care and treatment of Social Anxiety Disorder (SAD) is generally sought in adulthood even though onset usually takes place in early teenage years. In my experience delaying treatment in dealing with Social Anxiety leads to more serious impairments such as isolation, lowered self-esteem, and potential for depression.
Does your child or teenager experience sudden episodes of intense fear that arise rapidly and seemingly out of nowhere?
Panic disorders in children and teens sometimes show up as a sudden increased sweating, clamminess in hands, dizziness or lightheadedness, heart racing, shortness of breath, trembling/shaking or feelings of impending doom. Panic attacks severely affect a child or teens functioning whether in school or social situations. According to American Association of Child and Adolescent Psychiatry, normal development can also be affected.
Panic attacks tend to be sudden, lasting from minutes to hours, can be unexpected or induced by a trigger such as an object or situation. Fear of having a panic attack can lead to increased anxiety and lead to further impairment in functioning. Sometimes panic attacks can be difficult to diagnose in children, however, once diagnosed specific treatments can be very effective.
Is your child or teenager afraid to leave your side; has nightmares about being separated from you or another caregiver, experiences symptoms of physical illness in anticipation of being away from you?
Separation Anxiety is commonly thought of only occurring in children, however, it is also diagnosed in adolescents and even adults. For children, distress and significant fears develop with the imminent separation of someone to whom they are attached. This distress is greater than what is considered typical for the child’s developmental stage. The child or adolescent may also have unfounded trepidation that something bad may happen to their attachment figures.
One young man I saw at thirteen years old experienced almost debilitating worry that something could happen to his mother each time she drove to pick him up and as a result he almost never wanted to be away from her. Some of these fears have a basis in previous events, for example, an eight year old I assisted, experienced the passing of a parent at a very young age which led him to, as he got older, develop anxious thoughts around his other parent passing, therefore developed difficulties in being away from that parent. Separation anxiety may be associated with panic attacks due to co-occurring with an existing panic disorder.
How can I help my child or teenager overcome anxiety, worry, or panic attacks?
While we know there are several contributing factors to the development of anxiety disorders it must be noted that children and teens experience unique stressors and challenges which were not as present or even existed when you as a parent were their age. Some of these environmental stressors include:
The ubiquitous use of the technology, internet and social media.
Competitiveness in high school and gaining placement in desired colleges has significantly accelerated.
Children are now guided and feel pressured from an early age to be the best in their sport or other activities in order to stand out for college and other internship programs.
Structured activities for various reasons (some valid and some not so valid), has increased leaving little room for care-free downtime and imagination play, while exploratory and random outdoor and nature experiences have steadily decreased.
Family and community changes wherein support is not readily present continues to increase stressors on our young people.
Parents and caregivers have some control in these areas by being intentional in addressing these challenges. Monitor and talk openly and frequently with your child or teenager about their social media and internet use. Studies reveal that increased use of social media has significant correlation with anxious feelings especially in girls. Set guidelines that are beneficial to you child and that meet reasonable expectations. If you are unsure on what is a reasonable expectation of electronic and social media use, check with the American Pediatric Association.
Parents can help their student with being careful about incorporating balance into their lives, making sure as much as possible to include a mix of work, play and unstructured time. It is also important for parents and caregivers to recognize their own anxiety levels regarding school work, academic achievement and expectations.
Focus on highlighting efforts vs. results. Conversely avoid ‘rewards’ or ‘punishments’ to get expectations met. Motivating your child or adolescent through logical consequences, incentives, and calm family meetings which reinforces your values are more effective and less stressful or anxiety provoking.
Seek the support of others in your family or community and the collaboration of your child’s or teenager’s teacher or guidance counselors. You may feel stressed or anxious yourself dealing with your child’s symptoms. Make sure to self-care and seek your own therapy if needed.
Treatments for Anxiety
Psychotherapy (talk therapy) has been found to be effective in addressing anxiety symptoms and behaviors. Specific, evidenced based approaches such as Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Social Effectiveness Therapy for Children (SEC-T), and group approaches such as Mindfulness Based Stress Reduction Therapy(MBSR), have been found to help children and teens learn how to increase their coping, reframe overly negative interpretations, adjust unhelpful thinking patterns, develop skilled responses to anxiety provoking situations, increase calming and relaxing strategies, while conquering situations that contribute anxiety.
Arousal decreasing techniques such as meditation, mindfulness, biofeedback and deep muscle relaxation are helpful in recognizing and decreasing the physical symptoms of reactivity/arousal and anxiety symptoms such as increased heart rate and accelerated breathing.
Family therapy is useful in addressing anxiety in your child or teenager. Parents and caregivers not only play a useful role in any treatment, but often times parents have to learn or relearn skills to assist in supporting their child vs. inadvertently making the situation worse.
Medications can be helpful in managing your child or teen’s anxiety. Anti-anxiety and some antidepressants may help particular children feel more relaxed. They are most effective when used in conjunction with talk therapy. Ensure that there is collaboration between your child/teen’s psychiatrist and therapist.
Technology in combination with evidenced based approaches can also be useful. There are a variety of helpful apps, games and online tools when used appropriately can be helpful in promoting relaxation and reducing anxious feelings. Some examples are the Calm app, Smiling Mind app, GoZen.com and other videos on YouTube that teach kids meditation and mindfulness. (Listen to Simone Finnis LMFT's short meditation recording being used by staff at a local Elementary School as part of The Humanity Project’s work with school administrators to help increase mindfulness and reduce stress).
Health and lifestyle changes can have a positive impact on reducing anxiety behaviors and symptoms. Exercise, proper diet, and adequate sleep are all important components in helping your child manage and overcome anxiety challenges. I believe incorporating nature and undirected outdoor experiences are valuable in assisting your child or adolescent build up resilience for stressful times. Be sure to work with your child’s pediatrician to determine what is best for your child.
Your Child or Teen Deserves to Feel Better
If you’re concerned about your child or teen may be suffering from worry, anxiety, stress, or panic attacks, we can help!
Call our office to schedule your 15 minute complimentary consultation at 954-391-5305 to connect with a therapist who can help. We look forward to speaking with you and your loved ones!
*Simone Finnis, LMFT is a Licensed Marriage and Family Therapist and the Owner & Clinical director of Simple Therapy Now. Simone provides positive, practical, evidenced-based therapy for Individuals, Couples, Families, Teens and Children.