Anxiety and Children

This article is sponsored by CHOC Children’s Hospital

As a person who has struggled with anxiety for as long as I can remember, mental health is an important topic to me. Mental health needs to be talked about. Today’s article is focused on anxiety and children. Do you have an anxious child? I do. Which is why this post today on anxiety and children is particularly important to me. I had the opportunity to engage in a conversation with Dr. Christopher Min a licensed pediatric psychologist at CHOC Children’s about anxiety and children and he was so insightful.

You know the phrase the apple doesn’t fall far from the tree? Well, my oldest daughter, is my anxious apple. It is astonishing to watch her anxious behaviors and hear her thoughts sometimes, because I GET it. I wish she didn’t have this, but it is part of who she is just like it is a part of me. What I do want is  to give her the tools to help her manage it at a young age, because it took me until age 35 to seek ongoing help.

Anxiety and Children

Here are the questions I asked Dr. Christopher Min about anxiety and children.

How do you know the difference between normal worry and anxiety in children?

He started by explaining that worry is a natural and normal physiological response built into us as human beings to help us to survive. Way back when anxiety was necessary to keep humans from getting eaten by tigers and the ‘fight or flight’ response kept us alive. Worrying is very much part of being a human. However, for children with brains more sensitive to these triggers, anxiety might be hard to control. If the anxiety is prevalent, constant and persistent, some kids might need help to re-wire or re-train their brains to diminish the response and help calm their bodies.

Anxiety Symptoms in Children

There are different ways anxiety can manifest in children. When talking about the type of anxiety that is characterized by excessive and persistent over a number of different things, it is called generalized anxiety disorder.

Symptoms of generalized anxiety disorder in children include:

– Worry which is hard to control and becomes constant and consuming
– Irritability
– Sleep onset problems
– Fidgety
– Inability to relax
– Hyper vigilant / hyper aware of surroundings
– Fatigue
– Physical symptoms like persistent stomachaches or headaches, etc. in response to worry or anxiety
– For a full list of symptoms click here

Other Anxiety Disorders in Children

Anxiety can cause other different types of anxiety disorders in children as well, issues such as:

Panic disorder: Unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress
Social anxiety disorder (common in teenagers): persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions
Phobias: persistent fear and avoidance of a specific object or situation
Adjustment disorder: trouble adjusting as a result of a stressful event
Selective mutism: when children do not speak in certain settings

When do you know it’s time to seek help for your anxious child?

When anxiety interferes with everyday life and functioning it might be time to seek professional help from a licensed therapist. Problems with school refusal, difficulty sleeping, test anxiety, constant meltdowns, eating issues, etc. are not things to be ignored and anxiety can be treated under the care of a professional. Dr. Min stressed that a parent truly knows their child best, so if you feel in your gut that something is going on with your child, trust your instincts.

If you have concerns, schedule an appointment with a licensed professional trained with children and adolescents, preferably one that has experience with cognitive behavioral therapy (CBT).

What is CBT?

Cognitive behavioral therapy addresses the cognitive distortions or unhealthy anxious thoughts in combination with tools to help stop the dysfunctional behavior that go along with it. Cognitive therapy is an attempt to change or re-wire the anxious thoughts into more realistic and helpful ones. Behavioral therapy such as relaxation, positive reinforcement and exposure therapy work to diminish the fight or flight response. In combination, this therapy can be very effective in treating anxiety.

Anxiety and Sleep Problems in Children

I asked Dr. Min if I could ask him about something my daughter is  currently struggling with – problems going to sleep – and I am so glad I did because he had a lot of good advice.

He expressed sleep problems in children are a giant issue. Giant. In fact, CHOC Children’s even has a dedicated Pediatric Sleep Center where he is a psychologist on staff. The Sleep Disorder Center helps treat children that have problems falling asleep, staying asleep or fears of going to sleep.

Sleep Advice for Anxious Kids

• Keep a Bedtime Journal.

Thoughts that run through the child’s mind are one of the major issues with having problems falling a sleep. If a child is able to put pen to paper before bed and get all of their worries and thoughts out before, it can help. Bringing the journal to a therapist can then help with addressing the worries.

• Stop All Devices (Blue Light) One Hour Before Bed.

The major source of blue light is the sun and when we see the sun, are brains are cued to be awake. Electronics such as TV, tablets and phones also emit a high amount of blue light so that when looking at them, our brains are cued to think “it’s daytime” and the natural sleep hormones that kick in when it is time to sleep are halted. Removing devices one hour before sleep helps your body naturally do what it supposed to do at night – sleep!

• Behavioral Recommendations To Help with Sleep.

– Regular bedtime and wake time each day
– No naps for older children
– Use the bed only for sleep
– Keep room on the cooler side as being too hot can inhibit sleep
– Keep a regular bedtime routine they do every night

Positive Reinforcement System for Sleep Problems in Kids

The most common (and to me, personally frustrating) behaviors that go along with sleep problems in kids have to do with seeking out interactions with parents.  You know, one more glass of water, one more kiss, one more snuggle, etc. As a parent, we want our children to be independent and able to go to sleep, or put themselves back to sleep, without needing our help.

He said what children are looking for with these behaviors is control, so he suggested a system where kids are given a certain amount of “tokens”, say 2 – 3, at the beginning of a week that they can turn in for “one more” something.  Basically, it’s a pass to get out of bed or ask for something.

If at the end of the week, if a token was not used, it can be put towards a prize or reward that is really motivating for the child.

We might be giving this a try. I will let you know how it goes.

Thank you Dr. Christopher Min for the incredible advice and for taking the time to talk to me about this important topic!

For more information on the CHOC Children’s Mental Health Initiative and programs, click here. Together, let’s talk about it.