A 9-year-old girl has frequent meltdowns after school. She cries, yells and throws things around her room. She argues with everyone in her path until she finally collapses on her bed.
The girl’s mother is concerned she has a behavior disorder that’s worsening by the day, and she fears it could affect how she does at school as well. She has seemingly tried everything. Rewards and bribes work only temporarily, if at all. Her daughter’s behavior is negatively impacting the whole family, and mom is desperate for help. Her mother brings her to see me with the hope that therapy will help her daughter learn to deal with her anger and make better choices. Anger isn’t the problem, though. Anger is simply the symptom that rises to the surface.
What this little girl has is anxiety.
Parents often confuse anxiety with behavior problems, because when it comes to young children, anxiety tends to manifest as changes in behavior. These changes can be subtle and hard to detect at first, but over time they snowball.
[See: 10 of the Biggest Health Threats Facing Your Kids This School Year.]
Many Children Are Affected by Anxiety Disorders
The latest statistics from the National Institute of Mental Health show that anxiety disorders affect 1 in 8 children. Untreated anxiety disorders put children at risk for a range of issues from poor school performance, difficulty maintaining peer relationships and sleep disturbance to substance abuse as they get older.
But before you run off in search of a diagnosis and comprehensive treatment plan, it’s important to note that anxiety is a natural reaction to stress. Some anxiety is actually good for us. That voice in your head that reminds you to jump out of the way when a car rounds a corner at a high speed is your brain reacting to stress with just the right amount of anxiety.
Anxiety becomes a problem, however, when excessive worry interferes with normal daily living for at least two weeks. For children, it’s important to pay attention to changes at school, at home and among peers. You might find that the teacher sends home glowing reports but your child lashes out at home and no longer seeks peer interaction outside of school, as was the case for the 9-year-old girl who came to see me. Childhood anxiety can be tricky, so watch for these sneaky signs if you have concerns about your child:
Frequent meltdowns: Hollywood loves to portray anxious characters as fast talkers who ask a lot of questions and can’t stop pacing and worrying aloud. More often than not, anxious children work hard to internalize their anxiety when they’re out in the world, coming completely unglued once they get home. Tantrums are not just for toddlers. When big kids have prolonged and frequent tantrums and struggle to regulate emotions, anxiety tends to lurk beneath the surface.
Unsure if your child’s meltdowns are truly problematic? Take note of them — literally. Jot down information about the episodes, including the time of day; potential triggers — such as hunger, exhaustion and stress; how long a meltdown lasted; and what helped your child calm down. Look for a pattern to emerge.
Sleep disturbance: Sleep issues are often misunderstood as willful, negative behavior. Sure, there are kids in this world who push the limits of bedtime and ask for seven glasses of water the minute the lights go out. But many times sleep disturbance is a symptom of anxiety.
Keep a sleep log for a couple of weeks to get a baseline on your child’s sleep habits. Pay attention to these potential symptoms of anxiety:
— Frequently wakes up
— Night terrors
— Sleep walking, which can be related to stress, particularly if it’s out of the ordinary for your child
School refusal: Most kids have a few days here and there when they just don’t want to go to school. That’s perfectly normal. School refusal, on the other hand, means that a child refuses to go to school on a regular basis and has problems staying in school. This issue affects 2 to 5 percent of school-age children, and it can reoccur during the transition to middle school and high school. Children struggling with school refusal might exhibit some of the following symptoms:
— Tantrums just prior to leaving the house
— Physical complaints just before school, including headaches, stomach aches and sometimes even diarrhea
— Inflexibility
— Defiance
— Separation anxiety
Avoidance behaviors: One sneaky sign that I see in most of my anxious clients is avoidance behaviors. Avoidance is sometimes overlooked because it doesn’t seem like a big deal if a child wants to bail on a birthday party or take a season off. The key is to look for a pattern of avoidance and measure it against your child’s baseline. If your social butterfly suddenly wants nothing to do with play dates, parties and after school activities, take note.
Parents often tell me that anxiety seems to strike without warning. It can feel that way for the parent, but the child has likely been silently struggling for many weeks. Avoidance is simply an attempt to find emotional relief from symptoms that are difficult to manage on a daily basis.
Physical complaints: Anxious kids tend to have a long list of physical complaints. Some of those complaints will mimic the latest virus going around and you might think your child is physically ill. Other symptoms might seem almost absurd. Again, always look for patterns and consider the timing of the symptoms.
The truth is that anxious kids can and do worry themselves sick. Pay attention to these common complaints among anxious kids:
— Headaches
— Dizziness
— Stomach problems
— Muscle aches. That sore leg might be the result of your child clenching his leg muscles all day to stamp out anxious thoughts.
— Shortness of breath
[See: 10 Concerns Parents Have About Their Kids’ Health.]
How to Support Your Anxious Child
Anxious feelings are part of childhood, and not all anxiety becomes an anxiety disorder. If your child experiences symptoms of anxiety for a period of two weeks or more that interfere with his or her normal daily living, seek an evaluation from a licensed mental health practitioner. If you suspect that your child’s anxiety is mild, taking these steps may help:
— Listen to your child’s feelings and talk openly about anxiety.
— Empathize with your child.
— Plan extra time for transitions.
— Understand your child’s triggers and plan ahead.
— Reduce your child’s schedule to increase downtime.
— Develop and maintain a consistent, early bedtime schedule.
— Practice deep breathing exercises together.
— Work with the classroom teacher to reduce anxious feelings at school. Keeping a stress ball in the desk can be a big help.
— Resist the urge to dismiss or downplay worries.
— Create a stress-free zone in the home, and stock it with relaxing activities, such as coloring books, stress balls, clay, Play-Doh and soothing music.
— Modify expectations, particularly during times of increased stress.
[See: 9 Sports Injuries That Sideline Kids.]
When children learn how to manage and independently cope with their triggers for anxiety — which can include exhaustion, overscheduling and school-related stress — childhood anxiety decreases. Help your child by tuning in to his specific worries and triggers and trying several coping strategies to find a few that work for him.
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Sneaky Signs of Childhood Anxiety originally appeared on usnews.com
