Childhood Anxiety, Part 1: Definitions and Parent Concerns

All people feel anxiety. It is an important and ancient defensive feature of the human body. Without anxiety how else would we be alerted to imminent danger? Our “fight or flight” response to threat has helped to protect us and keep us safe as a species. When our minds become aware of a threat, our nervous system kicks into gear. Powerful hormones begin to race through our bodies and activate our heart and lungs for increased blood flow  and oxygen. In addition, there is a slight increase in blood to our arms and legs in preparation for this fight or flight response. Confronting the things that threaten us, or running away from them, keeps us safe.  Thus, although anxiety may at first appear to be an annoying, unpleasant and even painful experience, this is not part of its intended function. In fact, anxiety is critical to optimal performance. For instance, imagine a public speaker who has little or no adrenaline coursing through their bodies. Chances are their speech will not be very inspired.

A child’s experience of anxiety is very similar to that of their parents or other adults. All six of the anxiety disorders detailed for adults in the diagnostic manual of mental disorders also apply to children. The six disorders are panic disorder, specific phobias, obsessive compulsive disorder, generalized anxiety, social phobia and post traumatic stress disorder. What these disorders all have in common is an unusually intense fear that significantly interferes with a person’s daily functioning. This kind of anxiety is no longer improving performance or keeping you safe. It has gone beyond these positive effects and is now restricting you or your child’s life. While the underlying feelings of threat and physiological reactions are similar in kids and adults, what we see may be different. In fact, a seventh anxiety disorder is seen only in children  and is called separation anxiety disorder.

What are you likely to see in your child and when should you become concerned? Look for the following signs:

Childhood Anxiety, Part 2: What can parents do?

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Although some kinds of anxiety, such as a fear of strangers or separation, are normal parts of development, sometimes specific fears or a general sense of worry becomes so chronic or severe that it interferes with daily life. That’s one way to tell if your child has a problem (and Dr. G posted some other warning signs in Part 1), but you don’t necessarily need to wait that long to try and support your child through their fear and worry. Professional help may be required to address severe anxiety, but parents are on the front lines, so to speak, and you might be able to help. In fact, parents can use some of the same strategies as psychologists to help their kids learn to cope!

One form of psychological therapy that has proven to be effective in addressing anxiety for kids and adults is cognitive behavioural therapy, or CBT. Put simply, this treatment is aimed at changing underlying beliefs that lead to anxiety in some situations, along with encouraging behaviour to reduce anxious thoughts and feelings.

Childhood Anxiety, Part 3: How Beliefs Affect Behaviour

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Yesterday, Dr. Brian discussed an overall framework that many psychologists use to help kids and adults deal with anxiety. Cognitive Behaviour Therapy or CBT for short, involves examining your thoughts, challenging your thinking patterns and noticing the changes this can make in how you feel.

I often explain how beliefs can affect behaviour by giving the following example. You’re a student at a bus stop and your bus races by you without stopping. How do you feel? People answer this question differently depending on what they are thinking. If you’re thinking about how inconsiderate the bus driver is, you’ll be angry.   If you’re thinking of being late and your principal’s punitive reaction, you’ll be scared. If you’re thinking of how little your parents care about you being late, you’ll be happy to have an excuse to be late as it affords you more time with your friends. If you’re thinking of how this would not have happened if your parents had bought you a car like Billy’s parent did, you’ll feel envious.

Childhood Anxiety, Part 4: Controlling reactions to stress

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When I’m worried about something, it’s more than a feeling – it’s a physical sensation, and it isn’t pleasant. My clenched jaw and the tightness between my shoulders always come along when I’m feeling stressed. Other people might feel their heart race or their hands become sweaty. Sometimes these physical reactions lead people to feel more anxious. Someone who is having a panic attack might interpret their racing heart as a signal that they’re going to die! Many of us learn to recognize how our bodies react to stressful situations, and hopefully we’ve learned to manage both the stress and the effect it has on us physically. That learning takes time, though, and anxious kids are often unaware of their body’s stress signals.

On Tuesday, I wrote about Cognitive Behavioural Therapy, or CBT, and how many therapists teach their clients to pay attention to their thoughts, their physical reactions, and their behaviour when they feel anxious. Changes in one or more of these areas is thought to help people to feel better. Yesterday, Dr. G posted some ideas about anxious thought patterns, but how can kids manage their body’s response to stress?

Childhood Anxiety, Part 5: Taking action to control fear

IAN HOOTON / SCIENCE PHOTO LIBRARYWhat’s your first reaction when approaching an anxiety-provoking situation? As adults, many of us can take a deep breath, grit our teeth, and face our fear – if we couldn’t, there would be a sharp decline in the number of presentations at staff meetings. When kids feel afraid, though, many parents’ first reaction is often to protect them – to remove them from the source of their fear so they can feel better! But how can parents help their kids learn to control their anxiety instead so they can overcome fear? This week, we’ve written about how kids can monitor and manage anxious thoughts and physical reactions to stress, but avoidance of fearful situations may be one of the biggest obstacles to coping with anxiety for both children and adults.