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Although I am a healthcare provider, I am not your provider. The information provided here is strictly informational and for reference and should never be used in place of you or your child’s health care providers’ diagnoses or personalized advice.

Is your child doing things that you don’t understand? Of course they are, you may be saying. But, I am talking about acting strangely. All of a sudden they do not want to hang out with their friends or they are acting out all the time. Maybe your child is calling you from school to pick them up almost every day because “my stomach hurts”. These may be signs of childhood anxiety. Understanding the many faces of child anxiety is the first step to getting them the help they need to overcome it and thrive. Let’s face it, in today’s society, we all are likely having anxiety over something, children are no exception. They just don’t know how to handle or describe it.

“Why do children have anxiety? What do they have to be anxious about?” This is what many parents ask when we start talking about anxiety being a likely cause of their child’s new behaviors. Once I would start asking questions about their life, situation or family matters, the parents’ eyes would widen and you could see the lightbulb go off. Most people do not realize how everyday circumstances, even when the kids are not involved, affect them. For instance, you may be helping a friend because they are separating from their spouse. You would not think this would affect your child at all, however, you may be talking to or visiting this friend more often, your mood may be different because of this friend’s situation or if your friend has kids of their own, they may be talking with your child about what is going on. All of this can get your child’s mind wondering whether their parents may split up, will they ever have to change schools or how can they prevent this from happening in their home? All of these things will worry a child. There may be more observable circumstances that you are just not aware of such as bullying at school, a mean bus driver, struggling with a subject at school, different feelings about their sexuality or relationships. All of these things and so much more affect children of all ages.

How do I know if they have anxiety?

Many adults suffer from anxiety but their symptoms may be completely different than a child. See the post on adult anxiety for more information on this subject.

First and foremost, talk with your healthcare provider when your child starts acting differently. They can help pull out some details that you may not be thinking of. They can also rule our medical issues that may be causing symptoms.

What are the symptoms I need to look for?

This depends on age and situation. We will talk about the most common ones but please know that this is not an all inclusive list.

Toddlers:

• Tantrums (I know this is a normal toddler thing but when their personality changes they are trying to tell you something that they don’t understand). For instance, when my college roommate started dating a new person after a long-term relationship ended, her nephew (2 or 3 years old) didn’t understand why she was bringing someone else around and he was angry so he started being very mean to her and hitting and kicking her. This was very out of the norm behavior for him. Also, if a toddler runs away from a non-stranger or throws a fit when you leave the room, you must think, why are they afraid of this person all of a sudden!
• Not sleeping
• Nightmares or night-terrors
• Appetite changes
• Persistent crying

Childhood

• Changes in sleep
• Changes in appetite
• New onset fears
• Attention changes
• Crying a lot
• Persistent pains without a source Our neighbor would talk about her child having abdominal pain every night and crying before bed. After talking more about it, we discovered it happened only Sunday through Thursday. After having been to the doctor several times, we discovered that it was anxiety causing her stomach to hurt.
• Fixations on thing such as time. Our daughter used to want to have a clock around all the time. She would tell us every time the number changed. She would also tell her teachers when it was time to change activities based on the schedule on the board. We eventually had to stop letting her wear a watch because of this.
• Making unusual comments (out of norm and unexpected comments)
• Unusual or concerning make believe play
• Defiance
• Avoidance (not wanting to go to school) My mom likes to tell a story about how they had to pull the couch out to get me out from hiding every morning in 1st grade. Then they had to pull me out of the car and walk me into the school. Well, what she didn’t know at the time was that my teacher was very mean and would actually smack kids on the back when they were not paying attention and I was petrified of her.
• picking at scabs or constant fidgeting

Adolescence

• Avoidance from school, activities, friends
• Anger or aggression
• lack of focus
• dropping grades or just poor grades in general
• staying in their room all the time
• Fidgeting
• Fighting
• Self harm
• Alcohol/ Illicit drug use
• Behavior change

What can I do to help my child?

The most important thing you can do is to recognize something has changed and talk to your child. Be open minded and non-judgmental. They likely do not understand their feelings or why they are having them. Let them know that you want to help them. However, also knowing that you can not always handle their situations for them. Part of growing and maturing is to learn how to deal with problems appropriately.

As a parent or guardian our main job after recognizing and acknowledging there is a problem and to ensure safety. Obviously if your child is in immediate danger, being threatened, causing self harm or using illicit substances, get help immediately. Their life may depend on it. As a parent, one of the hardest decision you may ever have to make is to get an authority involved but by doing so, you may actually prevent catastrophic consequences.

Less emergent symptoms are still important and also need swift intervention. Your child’s healthcare provider can help at this point. They can help you develop a plan such as counseling, therapy or school intervention. You can help your child see different points of view regarding their circumstances. Contact the school to let them know about the issues your child is experiencing. Provide reassurance and unconditional love.

Allow your child to talk to you and you JUST LISTEN. One of the hardest things to do as a parent is to listen and not offer all the ways to help that you can think of. Sometimes just listening will give you the answers to what your child needs. Remind them you are there and you love them and you understand they are struggling and you want to help.

Coping

One of the hardest skills for kids to learn is coping. They don’t understand that their feelings are normal. All people will experience strong emotions at different points in their life. Anger, Fear, Doubt, Failure, Sadness etc. In the moment they are experiencing these intense emotions, they are most likely not sure what they are supposed to do. This is a skill that is developed over time and experience. Modeling healthy coping to your child is one of the most important life skills you can give them.

For instance, I have had patients who have come in because they are kicked out of school for fighting. The parents do not know what to do. After discussing the circumstances we discovered that the child’s father often talked about the fights he was in throughout school and how the patient’s older brothers would often torment him and were very aggressive with him when his parents were not around. Fighting and aggression were the coping skills he had learned. We came up with a plan to curb his anger when he was upset by doing something constructive such as working out. Not only would he make his body healthy in the meantime, he also became a record-setting athlete in the school. As he became stronger, his brothers eventually stopped messing with him. The father also recognized how sensationalizing fighting was affecting his son and worked on not talking about this part of his past around them.

An example of a younger child learning coping skills would be when a child becomes fearful of sleeping in their own bed after their mother had to be away due to hospitalization. The child wakes and comes into the room every night. Teaching them to cope with the anxiety of their mother’s absence could be managed by talking about it. Tell them where mom was or have them visit mom. Do a countdown until she comes back. Or, allow them to sleep in the room on a palate instead of getting into the bed. You could also sleep with the hall light on or the door open so they know you are still there.

Involve your child in the plan and talk about the coping skills they are learning.

Children and adolescents live stressful lives these days. Understanding what they deal with and recognizing signs of distress are important for parents. Acknowledging their struggles and offering to help shows that they are not wrong and that you understand them. Working together as a team (child, guardian, healthcare provider) is the most effective way to ensure your child’s success.

What are some symptoms you or your child have experienced and how did you manage them? Please share in the comments…