Anxiety in Children
 
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Early Learning and Elementary - March 2021
Anxiety is one of the most common mental health concerns for children and adults, affecting upwards of 20% of children and adolescents over their lifespan. Anxious youth are often quiet and well behaved, and thus frequently go unnoticed by their parents, teachers, and coaches. Alternatively others can be disruptive and act out, being labeled as having attention deficit disorder or being a “bad” kid. Both scenarios result in youth failing to receive the help they desperately need. Sadly, untreated anxiety can lead to depression, missed opportunities in career and relationships, increased substance use, and a decreased quality of life.
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Anxiety and the brain
There are two parts of the brain that are thought to be key players in the production and processing of anxiety – the amygdala and the hippocampus.  

Once the brain has encountered a threat (whether actual or perceived), it releases a surge of chemicals, like cortisol and norepinephrine. These chemicals organize the body to be more powerful, stronger, faster, more able to fight or run for our lives. When anxiety shows up in reaction to a real threat (one with a real need for fight or flight), this response is brilliant.
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Too often though, anxiety shows up In the absence of real danger and our body's 'fight-flight-freeze' response still gets triggered. For example, for some people having to get up and speak in front of a group of people can trigger the body's alarm system in the same way as if there were a real danger.

Anxiety doesn‘t weigh the pros and cons of anything – just the cons. This means that anxiety will swell just as much in reaction to a real life-threat, as it will to the things that might feel bad, but not life-threatening. When it comes to anxiety, dangerous things, important things, or meaningful things can all feel the same.
Anxiety and Culture
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Culture affects the way we express our thoughts, behaviors and emotions. It is therefore not surprising that there are cultural differences in the way anxiety is manifested and treated.

One of the main differences seen across cultures is the way anxiety is expressed. Someone from a culture where it is common to know the psychological term could easily describe anxiety using the specific word. In other cultures different words might be more common such as being nervous. Still in other cultures anxiety can take the form of physical symptoms, such as headaches, backaches or stomach discomfort. 
Although culture can affect both the way anxiety is expressed and how treatment is accessed, there is no evidence that the treatment for these conditions does not work in all cultures and ethnicities. 
anxiety vs anxiety disorder
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 A manageable amount of anxiety from time to time can be helpful. For example, it can motivate children to prepare for a test at school. Even happy events like moving to a new home or celebrating an important milestone can bring up anxiety—all of this is just part of being human.
NORMAL ANXIETY

Is related to a specific situation or problem

Lasts only as long as the situation or problem

Is proportional to the situation or problem

Is a realistic response to a realistic problem or situation

ANXIETY DISORDER

Anxiety may come up unexpectedly, for no reason

The response to a situation may be much stronger than expected
Anxiety becomes a problem when it gets in the way of the child's ability to participate in day to day life. For example, children who are so worried about being away from their parents that they are starting to miss school. Another sign that anxiety is becoming a problem is when a child is experiencing a high level of upset or distress over a period of time. 

Specifically, it is important to think about:

the amount of anxiety the child is feeling
the level of anxiety
how long it's been going on
how much the anxiety is getting in the way of how they function
how distressing it is for the child and for the family
May experience a lot of unrealistic anxiety,
such as fear of a situation that likely will never happen

May feel impossible to control or manage

May avoid situations or things that they believe to
trigger anxiety symptoms
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Anxiety disorders can be treated. When the anxiety happens too often and gets in the way of doing things at home, at school or with friends, it's important to seek help for your child from your family doctor. 

signs of anxiety
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Avoiding new things
Distressed by normal changes, breaks from routine
Tendency to highlight the negative
Physical complaints – Feeling nauseous, panicked, or sick
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Perfectionist
Difficulty sleeping
Argumentative (but rarely aggressive)
Very clingy outside of home or asking for reassurance
Avoiding unfamiliar situations
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Fatigue
Difficulty concentrating
May ask many unnecessary questions
Poor memory
Irritability
Muscle tension
Difficulty controlling the worry
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how to explain anxiety to your child
Here is a child-friendly explanation of why anxiety feels like it does. Nobody knows your child like you do so adjust it to suit. 

Anxiety is something that lots of people get but it feels different for everyone. Anxiety in kids is common, and lots of adults get it too. It happens because there’s a part of your brain that thinks there’s something it needs to protect you from. The part of the brain is called the amygdala. It’s...

A video for kids
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The 2 Questions That Can Help You Find Your ‘Brave’ When You Feel Anxious
A video for Parents
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UCLA Center for Child Anxiety Resilience Education and Support Director, Dr. John Piacentini and Clinical Psychology Fellow, Dr. Diana Santacrose suggest ways that parents can help their child manage feelings of stress and anxiety. They also note when parents might want to seek more support for their family
The Power of parents
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Recently, researchers at Yale did a groundbreaking study that found that parents had enormous power to reduce their child‘s anxiety, even if the child didn‘t do anything different. This study in no way suggests that parents cause anxiety. Loving parents do not cause anxiety. What it does suggest however is that parents can be a powerful part of the solution.
The study involved parents and their children who had been diagnosed with anxiety disorders. Half the children received weekly sessions of cognitive behavioural therapy. The other half received no therapy at all – but their parents received weekly sessions to reduce their accommodation behaviours. These behaviours included parents supporting avoidance, over-reassuring, changing the environment to avoid anything that might fuel anxiety, accommodating obsessive-compulsive behaviours.  For example, if a parent received loads of text messages a day from an anxious child they gradually reduced the number of messages they sent back to two or three.
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The results were remarkable. Children in both groups showed the same reduction in anxiety, regardless of whether they or their parents received counselling. In addition, the relationship between the parent and child was better when only the parents received therapy. 

When anxiety lays a heavy hand, it can be tough for our children to doing something different. What this research is telling us is that we don‘t need them to. Even without involving their children, parents have enormous power to reduce anxiety in their children by changing the way they (the parents) respond to anxiety.


My Anxiety Plan
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My Anxiety Plan (MAP) for children and teens is an anxiety management program based on cognitive-behavioural therapy (CBT).  CBT is an evidence-based psychological treatment that was developed through decades of scientific research and has been shown to be one of the most effective treatments for anxiety problems. 
The MAP program was designed as a self-help program for parents or caregivers to support children and teens with mild to moderate anxiety problems. Although MAP was designed to be used on your own, it can also be used while working with a mental health professional who can guide you through it.  
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Working through this material can be challenging, especially if your child is struggling with more moderate to severe anxiety issues. If your child has been diagnosed with an anxiety disorder the information and strategies in the program may not be sufficient. 

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Mighty Moe:
An Anxiety Workbook for Children


This book includes a story which explains in an age appropriate way what anxiety is and how it affects one’s life, and a workbook which provides children with various techniques on how to relax, think positively and solve problems. The flipbook can also be downloaded as a PDF.

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