Anxiety: Early signs in children

How do you know if she’s just having a bad hair day or if it’s a sign of ongoing anxiety she may be experiencing?

Anxiety disorders are characterized by persistent and excessive worrying. While someone with generalized anxiety might worry about various everyday things, someone with social anxiety typically has “intense or persistent fears or concerns about being judged negatively by other people,” said Rachel Busman, a resident of White Plains, New York clinical psychologist and cognitive psychologist and behavioral consultant specializing in anxiety. “You worry about saying or doing something that makes you look stupid or incompetent.”
According to a 2021 study, one in five children worldwide have anxiety symptoms that are “clinically elevated” or worse than normal. In the United States, between 2016 and 2019, 9.4% of children ages 3 to 17—about 5.8 million—had been diagnosed with anxiety, according to the US Centers for Disease Control and Prevention.

Anxiety symptoms can be hard to spot, but the sooner parents notice signs, the sooner psychiatrists can “help parents and children understand what’s happening,” said Dr. Rebecca Baum, Professor of General Pediatrics and Adolescent Medicine at the University of North Carolina on Chapel Hill.

Children with anxiety may begin to avoid anxiety-provoking situations. This behavior can fuel a cycle of increasing their fears, Baum added.

But “the sooner we have tools, the sooner we can get kids on a path that encourages them to be resilient and helps them face the things they’re afraid of,” Busman said.

Read on to learn about early physical, behavioral, and emotional signs of general or social anxiety and how you can help your child.

General Anxiety

Common signs of general anxiety in children – according to the UK National Health Service, Michigan State University, Baum and Busman – are:
  • difficulty concentrating
  • Trouble sleeping, bedwetting or bad dreams
  • Not eating right
  • attachment
  • Lack of confidence to try new things or inability to deal with simple, everyday problems
  • Avoiding everyday activities, such as meeting friends or going out in public or to school
  • Inability to speak in some social situations
  • Seeking validation (repeated questions to validate concerns, such as when and where to pick them up from school, or if the weather is really nice enough for a play date)
  • Physical symptoms such as going to the toilet more often; tearfulness; Headache; Dizziness; drowsiness; Sweat; Stomach pain; nausea; Cramps; Vomit; fidget or body aches (especially if they usually occur before an educational or social commitment)

Tantrums, irritability, or defiance could be misinterpreted as disrespectful behavior problems, but anxiety could be the underlying cause, Busman said. Refusing to do homework could be because they are afraid of making mistakes.

Kids “don’t necessarily have the tools to say, ‘This really bothers me,'” Busman said. “So play them out.”

social anxiety

Many of the symptoms of social anxiety are similar to those of general anxiety, but occur in social situations, Busman said.

Children struggling with social anxiety may show these signs, according to Children’s National Hospital in Washington, DC, the National Social Anxiety Center, and the Mayo Clinic:
  • Avoidance or refusal to attend school
  • Refusing to speak in social situations or speaking in a soft or low tone
  • Poor social skills, such as fear of strangers or not making eye contact
  • Fear or difficulty using public restrooms, using the phone, making public appearances, eating in front of others, being called to class, or being separated from parents
  • Physical symptoms such as rapid heartbeat, tremors, difficulty breathing, feeling like your mind is blank, and muscle tension

Having conversations that count

It’s important to get to the bottom of what’s frightening your child, but it must be done compassionately — without brooding over what might be making them feel defensive or stagnating and causing them to fail in the first place doesn’t want to speak to you.

Inquisitive and non-leading questions are good, recommends Busman. Open-ended requests such as “I’ve noticed that you are hesitant about this activity. What’s up?” might work better than “Were you afraid to go in or didn’t like these people?”

Ask your child how a particular event went, what he liked about it and what he found difficult.

According to Anxiety Canada, very young children may not be able to identify certain fears, e.g. B. Saying something stupid or other children see their fear. I don’t want people to look at my drawing” or “My voice sounds really weird,” Busman said.

If your child is honest about what makes them anxious, avoid dismissing the experience by saying, “That’s nothing to worry about” or “Don’t be a baby.” Also, avoid confirming fears. Saying “That sounds so scary; I’m so sorry you had to do that” can make the child feel more fragile, Busman said.

A good balance is to say, “That sounds tough,” and then a statement that acknowledges your child’s ability to rise to the challenge and that you know you can both figure it out together, Busman added.

If your child is afraid to start soccer practice and not kick the ball, use some form of the above statement and reassure them that they will improve with practice, but don’t overdo it by saying, that it will score the decisive goal – which could not happen.

“We get nervous sometimes because our kids are somehow having less-than-perfect moments,” Busman said, but teaching that imperfection is okay is crucial. Your child may sometimes miss the ball, and being liked by everyone is not realistic.

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“Coping with stress is an important part of childhood,” Baum said. Parents and carers can model this by “talking about times when they’ve worried about something but tried to address it, even if it didn’t go exactly the way they hoped it would.”

If you’re concerned that talking to your child’s teachers might create stigma or a problem where there may not be any, know that they are worth consulting as they expose your child to many hours a day in different settings and therefore “are often really good sources of information,” said Busman. “Sometimes kids at home aren’t as good at school and vice versa.”

A teacher can tell you how your child interacts with their peers and if they are still sad or anxious after you take them to school.

When concerns persist and “interfere with a child’s ability to do the things they need to do to be a child,” Busman said, “that’s a good time to seek more support.”

The best treatment for anxiety disorders is cognitive-behavioral therapy, which includes some level of exposure therapy, which can help children feel comfortable doing the things they’re afraid of, Busman said.

After years of debilitating social anxiety, a special tool changed my life

Your child’s GP can help “distinguish between what is typical for the child’s age/developmental level and what might be a cause for concern,” Baum said. “Even if the symptoms are typical for the child’s age, families can still appreciate help with successful treatment.”

Baum added, “Getting right in and even just beyond the child’s comfort zone (is) where growth happens.”

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