The number of children who are feeling anxious is on the rise – and that was before they were faced with the unprecedented challenges of Covid-19 and the instability it brings. So how can we help our children cope?
Increasingly common, anxiety in younger children can present itself in myriad ways – everything from head and stomach aches, through to irritability and anger. As such, it can be mistaken for something else, and the real problem left untreated. “
Parents may find that their child’s sleep is being impacted, they may be irritable, or they aren’t keen to engage in the activities they once enjoyed,” says Dr Robert Chandler, clinical psychologist at The LightHouse Arabia. “Younger children may complain of feeling physically unwell and report tummy aches. Parents may notice that their children are clingy and find it difficult to separate. Aggression or violent outbursts can be a sign of anxiety, as often what underlies and drives the anger is in fact anxiety.”
How, then, as parents, can we diagnose anxiety in our children? “Firstly, it is important to remember that some anxiety is normal and in fact helpful for young people,” states Dr Chandler.
“Diagnosing an ‘anxiety disorder’ consists of two parts; firstly, the amount and type of symptoms a child is showing, but crucially, the impact these symptoms have on day-to-day life. For example, it is normal for children to worry from time-to-time about what others might think of them, or about an upcoming exam. When these worries occupy a great deal of the child’s time and energy and prevent them from participating in the things they enjoy, we would consider this excessive anxiety.”
As Dr Chandler suggests, the sources of anxiety can be obvious in older children – exams, friendships, to name but two – but they are less discernible in the young. “In younger children, sources of anxiety typically include separation; that is, difficulty being away from a parent or primary care giver. Younger children rely on their parents to provide them with security, predictability and containment, and so being separated can be understandably distressing.
“If there is animosity in the family home between parents, or one parent is struggling with their own emotional or physical health, younger children can pick up on this and worry, because their sense of emotional security is under threat. In these situations, parents might find that children present with behavioural issues, including aggression, because they do not have the ability to put their thoughts into words, and so anxiety is expressed through obvious and overt behaviour.
“Typically, around the ages of 11 to 12, young people are in a period of transition; physically, socially and emotionally. The focus of anxiety often shifts towards social factors and the young person’s place within social circles outside of the family. As young people progress through their teenage years, anxiety commonly manifests in the form of body-image issues, the feeling that the young person is not as good as their peers (low self-esteem), navigating social relationships, or exam stress. Clinically, we see increasing numbers of young people in their teenage years express anxiety about their futures, most commonly in terms of obtaining high grades and jobs, and climate change.”
It’s the latter that poses a very real problem, says Dr Chandler. Research indicates one in five children aged eight to 16 have nightmares about the state of the world, a fact only amplified by the threat of the global pandemic and climate change.
“Around the age of 11 or 12, young people develop the cognitive abilities to think abstractly and imagine different futures. Parents may find that their children are spending long periods of time focussing on and speaking about climate change.
“Often with anxiety, the actual threat is nowhere near as threatening as it is perceived to be. Climate change is different; it is a very threatening, life changing prospect for young people, and their concerns are well founded. The threat is real.
“Parents should give time to allow their children to express their concerns about climate change; validate their emotions and tell them it is ok to feel worried. If anxiety about climate change can be channelled into driving small changes, this can help; encourage the young person as part of the family to ensure that recycling is done and take steps to reduce carbon footprints. Parents can model taking the car and flights less often. If young people see their parents are environmentally active, but also able to use their contained anxiety to drive eco-responsible behaviours, this is likely to help contain the anxiety. If symptoms persist, parents should consider seeking professional support.
A lot of school-aged children will have experienced extra stress during the COVID-19 outbreak – what can we do to help them cope with the ‘new normal’? Especially if they are worried about things like coming into contact with others, falling ill, or having a family member fall ill?
“Children of all ages, but especially younger children, learn from their parents; I’d encourage parents to try to model composure and calmness, as well sensible (but not excessive) precautions for keeping safe, such as regular hand washing. If parents do have their own excessive anxieties, I’d encourage parents to find ways to manage this, because it can be overwhelming for young people to see their parents in highly anxious states.
“When treating anxiety, we often talk about and write down the costs and benefits of excessive anxiety; what is the excessive anxiety costing you (not seeing friends; spending long periods of time worrying about the health of others),versus the benefits of being anxious to this extent (to which they are often very few benefits). Helping young people to think of the bigger picture in this way can be helpful.
“I’d encourage parents to avoid giving the message that loved ones will not get sick in the future, tempting as this is, especially with younger children. Instead, parents should acknowledge that people do get sick from time-to-time, whilst highlighting the coping resources and resilience of the family. Drawing from historical examples can be helpful; ‘remember when grandma got sick – what did we do as a family to cope and to get through?’”
If we believe that our child is anxious and are eager to seek support, their school should be the first stop. “Reach out to the school and the child’s teacher; ask them if they have been noticing the same patterns,” suggests Dr Chandler. “A phone call or meeting with the school can help to consider different ways to support across the home and school environment. Schools will differ in terms of what they offer to provide support, so making contact to find out in the first instance is vitally important.”
As parents, there is also plenty we can do to support the school’s efforts. “Parents can make space and time to allow their children to discuss their worries. Validating their concerns, empathising and taking a compassionate stance towards the young person is essential. Try and avoid rushing in too quickly with ‘problem solving’ strategies to combat the anxiety, although this is something that will need to come later. If in doubt, seek support from a specialist clinic.
At a more general level, parents should try and ensure their children are eating well, taking regular exercise, are well engaged with clubs and hobbies, and sleeping well. These basics really go a long way in helping young people to feel emotionally healthier.”
If all efforts fail to help the child cope and their anxiety is impacting on the day-to-day lives of the whole family, then “it is important to seek professional support,” states Dr Chandler. “Research shows that early intervention is key, as the longer anxiety goes untreated, it becomes engrained.”