Helping Children Deal with Anxiety . . . and the Best Ever Children’s Anxiety Tip Sheet

Last week I got a press query to answer a few questions for an upcoming article in Parents magazine. The questions were sent to a broad spectrum of media reps and professionals. There was understandably no guarantee I would be quoted in the magazine.

No surprise, I wasn’t quoted. But my media connection was thoughtful enough to send me the article (it came out a couple days ago). IMHO commentary in the article was really good, and so I’m including a link to the article below.

Although I like the article, I have one objection. The authors immediately pathologize children’s anxiety. In the second sentence of the article, they write, “Both conditions (separation anxiety and social anxiety) are treatable with the proper diagnosis.” Using words like “conditions” and “treatable” and “diagnosis” deeply medicalizes children’s anxiety and is a bad idea. Separation anxiety and social anxiety are NOT necessarily mental disorders. It would have been better to start the article by noting that given our current global situation of uncertainty–with COVID, and other sources of angst all around us–it’s normal and natural for children to feel anxiety.

This blog post has three parts. First, I’m including a link to the article. Second, I’m including my responses to the media query. Third—and I think the best part—is a old handout I wrote for helping parents deal with children’s anxiety and fear.

Here’s the article link: https://www.parents.com/toddlers-preschoolers/how-to-help-your-kids-adjust-when-they-go-back-to-daycare-and-school-after-covid-19/

Here are my responses to the magazine’s questions:

  • What is anxiety, in a nutshell?

Anxiety is a natural human emotional response to stress, danger, or threat. One thing that makes anxiety especially distinctive and problematic is that it comes with strong physiological components. Other words used to describe anxiety states include, nervous, worried, jittery, jumpy, scared, and afraid.

Anxiety usually has a trigger or is linked to an activating situation, thought, or physical sensation. Hearing about COVID in the news or seeing someone fall ill can activate anxiety in children (and adults too!).

Anxiety is often, but not always, about the future because people tend to worry about what will happen or what is unfolding in the present. Even when children feel anxious about the past, they tend to worry about how the past will play out in the future.

  • How has COVID-19 affected children mentally? Has there been an uptick in anxiety-related conditions?

COVID-19 is a stressor or threat because of its implications (it can kill you and your loved ones) and because of how it affects children situationally. During my 30+ years as a professional psychologist, anxiety in children, teens, and adults has done nothing but increase. COVID-19 is another factor in contemporary life that has increased anxiety.

In some ways, the fact that more children are feeling anxious can be a positive thing. I know that sounds weird, but anxiety is mostly normal. A professor of mine used to say that the old saying “Misery loves company” isn’t quite true. What is true (and supported by data) is that misery loves miserable company. In other word, people feel a little better when their problems are more universal. When it comes to COVID-related anxiety, we should all recognize we’re in good company.

  • What are the symptoms of social anxiety in kids?

Social anxiety is defined as fear of being scrutinized or negatively evaluated by others. Symptoms can be physical (headaches, stomach aches, shaking, etc.), emotional (feeling scared), mental (thinking something terrible will happen), and behavioral (running away). Social anxiety is usually most intense in anticipation and during exposure to potential social evaluation. Of course, almost always, anxiety will make us imagine that everyone is staring at us—even though many other kids are also feeling anxious and as if everyone is staring at them.

  • What are the symptoms of separation anxiety in kids?

Separation anxiety occurs when children leave or part from a safe person or a safe place. Leaving the home or leaving mom or dad or grandma or grandpa will often trigger anxiety. The symptoms—because it’s anxiety—are the same as above (physical, emotional, mental, behavioral); they’re just triggered by a different situation.

  • How can you help children cope with anxiety–both in general and specific to each condition?

Children should be assured that anxiety is a message from your brain and your body. When anxiety spikes, there may be a good reason for it, just like when a fire alarm goes off and there’s really a fire and there’s physical danger and getting to a safe place is important. Children should be encouraged to identify their safe places and their safe people.

However, sometimes anxiety spikes and instead of a real fire alarm, the body and the brain are experiencing a false alarm. When there’s no immediate danger and the anxiety builds up anyway, it’s crucial for children to have a plan for how they’ll handle the anxiety. Having a plan to approach and deal with anxiety is nearly always preferable to letting the anxiety be the boss. Leaning into, facing, and embracing anxiety as a normal part of life is very important. We should all avoid taking actions designed to run away from or avoid anxiety. Developing a personal plan (along with parents, teachers, and counselors) for dealing with anxiety is the best strategy.

And, finally, here’s my tip sheet for helping with children’s anxiety

How to Help Children Deal with Fears and Anxiety

  1. Manage Your Own Anxiety and Negative Expectations: If you don’t have and display confidence in your own preparation and skills, YOUR WORRIES and negative expectations will leak into the child. Additionally, if you don’t show confidence in your child’s coping abilities, that lack of confidence will leak into them too! 
  2. Use Storytelling for Preparation and to Teach Coping Strategies: “Let’s read, Where the Wild Things Are.” Afterwards, launch into a discussion of how people deal with fears.
  3. Focus on Problem-Solving and Coping (especially as preparation): “How do you suppose people manage or get over their fears?”
  4. Instead of Dismissing Feelings, Use Soothing Empathy: “It’s no fun to be feeling so scared.”
  5. Show Gentle Curiosity:  “You seem scared.  Want to talk about it?”
  6. Provide Comforting Reassurance or Universality (after using empathy and listening with interest):  “Lots of people get afraid of things.  I remember being really afraid of dogs.”
  7. Offer Positive (Optimistic) Encouragement:  “I know it’s hard to be brave, but I know you can do it.”
  8. Have and Show Enormous Patience (connection—and holding hands—reduces anxiety):  “Yes, I’ll help you walk by Mr. Johnson’s dog again.  I think we’re both getting better at it, though.”
  9. Set Reasonable Limits:  “Even though you’re scared of monsters sometimes, you still have to be brave and go to bed.”
  10. Model how to Sit with and through Fear (No negative reinforcement!): One thing that’s always true is when fear is big, it always gets smaller, eventually. “Hey. Let’s sit here together and watch our fear go away. Let’s pay attention to what makes it get smaller.” (This might include direct coping skill work . . . or simple distraction and funny stories).
  11. Plan and Model Anxiety Management Skills: Specific skills, like deep breathing, aid with coping. Once you find some techniques or skills that are better than nothing, start to practice and rehearse using them. This can be for preparation, coping during the anxiety, or afterwards. “Let’s sit together and count our breaths. Just count one and then another. And we’ll try to find our sweet spot.”

2 thoughts on “Helping Children Deal with Anxiety . . . and the Best Ever Children’s Anxiety Tip Sheet”

  1. John,
    I totally agree with you regarding anxiety. We all experience anxiety and stress in our lives. We need to learn coping skills to handle these emotions and teaching them to children at a young age is essential.

    When I was counseling elementary age students we would talk about their worries and categorize them by the ones they need to let go, ( not likely to happen) the worries they can control, and those aren’t in their control. Just the act of talking about them helped, and then we could apply strategies to the different triggers. The younger we all learn coping skills, the better! Thanks for all your work in helping children!

    1. Thanks Peggy! Not surprisingly, your approach with elementary school students sounds great. Talking is good by itself, but even better when you help the kiddos organize their worries. Very cool. I wish I had been in one of your classes or had you as my school counselor!

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