Unlike aggression, impulsivity or hyperactivity, anxiety often goes under the radar in kids, said Elizabeth Penela, Ph.D, a psychologist who specializes in treating anxiety in kids. It might be because anxiety typically manifests as somatic symptoms. For instance, kids might have headaches, muscle tension and a queasy stomach, she said.
They can feel anxious about all sorts of things — from doing well on a test to what their peers will think of them. They also might worry about everyday issues, such as: “Is Mom going to be late to pick me up? Does our car have enough gas? Will I have enough time to clean my room and do homework?”
Even when kids receive reassurance from others that there’s nothing to fret about, many who struggle with anxiety still keep worrying, Penela said.
Kids also avoid situations that trigger their anxiety — though they won’t recognize that this is why they’re avoiding them. “[I]nstead they might say that they are avoiding a situation, because they don’t like it or simply ‘don’t feel like it.’” If a child is struggling with social anxiety, they might say they don’t want to attend a birthday party because it’s boring or because they’re tired, Penela said.
Seeing your child struggle with anxiety can be really hard. Fortunately, there are many ways you can help. Below, Penela shared four strategies.
Help them label their anxiety and empathize with how they feel.
The first step is to help your child identify the feeling of anxiety and include details about why you think this is hard for them, said Penela, who practices at Pediatric Psychology Associates in Coral Springs, Fla. For instance, you might say: “Since you don’t know that many kids at this birthday party, it seems like it might feel a little scary to you.”
Give your child time to respond. Then empathize by communicating that you know this is difficult for them: “It can feel hard to start to play with other kids when you don’t know them very well.”
Encourage them to face their fears.
The next step is to make a supportive comment about your child’s ability to face their fears. For instance, you might tell your child that you remember a recent time they did well interacting with kids they barely knew.
If they’re nervous about going to school, according to Penela, you might say: “I remember when you first went to Ms. X’s class. You felt a little nervous, but then you spent the whole day there, and you had a great time!”
You also might give your child ideas on how to approach the situation, she said. For instance, at the birthday party, you “point out a peer who is playing with a toy that your child enjoys and suggest [they] talk to the peer about this toy.”
Expose them to their fears gradually.
Penela stressed the importance of helping your child face their fears gradually. If your child is nervous about unfamiliar people, have them engage in brief interactions with acquaintances, she said. Then “gradually work up toward longer interactions with less familiar [people].” If your child is scared to go into the ocean, have them wet their toes first, she said.
It also helps to understand what your child is specifically scared about. For instance, gently ask your child: Are you scared of drowning? Are you scared of animals in the water? Then as they wet their toes — approaching the feared situation — ask about these specifics: Do you feel like you’re drowning? Can you see any animals?
“In other words, allow the child to learn based on their own experience that their worries are not based on facts.”
Reflect back questions.
“Anxious children tend to ask a lot of questions,” Penela said. And once they get those questions answered, they typically only have more. Instead of trying to respond to all their questions, “try turning the question back to your child in a sensitive way.”
Penela shared this example: Your child asks, “Am I going to know any of the kids at that birthday party?” You respond by saying, “I’m not really sure. What’s happened other times that we’ve gone to birthday parties? Did you know all of the kids, some of the kids? How did it go?”
“Reflecting the question back to your child, and helping them think through responses based on their previous experiences or available facts is the best way to help them answer these troubling questions.”
Try using these strategies consistently. If your child’s anxiety stays the same or worsens, and interferes with their life, seek professional help, Penela said. Look for a psychologist who specializes in treating anxiety with cognitive behavioral treatment (CBT). Research has found that CBT is an effective treatment for kids (and adults). “The idea of ‘facing your fears’ is at the heart of CBT.” And children can learn the skills to confront their fears effectively, she said.
Anxiety can feel big and overwhelming and scary to kids (and us adults!). Thankfully, anxiety is highly treatable. By facing their fears gradually and with support, your child can feel better and become more resilient.
Penela suggested checking out Ronald Rapee’s book Helping Your Anxious Child: A Step-by-Step Guide for Parents. “[I]t uses an evidence-based model, but without being overly technical and is easily accessible to all audiences.”
Worried child photo available from Shutterstock