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Anxiety in Kids: How to Turn it Around and Protect Them For Life

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Anxiety in Kids: The Skills to Turn it Around and Protect Them For Life

Anxiety is a normal response to something dangerous or stressful. It becomes a problem when it shows up at unexpected times and takes a particularly firm hold. When anxiety is in full swing, it feels awful. Awful enough that anticipation of the feeling is enough in itself to cause anxiety.

We already know that anxiety has nothing to do with strength, courage or character. It picks a target and it switches on.

When that target is a child or teen, it can be particularly distressing, causing problems with sleeping, eating and missed school from unexplained illnesses such as sick tummies or headaches. 

One of the worst things about anxiety is the way it can happen without any identifiable cause. The physical feeling is familiar – that panicked feeling that comes when you miss a stair or as my daughter recently described, ‘that feeling you get when you’re almost asleep and you feel like you’re falling.’ (‘Yes, we’ve dealt with it in our home too. It’s under control now, so I can assure you this works.)

The good news is that anxiety in kids is very treatable and they are particularly responsive. I often think we don’t give them enough credit. They’re so open to possibility, and very quick to make the right connections when they’re given the right information and support. As the adult in their life, you’re the perfect one to give it.

Anxiety in Kids and Teens: Turning it Around 

  1. Don’t talk them out of it.

    As a parent, the temptation is to reassure your child with gentle comments in the way of, ‘There’s nothing to worry about,’ or ‘You’ll be fine’.

    This comes from the purest of intentions but it runs the risk of them feeling as though there’s something wrong with them. The truth is that when anxiety has a hold of them, they can no sooner stop worrying than fly to the moon. As much as they want to believe you, their brains just won’t let them.

    What they need to hear is that you get it. Ask them what it feels like for them. They may or may not be able to articulate – and that’s okay. Then, ask if it’s ‘like that feeling you get when you miss a stair,’ (or ‘that feeling you get when you feel like you’re falling in your sleep’). Often, this in itself is such a relief because ‘someone gets it.’

  2. Normalise.

    Explain that:

    •. Anxiety is normal and everyone experiences anxiety at some time in their life – before an exam, when meeting new people, going for an interview or starting at a new school.

    •  Sometimes it happens for no reason at all. That’s also normal. It happens to lots of adults and lots of kids but there are things you can do to make it go away. 

  3. Explain why anxiety feels like it does.

    Out of everything, this is perhaps the most powerful intervention for anyone with anxiety. Anxiety causes the most problems when it seems to come on without any real trigger. There’s a reason for this, and understanding the reason is key to managing the anxiety.

    Here is a child-friendly explanation. I’ve used it for a variety of ages, but 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. 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 not very big and it’s shaped like an almond.  

    It switches on when it thinks you’re in danger, so really it’s like your own fierce warrior, there to protect you. It’s job is to get you ready to run away from the danger or fight it. People call this ‘fight or flight’.

    If your amygdala thinks there’s trouble, it will immediately give your body what it needs to be strong, fast and powerful. It will flood your body with oxygen, hormones and adrenaline that your body can use as fuel to power your muscles to run away or fight. It does this without even thinking. This happens so quickly and so automatically. The amygdala doesn’t take time to check anything out. It’s a doer not a thinker – all action and not a lot of thought.

    If there is something dangerous – a wild dog you need to run away from, a fall you need to steady yourself from – then the amygdala is brilliant. Sometimes though, the amygdala thinks there’s a threat and fuels you up even though there’s actually nothing dangerous there at all. 

    Have you ever made toast that has got a bit burnt and set off the fire alarm? The fire alarm can’t tell the difference between smoke from a fire and smoke from burnt toast – and it doesn’t care. All it wants to do is let you know so you can get out of there. The amygdala works the same way. It can’t tell the difference between something that might hurt you, like a wild dog, and something that won’t, like being at a new school. Sometimes the amygdala just switches on before you even know what it’s switching on for. It’s always working hard to protect you – even when you don’t need protecting. It’s a doer not a thinker, remember, and this is how it keeps you safe.

    If you don’t need to run away or fight for your life, there’s nothing to burn all that fuel – the oxygen, hormones and adrenalin – that the amygdala has flooded you with. It builds up and that’s the reason you feel like you do when you have anxiety. It’s like if you just keep pouring petrol into a car and never take the car for a drive.

    So when the amygdala senses a threat it floods your body with oxygen, adrenaline and hormones that your body can use to fuel its fight or flight. When this happens:

    ♦   Your breathing changes from normal slow deep breaths to fast little breaths. Your body does this because your brain has told it to stop using up the oxygen for strong breaths and send it to the muscles to they can run or fight.

    When this happens you might feel puffed or a bit breathless. You also might feel the blood rush to your face and your face become warm.

    ♦    If you don’t fight or flee, the oxygen builds up and the carbon dioxide drops.

    This can make you feel dizzy or a bit confused.

    ♦   Your heart beats faster to get the oxygen around the body.

    Your heart can feel like it’s racing and you might feel sick.

    ♦   Fuel gets sent to your arms (in case they need to fight) and your legs (in case they need to flee).

    Your arms and legs might tense up or your muscles might feel tight.

    ♦   Your body cools itself down (by sweating) so it doesn’t overheat if it has to fight or flee

    You might feel a bit sweaty.

    ♦   Your digestive system – the part of the body that gets the nutrients from the food you eat – shuts down so that the fuel it was using to digest your food can be used by your arms and legs in case you have to fight or flee. (Don’t worry though – it won’t stay shut down for long.)

    You might feel like you have butterflies in your tummy. You might also feel sick, as though you’re going to vomit, and your mouth might feel a bit dry. 

    As you can see, there are very real reasons for your body feeling the way it does when you have anxiety. It’s all because your amygdala – that fierce warrior part of your brain – is trying to protect you by getting your body ready to fight or flee. Problem is – there’s nothing to fight or flee. Don’t worry though, there are things we can do about this.’

  4. Explain how common anxiety is in adults and kids.

    About 1 in 8 kids have struggled with anxiety – so let them know that in their class, there’s a good chance that 3 or 4 other kids would know exactly what they’re going through because they’ve been through it before. Maybe they’re going through it right now.

  5. Give it a Name.

    ‘Now that you understand that your anxiety feelings come from the ‘heroic warrior’ part of your brain, let’s give it a name.’ Let your child pick the name and ask them what they think of when they picture it. This will help them to feel as though something else is the problem, not them. It also demystifies their anxiety. Rather than it being a nameless, faceless ‘thing’ that gets in their way, it’s something contained – with a name and a look. 

  6. Now Get Them Into Position.

    ‘The problem with anxiety is that [whatever their ‘heroic warrior’ is called – for the moment, let’s say, ‘Zep’] Zep is calling all the shots but we know that you’re really the boss. Zep actually thinks it’s protecting you, so what you need to do is let it know that you’ve got this and that it can relax. When you get those anxious feelings, that means Zep is taking over and getting ready to keep you safe. It doesn’t think about it at all – it just jumps in and goes for it. What you need to do is to let it know that you’re okay. 

    The most powerful thing you can do to make yourself the boss of your brain again is breathe. It sounds so simple – and it is. Part of the reason you feel as you do is because your breathing has gone from strong and slow and deep to quick and shallow. That type of breathing changes the balance of oxygen and carbon dioxide in your body. Once your breathing is under control, Zep will stop thinking he has to protect you and he’ll settle back down. Then, really quickly after that, you’ll stop feeling the way you do.’ 

  7. And breathe.

    Breathe deeply and slowly. Hold your breath just for a second between breathing in and breathing out. Make sure the breath is going right down into your belly – not just into your chest. You can tell because your belly will be moving. Do this about 5 to 10 times.

    Practice before bed every day. Remember that Zep, the warrior part of your brain, has been protecting you for your entire life so it might take a little bit of practice to convince Zep to relax. But keep practicing and you’ll be really good at it in no time. You and that warrior part of your brain will be buddies – but with you in control.

    One way to practice is by putting a soft toy on your child’s belly when they lie down. If the toy is moving up and down, their breathing is perfect. 

  8. Practice mindfulness.

    An abundance of scientific research has demonstrated the profound effects of mindfulness.  MRI studies have shown that practicing mindfulness increases the density of gray matter in the brain, providing relief and protection from stress, anxiety and depression. See here for more information.

    Mindfulness doesn’t have to be complicated. Essentially, it’s being aware of the present moment, and there are plenty of fun ways introduce children to mindfulness.  

    Start by explaining that anxiety comes about because of worry about the future and what might happen. Sometimes these thoughts happen in the background – we don’t even know they’re there. Mindfulness helps you to have control over your brain so you can stop it from worrying about things it doesn’t need to. It trains your brain to stay in the here and now. The brain is like a muscle and the more you exercise it the stronger it gets. 

    It sounds easy enough but minds quite like to wander so staying in the moment can take some practice. Here’s the how:

    1. Close your eyes and notice your breathing. How does the air feel as you draw it inside you? Notice the sensation of the air, or your belly rising and falling. Notice your heart beating. If your mind starts to wander, come back to this.
    2. Now, what can you hear? What can you feel outside of you and inside your body? If your mind starts to wander, focus on your breathing again. 

Remember that anxiety in kids is very treatable but it might take time. Explain to your child that his or her very clever and very protective brain might need some convincing that just because it thinks there’s trouble coming, doesn’t mean there is. Keep practising and they’ll get there. 

A Book for Kids About Anxiety …

‘Hey Warrior’ is the book I’ve written for children to help them understand anxiety and to find their ‘brave’. It explains why anxiety feels the way it does, and it will teach them how they can ‘be the boss of their brains’ during anxiety, to feel calm. It’s not always enough to tell kids what to do – they need to understand why it works. Hey Warrior does this, giving explanations in a fun, simple, way that helps things make sense in a, ‘Oh so that’s how that works!’ kind of way, alongside gorgeous illustrations.

 

 


 

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800 Comments

Christine

This is a wonderful article! I’ve read so many books on anxiety but you have managed to write about it in a way I can really understand. I suffer (& I mean SUFFER) from anxiety & I’ve been taught all of these techniques but to be able to put it all together visually is brilliant! Do you have a link to a mindfulness script I could try?

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Hey Sigmund

Hi Christine,

I’m so pleased the article helped you. Here are some scripts to try:

http://www.mindful.org/resources

Here is one that is suggested by Harvard Medical School. Down the bottom of the page are links to audio scripts – http://www.health.harvard.edu/blog/mindfulness-meditation-helps-fight-insomnia-improves-sleep-201502187726

And finally …
http://onlinelibrary.wiley.com/store/10.1002/9781119993162.app1/asset/app1.pdf;jsessionid=26D94301EACCC6641F760B3C56D77B39.f01t02?v=1&t=iao07mqy&s=2b4216ba9c6698d37c484901f324824972e60a7b .

Hope you can find something that works for you in these.

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suzi

great article. I’ve recently been doing some anxiety support and one of the BIG things which has actually helped is switching off the reassurance and sympathy and moving on to solutions. working through her worries in a child friendly way, working together on suggestions so that she can build her own resilience as she grows older to solve her own worries and anxieties. its made a huge difference and I just wish that someone had told me it years ago so I could have implemented it earlier on in her life.

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deb

I have a 3 yr old who is totally wild and bouncing off the walls. The pediatrician said it was anxiety. He talks constantly and is a nightmare at school.
He is very bright and has a quirky sense of humor but. Don’t understand how this can be anxiety.

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Hey Sigmund

Anxiety can take on different shapes and can look differently in different kids. It would be completely appropriate to ask your son’s paediatrician to explain to you how the diagnosis of anxiety was reached. Hopefully this will help you to make sense of things and it’s always good to have as much information as possible. If after speaking further with your son’s doctor something still doesn’t feel right, I would trust your intuition and seek another opinion.

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K

Have you considered looking into your child’s diet?
My child was lime this too… It turned out to be ADHD

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Jean

Wild, bouncing off the walls, rushing through everything, talking fast – that is exactly how my daughter experiences anxiety. And she also has ADHD which does not look like her anxiety response so I’d trust that anxiety dx is correct and go from there.

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Sarah

I think this is a very good article, my son has suffered for a long time and was only really pointed out to me when he changed school , it’s heart breaking to see your child suffering and leaning to understand there fears , I my self have needed help to understand and now we are in a much better place and talk about it rather than telling him he will be fine and there is nothing to worry about , in a child’s mind it won’t be fine untill they understand ,
I was offered meds for him but wanted to try a placebo affect and I give him fish oil every day and this really helps him we see a difference in his anxiety if he misses a day .

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Hey Sigmund

It’s so difficult to see someone you love having to deal with anxiety isn’t it. You’re absolutely right about talking about it rather than telling them there is nothing to worry about. There is actually some evidence that shows that fish oil is good for anxiety, so it may not as much a placebo as doing something actually beneficial. There’s a lot we’re still learning about the brain but omega 3 is good for brain health and it seems to help with anxiety as well. There is some information and some other ideas here http://www.heysigmund.com/anxiety-without-medication/ .

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Catherine

Thank you for this article. It has given me some new ideas. I teach a three year old girl in a small setting who has severe generalised anxiety and although we make progress, it is very slow. She has very little understanding. I have spoken of it being common, led her through meditations and taught her to ‘breathe in a flower and blow out a candle’. She says ‘I don’t want to breathe, I don’t like soft toys, I don’t know what bananas do, I don’t know if your trees are growing…’ All day. I sometimes teach her particular skills and ask her to share so she is not ‘the powerless’ member of the group. I offer to read a book or play a game after she’s completed one task on her own or with a classmate. I believe my attention is her currency. Any further ideas for the very young would be great. Thanks.

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Hey Sigmund

It sounds as though you are doing a wonderful job. One on one attention is really important, and it’s great that you are able to give this to her. For kids who are anxious, their fight or flight response can be easily triggered in a bigger group, particularly for younger kids who are still learning how to manage their response. You’re encouraging brave behaviour by rewarding her after she does something difficult, which is also really important. Progress can be seem slow, but celebrate the little things – they’re the things that will all add up to the big things. Here are some other things that might help http://www.heysigmund.com/anxiety-in-very-young-kids-11-ways-to-make-a-difference/ . This little one is very lucky to have you.

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Anushka

This article is brilliant. I hope i’ll do a good job of converting it for a 6 year old.

One thing I will say as a person who’s suffered from terrible shortness of breath due to chronic anxiety is that it’s frustrating and anxiety inducing to be told to “just take deep slow breaths” When you absolutely cannot.

I think once you slow down and begin to acknowledge you’re safe and separate yourself from the feeling a bit then the breathing naturally slows. For my with my symptoms (and my son is the same) the breathing can’t be focused on directly in the height of an anxiety attack.

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Hey Sigmund

You’re so right about it being almost impossible (or impossible!) to take deep slow breaths in the thick of an anxiety attack. The reason breathing is important is because it initiates the relaxation response, which is hardwired into us in the same way the fight or flight response is. The relaxation response was discovered by Harvard cardiologist and when it’s triggered (as it is with deep, strong breathing), it surges your body with neurochemicals that reverse the fight or flight response. The problem is that accessing it when you need isn’t that easy. The way to get around this is to practice breathing as much as you can when you’re not anxious. Try a couple of times a day (if you can) being still and breathing in for 3, hold for 1, out for three, hold for 1. Try to get your son to practice it before bed with a toy on his belly, so that he can make sure the breaths are strong and deep and coming from his belly, not his chest (the toy should move up and down when he breathes). It will take some practice, but it will eventually make it easier to access deep, strong breaths and trigger the relaxation response when you’re in the height of an anxiety attack. There is some information about it in this article http://www.heysigmund.com/managing-anxiety/ . Also, just in case you haven’t read it, here is some info about helping younger ones with anxiety http://www.heysigmund.com/anxiety-in-very-young-kids-11-ways-to-make-a-difference/ . Being in the thick of an anxiety attack feels awful, I know, and I hope the information is able to help you and your little man.

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Stephanie

Yes, it in early impossible to try deep breathing in the midst of an attack. Regular practice is so impotant! Keep in mind that physiologically , anxiety raises your heart rate and rapid heart rate fuels anxiety ( perfect in actual danger but a vicious cycle in anxiety) .

The intra thoracic pressure chances in deep slow breathing decreases the heart rate and breaks the cycle.

Practice helps in two ways- it prepares you to be able to do it in an attack. It also is a regular reminder that you have a tool to help. This reduces the fear of having an attack, which is so crippling in people with anxiety disorders.

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Maria

I just wanted to add another ‘concept’ if I may…
I have suffered anxiety myself after a trauma in my teenage years. It was overwhelming and although I tried the techniques mentioned which helped me calm down during an episode of anxiety, it didn’t stop them from re-occurring.
At one point, I was having blackouts during the middle of the day for no reason… My GP advised me to seek psychological therapy and take some medication.

I felt deep down that I wanted to control the problem from within not with medication.. Something inside me just knew that medication was only going to mask the problem for me. (I will take a minute to mention that I don’t disregard the power of medication or judge anyone who chooses that path!!)
But for me.. I needed to keep looking.. I came across the book ‘The Brain that Changes Itself’ by Norman Doidge who is an internationally renowned Psychiatrist, and he spoke about Neuroplasticity or the ability of the brain to change and adapt. This made sense to me… If my brain could change to start triggering anxiety following a life event, it should also be able to ‘change back’.

I immediately started my journey of looking for a practitioner of neuroplasticity (sometimes called a neurotherapist) to try and re-train my brain not to have these inappropriate responses. By this stage I had been suffering from anxiety for almost 2 years and it was slowly taking over my life!
Well to my astonishment, I found one in Perth (Australia).. Which is rare! So I went along and within 4 weeks I had not only stopped having anxiety episodes, but I felt amazingly in control of my brain… Something I had not experienced before. I Received treatment for around 12 weeks and I have never had another anxiety attack since… This was 6 years ago! 🙂

I have spoken about this with many people who I have come across with anxiety… Many have tried the same approach.. And for the majority it worked similarly to how it worked for me…

I hope this helps someone else out there because it changed my life!

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Don Hughes

I see a lot of people immediately mentioning meds. A seemingly good rule of thumb in the decision to try meds was told to me by the psychiatrist who diagnosed my son with Asperger’s; he said he tries to stay away from meds unless the condition in question affects the child’s self esteem. He tried to never use the medical option simply to make the child more manageable to teachers or parents. I have stuck with this approach with my son and it has worked well for him.

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Hey Sigmund

I absolutely agree with you! That advice from the psychiatrist is gold. There is a place for medication, but it’s important to remember that anxiety is something that needs to be managed throughout the lifetime, as there’s no ‘cure’ as such. The concern with medication is the risk that it will create a dependancy by undermining the learning of those important skills. Although learning how to manage anxiety can take time, once the skills are learnt, people can be really successful in keeping their anxiety at bay and not letting it intrude on a happy, productive, full life. Thank you for sharing this.

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carolyn

My daughter who is an adult now. Has always had social anxiety an example in HS I found out she was not going to lunch she was going to the restroom and staying in there during lunch. As an adult example she was watching her niece who fell and hit her head. She was freaking out thinking that her sister would be so mad that she would never want to see her again and that her niece was going to have brain damage. She also cant have anything out of place too long. She got a new couch and the kitchen table had to be moved out of the way. With in 5 min she said to me I need to put the table back theres to much out of place and we moved it back and she looked and had to move it a half of inch or so then like another 1/8in. Maybe not those exact measurements but I wanted a good description for you. Also shes pregnant and very first sonogram she wouldnt even look at the screen she looked at me and asked does everything look normal? I want to help her relax just a little it seems stressful to constantly have those feelings. Any tips on how I can help her deal with those feelings?

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Hey Sigmund

It’s difficult watching someone you love go through this isn’t it. Here is some information that might help you: http://www.heysigmund.com/when-someone-you-love-has-anxiety/. Also, if your daughter is open to it, here is some information on mindfulness which helps to strengthen and protect the brain against anxiety:
Mindfulness: Why it Works http://www.heysigmund.com/mindfulness-and-health-this-is-why-it-works/
Mindfulness: The Difference 10 Minutes a Day Can Make: http://www.heysigmund.com/mindfulness-what-how-why/

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Nicole

Do you have any thoughts on school refusal anxiety. We have Been experiencing this for 12 months. We are seeing a therapist for the last 10 months along with medication. Which we have seen some improvement but is still extremely challengingfor our daughter. Have you come across this before?

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Jayme

Thank you for this article! I can’t wait to share some of this with my daughter! She’s struggled with anxiety almost her entire life. What seemed like severe separation anxiety for several years turned into more than that in Kindergarten. She didn’t play on the playground ONCE that year! She said she didn’t want the teachers to see her playing. She has never done any imaginative play in front of me. She only pays like that behind a CLOSED door by herself. She asks me go away so she can play. She’s 8 now. I can hear her through the door, and it’s amazing how creative she is, but makes me sad that I’ve never gotten to witness it. Last year we added a baby to the family and her anxiety went from 1 to 10000! She wouldn’t hold the baby, she started having panic attacks, had an INTENSE fear of germs to the point that she couldn’t leave the house. We put an emergency call into the pediatrician after she begged is to take her to the hospital because she couldn’t take it anymore! It was her cry for help! We put her on zoloft after swearing we wouldn’t go the medication route. She’d already been in counseling. I must also say she complained of headaches almost EVERY DAY. The doctor said she just needed more sleep. Turns out that was a symptom of anxiety! She also has extreme sensitivity to clothing and the way it feels. This seems to be related to the anxiety. Getting her dressed for the past 3 years has been nothing short of a nightmare! We’re trying to wean her off of the meds because about 6 months on the medication and once we were on the psychiatrist desired dosage for her she’s had a big personality change! Very ADHD like behavior. Wild, unable to organize thoughts, rushing through everything, failing tests, etc. Anyone else experienced this? She was the COMPLETE opposite of this before meds! Her past teachers can’t believe what I’m telling them! I’m worried these are permanent changes due to meds. She’s been on Zoloft 10 months. Psychiatrist says it’s the only safe option for kids. We’re at a loss. I’m trying essential oils, diffusing at night in her room. We’ve also bought a program we do with her because she didn’t think counseling was helping. More suggestions or insight is VERY WELCOMED!

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Hey Sigmund

Jayme, it sounds as though your family has been through a tough time. This must be awful for your daughter and really difficult for you to see her struggling like this. If you can help her to understand why she’s feeling the way she’s feeling, it will help to demystify things for her and help her to feel more in control of what’s happening. One of the things that makes anxiety so difficult to deal with is that it doesn’t make sense. Making sense of it for her can really help to empower her. There is a lot of information under ‘Being Human’ in the menu bar, and hit. When you click on it, a menu will drop down. Click on anxiety there and it will take you to a bundle of articles. The ones I think would be important for you are:

>> What to Say to Kids When They are Anxious http://www.heysigmund.com/building-emotional-intelligence-what-to-say-to-children-with-anxiety/
>> Mindfulness for Children http://www.heysigmund.com/mindfulness-for-children-fun-effective-ways-to-strengthen-mind-body-spirit/ (There is a stack of research that has shown how mindfulness can change the neural pathways and strengthen the brain against anxiety)
>> Anxiety – 15 Ways to Feel Better Without Medication http://www.heysigmund.com/anxiety-without-medication/

There are quite a few things to try and its good to have a bit of a toolbox. I hope this is able to help your daughter find some comfort. She sounds pretty wonderful.

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Alison

Jayme, you might also check out the book The Highly Sensitive Child by Elaine Aron if you haven’t already ready it. It sounds like your daughter might be highly sensitive. My daughter, now 11, is highly sensitive and highly anxious. Reading THSC has helped me understand her.

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Kris

Jayme, I don’t know if it applies, but the below causes also have anxiety, headaches, sensitivity as some of the symptoms.
It could be worthwhile checking her digestion and elimination. Does she have bloating after eating? Constipation or diarrhea? Those could be indicative of SIBO (small intestinal bacterial overgrowth). Small intestine should be almost sterile but if there’s dysbiosis, some gut bacteria produce fermentation and the gases released are very toxic to the brain (there is gut-brain axis and the brain and nerves DO get affected). While Vit. B5 (pantothenic acid) will not cure it on its own, you may check if it helps (the effect could, sometimes, be felt within less than an hour). Adding sublingual B12 (methylcobalamin) could also help. My severe anxiety of a couple months, for which I used everything I could find (journaling, diet, herbs, mudras, acupressure, sedating Triple Warmer techniques from youtube) kept coming back daily and I found out it was SIBO related.
Also worth checking are food and/or chemical allergies/sensitivities as they can affect the brain and may cause brain inflammation. Then anxiety can be one of the symptoms.
Naturopathic or homeopathic doctor could be bigger help with anxiety than a regular pediatrician.

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Jen

My daughter is 7 years old. Everyday she tells me she doesn’t feel good. She has convinced herself that she will get sick and is terrified of vomiting. She had a friend over and got sick and is now in fear that she will get sick anywhere she goes. She has difficulty sleeping and seems like a child that is uncomfortable in her own skin Right now. We have been seeing a counselor but are moving forward with a psychologist. Are we doing the right thing?

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Hey Sigmund

Jen you are definitely doing the right thing. Do what you can at home too though. Sometimes kids with anxiety find it hard to open up to strangers, so you might need to be patient before you see change. She is probably terrified of vomiting because that’s how she feels when she gets anxious. It would be scary for her if she doesn’t understand why it’s happening. Talk to her about her fierce little worrier. She will trust you more than anybody, which means you have more power than anyone to make a real difference. It’s really important that your daughter understands as much as she is able about why she feels the way she does. Practice breathing with her at home and explain why this is important and why it will make the sick feeling go away. Also encourage her towards a regular mindfulness practice (see here http://www.heysigmund.com/mindfulness-for-children-fun-effective-ways-to-strengthen-mind-body-spirit/) as well as exercise. She might already be getting plenty of exercise but if she’s not, maybe try going for a 20 minute walk with her or anything that gets her moving – kicking a ball, dancing in the kitchen – anything. Mindfulness and exercise have been shown to strengthen the brain against anxiety. Let her know that it’s making her brain stronger. There is also some more information here that might help you http://www.heysigmund.com/building-emotional-intelligence-what-to-say-to-children-with-anxiety/. Don’t underestimate the difference you can make by giving her the right information.

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Jen

Thank you! Now I have some other ways to try and help her and some positive things to say to her.

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Jen

How can I help her when she can’t settle down and really isn’t willing to do anything I suggest? It seems like she’s stuck in the thought of getting sick and there’s nothing I can say or do to help her.

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Hey Sigmund

This will take time to turn around, because it has been a fixed way of responding for a while. When she’s in the thick of her anxiety, she won’t be able to settle down or hear you. All of her energy will be focussed on her fight or flight response. This is why it’s important to practice the strategies and have the conversations when she is calm.

Acknowledge her feelings and validate where she is at, ‘I really understand that you feel like you’re going to get sick no matter what. That must be a really scary thing for you to feel. I get that. Let’s just try something new. I’m going to do it too because it will strengthen our brains. If you want to try it when you’re feeling like you’re going to be sick, that’s up to you, but you don’t have to.’ Give her all of the control she needs. She needs to know that you get it, so let her know that you understand how scared she is of getting sick. Acknowledge it, without trying to change it. Explain why breathing strong deep breaths is important for all of us, but that it’s completely up to her whether she uses it or not when she is anxious. Be patient though and don’t be disheartened if she doesn’t grab on straight away. It will take time.

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Jen

What can I do when she appears to be angry and can’t get the thought out of her head? She paces and is mad and it almost seems like she is having a temper tantrum. She also excessively takes her temperature thinking it will help. She cries and nothing seems to console her. She is mean. What is happening during this time. Is it a panic attack?

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Hey Sigmund

When this happens, she needs to know that you can see what she’s going through and that you understand. Don’t try to talk her out of what she’s feeling. The emotions are too intense and it just won’t work. Try some of the strategies in the article. You won’t be able to change anything when she is in the thick of an anxiety attack, which is why the breathing, mindfulness, explanations etc. have to happen when she is calm and able to hear you.

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RW

Jen,
My now 13 yr old son, started out like your daughter with fear of vomiting. If anyone at school had the stomach bug, he would have excessive worry that he would get sick too. Because of the intensity and frequency of worry that interfered with school/sports, we took him to a counselor that then led to psychiatrist that led to medication that led to thoughts of suicide (even with med changes). We eventually found a PhD psychologist that did neurofeedback. By the time we had started with this guy, my son had not been to school for 4 months due to fear of getting sick, panic attacks, anxiety. After 5 sessions of neurofeedback my son was back at school half days and by 8 sessions he was back full time and has not looked back. He does still fear getting the stomach bug, but he can now handle being at school even though others have been out with the stomach bug. I can’t recommend neurofeedback enough. No side effects and fairly quick response.

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Always there

My kids are all predisposed… family history. One of my daughters who suffers from Anxiety (vomiting has been the focus.) has made incredible progress with Cognitive Behavior Therapy. We started extensive therapy in third grade when it was the worst and she is now 18 years old. Although she experiences anxiety on a daily basis, her coping skills that she learned with cognitive behavior therapy at a young age have been beneficial to her coping now on a daily basis. I have never been against medicine but it was always my last option as a parent. To date, she has been medicine free. She still lives at home, thriving at college and is the love of my life. I am so proud of her! It’s a struggle for her daily and for us as a family but we stick together. When I look back and think of the hours of therapy, driving to and from, working on skills, etc… etc… it was all worth it. Hang in there if your experiencing this. It will eventually get a little easier. The key is to stick together and let your loved one know that you are in it with them. It’s not their fault that they’ve been cursed with this and together you will fight it.

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asma

Its realy helpfull article.
My daughter is 4 years 5 month old. She is socially shy and get anxious when we go outside or if guests come to our home. She never greets . Anf never eat before others. She is going to nursery since she was two years old and from the age of 4 years she is going full day school. Im school she has only one friend she only plays and talk with her never talk to teacher and not even greet for a single time. I tried to contingent her brhavior with reward if you greet your teacher then you ll get reinforcer. Bt in evry situation its not possible. She has eating n digestion problems i am so worried about her. When i worked with her before going to situation like if we r going n i prepare her if you would say hello you ll get toy in such situation she greets but while saying hello she gets sweating n fast heart beat. Plz suggest met

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Daniela

Hi Asma, my daughter had similar characteristics when she was in daycare – never spoke or played with other kids and never greeted her teachers – she’d walk in so shy each time. We started occupational therapy with her to build up her confidence – my daughter wouldn’t go on a swing, trampoline or play equipment. We found that as she found the courage to do these things through occupational therapy, she became more confident. In her first year of school she was much better socially and had a great group of friends. She still has anxiety but she’s getting better dealing with it. It took about 12 months of occupational therapy to see the difference but it’s been worth it. She continues to go every fortnight just to teach her skills to help her deal with different situations

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Pam

I wish my mum and dad knew this as I was growing up! This is great stuff. Helping me even now as an adult, and I can use it for my kids and others.
Thankyou.

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LeAnn

Such a well written article! One of the best I’ve read regarding childhood anxiety. My sweet 10 yr old daughter has shown signs of anxiety since birth… (she gets it from her mom as I’ve suffered with GAD all of my life) It was heart wrenching to watch her suffer from the same demon that had robed me of so much peace/happiness growing up. I’ve always yearned for a list of suggestions to refer to when she is in the throws of an anxiety attack….. and these are wonderful. Thank you!!

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Elizabeth Miller

As a trauma therapist, I am thrilled with what I am learning here, as well as seeing how encouraging this information and discussion is. I certainly do not want to imply that all anxiety is trauma based, but I would encourage parents and practitioners to remain calmly aware that significant symptoms that crop up, often seemingly from nowhere, can be a distress reaction to harm. No doubt, ADHD symptoms can be ADHD with or without trauma, but I believe it is important to recognize and differentiate behavioral indicators of what a child cannot articulate or, perhaps, even recognize as abuse.

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Andre Alyeska

“Have you ever made toast that has got a bit burnt and set off the fire alarm? The fire alarm can’t tell the difference between smoke from a fire and smoke from burnt toast – and it doesn’t care. All it wants to do is let you know so you can get out of there.”

This is a great analogy! I worked in residential treatment for years and will probably return. Helping kids see the difference between perceived and real threats/stressors is huge. I’m going to use this.

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Hey Sigmund

Thanks Andre. It can really help kids to have something concrete to help them make sense of things can’t it. I’m pleased this will be useful for you.

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Paula

THANK YOU!!! Our 9 year old has anxiety that keeps her up at night for hours, makes it hard to go back to school after a weekend or any kind of school break and has sent her into full-blown panic attacks. We have had her in counseling and learned some strategies but nothing is as powerful as this. I could see the relief on her face when I explained the physiological process and how she does not have to let it control her. This all makes so much sense and just that validation that, “yes, all of those sensations you experience ARE real AND there is something we can do about it” was priceless.

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Hey Sigmund

Paula I’m so pleased you read this article and have shared it with your daughter. It can make such a difference for them when they understand what’s happening. Kids can do amazing things with the right information can’t they!

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Lisa Tuggle

I enjoyed this article. As a school counselor I see quite a bit of this and what I wanted to mention is this: Very often the “worries” are completely irrational, so there really isn’t a trigger. For example a child with perfect behavior is anxious because she’s worried about getting in trouble at school. Another has anxiety because she’s “worried” about getting sick and throwing up at school. In reality this had only happened once.

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bridgit

I cannot express to you the relief this article has brought to our home. Homework was a daily fight, as was emptying the dishwasher… don’t even get me started on filling it! We counted “fits” a few weeks ago: 32 in one week. Since having this conversation(s) with our child, 3 is the most there have been in a day, 0-1 being the norm. This has been life changing: thank you for the work you do!

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Hey Sigmund

Wow! That’s amazing! I’m pleased to hear this has worked so well for you. I can write about it but it’s up to parents and kids to be open to the information and to do something special with it. Sounds as though that’s exactly what you have done – and what an incredible difference. Thanks so much for letting me know.

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Sharon

To medicate or not to medicate?? A difficult decision for any parents of children suffering from anixety or any form of mental health problems. Having a 12 year old who has suffered on and off from anixety most of his life we hit a really rough patch 3 months ago that intensified when school went back a few weeks ago. His support network was fantastic and he was talking to you us about everything but the physical symptoms were weighing him down more than anything. Feeling sick all the time, stomach pains, vomiting at school, crying at the drop of a hat for no reason, not eating etc, etc. anyway cutting a long story short we went to a health food shop and discovered Adol Essence (designed for anixety in adolescents). OMG the turn around with 24hrs was amazing. I wanted to share this for anyone who maybe looking for an alternative to SSRIs etc. We are also about to start working with a GP and we are not against medication but to find something that has had no side effects has been amazing. As Tim said in an earlier post it’s hard for them to use the breathing techniques and mindfulness when they are feeling so bad. Now that he can think clearer and concentrate better he can use the techniques and practice them as well. Thanks for the awesome article/s! As parents of kids with anxiety i believe we need to be open to everything, trust our gut and keep looking until we find what works the best for our child. This may mean stepping outside of our own beliefs and keeping an open mind. This isn’t about us it is about them.

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asma

my 4.5 years old daughter has anxiety . she is very shy and get anxious in social situations does not eat wel and sleep is also very short . she is never speak to her teacher in the class and has only one friend only plays with her. never greet any one and feel sever anxiety in new situation. has night terrors also. plz suggest me

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Hey Sigmund

Asma many of the things you are describing aren’t unusual given that your daughter is 4 years old. Many young children get shy and quiet when they are in social situations or unfamiliar situations. It is also not unusual for kids this age to only have one particular friend, particularly if they are naturally shy. Your daughter may naturally have a shy temperament, which is completely okay and is something that she will learn to manage in time. Shyness and anxiety are different though, and it may be that your daughter does have anxiety but it is difficult for me to say, and to separate the behaviour which is normal given her age, and that which might be driven by anxiety, without knowing more. If you are concerned, it would be helpful to speak to a counsellor who can properly assess your daughter and help with some strategies. Night terrors (which are different to nightmares) have been associated with normal sleep development in children and they generally grow out of night terrors at around 6 years of age. Night terrors are distressing to watch as a parent, but there is generally no need for concern as it is generally not a sign of a deeper psychological or medical issue. Again, it is difficult to say for certain without knowing more but a counsellor would be able to help you with this. Unlike nightmares, with night terrors children don’t remember them in the morning because they are in such deep sleep when the night terror happens. The main things for your to do are to have a nightly bedtime routine and to make sure she is calm when she goes to bed. Night terrors can be more common in kids who are tired or stressed, so if you are concerned, I would strongly encourage you to see a counsellor who will be able to help you get to the bottom of what might be happening for your daughter or to see if there is any need for concern.

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asma

thank you so much for reply this is what her teacher says me she ll come out of it its normal at this age group but i am very concerned because she is going to school from last 3 years n how its is normal if child goes every day to class and never speak a single word in 2 years. she never speak in the class never answar to any question if teacher asks never greet any one in the class. moreover a person comes to my home for religious teaching every day she met him every day for three months of period and does nt talk to him if i force her and she says hello but her heart beat fast nad she got sweating and she is in fight flight reaction. i want to add she always remains worried over daily routine things every morning she wakes up with worry in her mind e.g, shall i get seat in the class next to my friend ?
we are getting late from school
i ll not wear jeans only dress etc.
at night it is almost always difficult to get sleep she remains worried door should not close light should not off if i get frightened during sleep. she has very restless n short sleep. while walking with her in street i feel tension in her facial muscles and never loose her muscles. if i go out with her to new place she remains tens and repeatedly ask me i am afraid we ll get lost , do u m
know the way back to home ?
now i am more worried because she sarts complaining other children make fun of me they dont like me because i am smaller than them. no body be my friend and i dont know how to make friends.

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Brenda

I’m not an expert by all means and I’m practically in your same situation. I suggest you consider joining a parent support group to help guide you. It’s important for us caregivers to gain the confidence that our children are lacking. My daughter has experienced panic attacks and anxiety with Selctive Mutism. Having a routine helps her cope with her anxiety so running late for school or forgetting her backpack for example may trigger her anxiety. It’s happened to my daughter and I’ve had to make adjustments to our lifestyle to help her with it. by having a routine you’re providing comfort and security so that when you do run late or forget her homework, she’ll be able to better handle the situation. I remember forgetting to put her homework in her folder one time and letting her teacher know but not my daughter. I knew that if I’d tell her she’s build her anxiety to a point where she’d cry. I waited anxiously at the end of the day to ask her how her day had gone without any emphasis. She later says to me “mommy, did you know that you forgot to put my h.w in my bag”? I said “I did baby, I’m sorry. Was everything ok”? She says “yes” and smiles. First thing we learned from therapy was to build her confidence and self esteem and things should fall into place. You’ll only cause more anxiety by drilling them about her insecurities and concerns. Reassuring her constantly should ease her worries. It all takes time and practice. Again, I’m no expert but I’m learning as we go and talking to other parents and professionals and doing research pays off. Best of luck!

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Monique

Hi Asma,
People used to tell me my daughter was just shy and would grow out of it too. Her behaviour sounds very familiar to your daughter. I eventually learned about Selective Mutism and the description fit my daughter. We are now overcoming the mutism and she is able to talk to many friends at school and even her teachers in certain situations. The earlier you learn techniques to help her find her voice the better she will respond. Best wishes on your journey.

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Cristina

Monique,

My daughter was diagnosed in preschool with selective mutism and now she started kindergarden. I would like to find out more techniques that helped your daughter find her voice at school. Is it possible for us to get connected?

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Eric Lewkowiez

Night terrors are a developmental phase that she will grow out of in time. If your daughter speaks normally at home to family members she has selective mutism which is clearly anxiety related. Selective mutism is more common in children whose parents are immigrants who English is a second language. Florida International University has an excellent resource for families with children with selective mutism.

http://www.selectivemutism.org/find-help/treating-professionals/florida-international-university

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Lisa

Sounds like my daughter. When she was in pre-school her teacher mentioned she never heard her speak and wondered if her could. I was taken back. I knew she was “shy”, but at home she was very chatty. Long story short, she was like diagnosed with Selective Mutism. Putting a name to it and being able to get her proper help has been a true blessing. Adults can have SM too. You might Google it and see if it sounds like your daughter symptoms. My daughter is in high school now and although she’s made great slides, she still struggles in certain situations.

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Sara

Thank you so much for this article & your perspective on anxiety. My 3yr old, who has been labeled as gifted by his doctor and teachers, struggles with intense & uncontrollable emotions. I’m not referring to normal toddler emotions either, I’m talking about todder emotions on steroids. I haven’t had him tested since he just turned 3, but he’s been reading since 2 1/2 and is teaching himself spanish so I believe them lol. Anyways, after reading your article last night it all made sense. It’s obvious when he is in the middle of these manic moments he has no control & I’ve been struggling with more of the fight than flight response for quite some time. This morning I had a similar conversation with him about what’s going on in his body & brain & why it’s going on. He named his feeling grey & I made up a little song (because he is still only 3) to sing when he starts to feel it. I am amazed & oh so grateful that today I finally saw progress. For the first time he has been able to be in control of what he is feeling & the difference I witnessed within him is remarkable. We will continue to work on deep breathing & mindfulness & thank you thank thank you for sharing this.

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Hey Sigmund

Sara, you’re so welcome! I’m pleased this has been helpful for you and your son. Your little man’s experience makes a lot of sense. He sounds like a thinker so it’s understandable that being able to understand what is happening inside himself would be important to him. A song is a wonderful idea and such a great way anchor for him when he starts to feel his big feelings. It sounds as though he is in great hands.

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