Childhood Anxiety: What parents should know and how they can help

Dr. Kiera Boyle is a Supervising Psychologist at Franciscan Children’s. She specializes in working with children and adolescents who struggle with mood disorders, anxiety, adjustment difficulties, school refusal, and those who have experienced trauma. To learn more about our Outpatient Mental Health services, please click here. To make a referral, please call us at 617-254-3800 x3141.

Dr. Kiera Boyle and a patient play a game of “Stratego” during a therapy session. During play therapy, children are often allowed to choose the activity. This gives them a sense of control and helps them to express feelings they might otherwise keep inside. At home, letting your child choose the game you play can help them ease into conversation about what is worrying them.

Childhood anxiety is a hot topic for many parents and families. We recently asked Dr. Kiera Boyle, Supervising Psychologist at Franciscan Children’s, to answer some popular questions about how children experience and express anxiety and how parents can help manage it.

Q: How do children express and experience anxiety? Is it different from adults?

A: Adults and children experience the same major symptoms of anxiety: worries that are hard to control, difficulty sleeping, irritability, fatigue, and feeling tense. However, children tend to experience physical symptoms of anxiety more than adults, and often suffer from headaches, gastrointestinal issues, chest pain, or drowsiness. Anxious kids also often show difficulties paying attention in the classroom, and can be misdiagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). Some children with anxiety may come across as irritable and demanding, trying to control things around them. Others might avoid anxiety-provoking situations, appear timid, and cry easily. The symptom picture of anxiety can differ from child to child based on age and other factors.

Q: What should parents know about their child’s anxiety?

A: First, your child may not be able to tell you that he or she is anxious. You may notice that they take frequent visits to the school nurse, or report feeling tired all the time. They may try to avoid going to school or other activities that cause them anxiety. Your child might get up multiple times during the night to check that the door is locked. All of these are possible signs of anxiety in children.

Second, it is not your fault that your child is anxious! But, there are things you can do to help. Talk with your child about his or her worries, and don’t dismiss them. Show your child that you are prepared and can help them stay safe. For example, create a plan for what to do if your house catches fire, or in the event of an earthquake. In the case of anxiety about academic performance, praise and reward them for their effort rather than the outcome of the assignment. Remind them that you don’t expect perfection, and that trying their best is good enough. If your child’s anxiety continues or gets worse, you may want to consult a mental health professional for assistance.

Q: What are some common sources of anxiety for children?

A: Children’s anxiety tends to relate to issues about their performance in school or sports; they may come across as perfectionistic or overly-focused on rules. Many kids worry about social issues, such as fitting in with peers. Some children may become fixated on world events or potential catastrophes, such as the election or the possibility of earthquakes or terrorist attacks. Kids can also develop anxieties about monsters, ghosts, murderers, etc. after being exposed to frightening television or video game content. Try to monitor what your children watch and play—if it’s at all scary for you, it’s probably way too scary for them!

Q: How might mindfulness and meditation help children with anxiety? How should this be introduced to children?

A: Mindfulness and meditation are excellent to practice with anxious children. They give children a sense of empowerment by teaching them that they have some control over their bodies, and can calm down when they get anxious. They are also great for teaching executive functioning skills such as self-monitoring, which are beneficial in many areas of life.

A good first step is teaching children to focus on their breathing with fun techniques like “Belly Breathing.” One great, 3-minute video to teach breathing to kids is HEALTHY HINTS: Belly Breathing. Make sure to practice with your child and keep trying until they can do it on their own! Create a routine and have them do their Belly Breathing before bed every night, or when they get home from school.

Children with anxiety, especially those who tend to be more perfectionistic, might struggle with meditation and mindfulness at first. They may worry that they aren’t “doing it right.” Start by doing the activities with them, and talk afterwards about what is difficult for both of you. Help them understand that mindfulness and meditation take practice, and there is no right or wrong way to do them.

One great way to make mindfulness and meditation fun for kids is with apps they can use with you or on their own. A great app with sessions specifically for kids is Headspace. Another excellent one that would be appropriate for older children or teens is Smiling Mind. Both are free, and provide multiple sessions to walk the child through learning to be mindful.

Q: How does a parent’s own anxiety impact children’s anxiety?

A: Anxiety is somewhat influenced by genetic factors, meaning that anxious parents may pass on their tendency toward anxiety to their children. While there is nothing we can do about genetics, it certainly isn’t destiny.

Anxious parents can sometimes become overprotective of their young children, inadvertently teaching them that the world is dangerous. Because parents want the best for their kids, they can sometimes get overzealous about academic performance or sports. We can all take out our anxieties on those around us.

The most important thing parents can do to help their children be less anxious is to be aware of their own anxieties and try to manage them. This could mean scheduling time every month to talk with a friend, taking yoga classes, seeing a therapist, practicing mindfulness or meditation, enjoying a stress-relieving hobby like gardening or painting, or any number of other activities that help manage anxiety. Not only will you be less likely to take out your anxieties on your children, you will also be providing them a role model for self-care.

If you feel comfortable, it might help to talk to your child about your experience of anxiety and what helps you. Children can feel like something is wrong with them and they are alone—helping them feel that they can talk to you about their feelings without shame is half the battle!