Let's face it: Kids today are no strangers to stress. In this media-saturated world, children face scary stuff every day, from wars and natural disasters to divorce and school pressure. In addition to the mental toll, anxiety affects kids' bodies, too: A 2008 study published in Brain, Behavior, and Immunity found that family stress directly compromises immune function and increases illness in children. As a parent, how can you help?
First, take a deep breath. “Childhood anxiety is not a new problem in our society,” says Anandhi Narasimhan, MD, a Los Angeles physician specializing in child and adolescent psychiatry. All children will go through stages of normal fears and worries, with anxiety showing up as stomachaches, headaches, potty accidents, hitting, sleep problems, and more. Here, experts offer tips to discern normal versus unhealthy stress levels and to help your child develop coping skills for life's inevitable hardships.
Make space. Barring signs that may indicate a need for expert help (click on “When To Do More," above), start by simply listening to your child. “When my children are upset my immediate instinct is, ‘how can I fix this?’” says Natalie Geary, MD, an integrative pediatrician and mother of three in New York City. “But you need to step back, listen, and empathize without trying to problem solve right away. If you allow the child to express his or her discomfort, and if you step back and try to gain some perspective, you may start to discern the triggers for his or her anxiety.” Trying to solve the problem immediately can backfire, she says.
Create a consistent time, such as snack break after school, to allow your child to download her day. You'll learn more about what causes her stress — and she'll gain confidence in your care and her own ability to face fears.
For many school-age kids, performance anxiety becomes an overriding constant, and, unfortunately, parents often play a role by “projecting a lot of their own ambitions onto their kids,” says Geary. Carl Honoré, author of Under Pressure (HarperOne, 2008), cites parents' good intentions, but blames modern forces — including a perfectionist culture, an unsure and hypercompetitive workplace, and older first-time parents who bring a workplace ethos to child rearing — that conspire to put pressure on kids. “What we're squeezing out is the simple, soaring human pleasure and joy of being a child,” says Honoré. “And the worst part of it is, we're trying to do the right thing.” Take a look at how you might need to lighten up on expectations for your child.
“Children are expected to visit a pediatrician for preventive health, and we should adopt the same principle for mental health,” says Narasimhan. “If anxiety is impacting a child's functioning, such as causing him to want to avoid school or public places; if he is having extreme difficulty separating from caretakers; or if he is complaining of frequent pains which the pediatrician doesn't believe there is a medical explanation for, a child should be taken to a therapist or psychiatrist” to screen for anxiety. When appropriate, Narasimhan recommends cognitive behavioral therapy, during which a therapist teaches the child specific strategies to combat fears and address certain feelings and behaviors. “This may include deep-breathing exercises, progressive muscle relaxation, and alternative coping thoughts,” she says. A 2008 meta-analysis of clinical trials concluded that cognitive behavioral therapy can play a key role in alleviating childhood anxiety.
Speed breeds stress. “Don't be in such a rush,” advises Geary. “Whatever you can take out of the day, take out.” Honoré agrees: “If your child is falling asleep in the backseat en route to an extracurricular, or if you're pulling her out of ballet early to get to volleyball, it's probably too much.” Sit down and work out a looser schedule, whether that's limiting kids to one instrument and one sport or instituting a weekly “rest” day where playtime replaces all homework and chores. Says Geary: “What I see a lot is kids coming in with stomach pains or school issues, or they're hitting, and nine times out of ten I feel like saying to the parents, ‘Just take your kids to the playground, sit in the park with them, and get really dirty digging in the mud.’ And if they did that for a month, they'd be fine.”
Pay attention to food
“If blood sugar drops, it's a very anxiety- and irritability-producing sensation,” says Geary. “Try to feed children food that provides slow-release nutrition, meaning they're not getting a jolt of hard-to-digest fat, protein, or sugar.” Her snack choices include low-fat cheese and hummus, or whole-grain bread and nut butter.
Children often reflect their parents' moods, so create calm. “I think things like massage, maybe with calendula oil or something that smells nice for the child, is wonderful; it's the interaction of the touch and the stillness,” says Geary. At bedtime, have a cup of herbal tea with your child. “It's more the ritual of a warm drink at the end of the day than actually what they're drinking,” she says. “They will absorb the fact that you're spending time with them.”
Gentle remedies for anxiety
Bach Rescue Remedy Kids
Give 2 drops of this alcohol-free formula directly on the tongue during high stress, or put 2 drops into a water bottle to be sipped throughout the day
5-HTP and L-theanine
Check with your health care provider to see if these naturally calming amino acids may be an appropriate therapy for your child.
Source: Doni Wilson, ND.
When to do more
Consider a professional consultation if you or your pediatrician think your child's behavior (for his age) warrants special attention.
Obsessive-compulsive disorder (OCD)
Repetitive obsessive thoughts, such as being contaminated with dirt; compulsions, such as repetitive hand washing
Panic attacks, very rapid heartbeat, feeling dizzy or nauseated, a sense of impending doom
Intense fear of something (for example, heights, dogs, clowns); extreme avoidance of situations where it might be encountered
Post-traumatic stress disorder (PTSD)
Flashbacks of a traumatic event; extreme irritability; avoiding reminders of the trauma
Consistently, chronically inconsolable upon separation from a loved one
Source: Anandhi Narasimhan, MD.