Children can show symptoms of anxiety from an early age. Know how to detect them

Over-attachment to parents could be one of the signs a child has an anxiety disorder, experts say

Your daughter doesn’t want to play with the other kids at the park, doesn’t want to go to a friend’s birthday party, or go swimming with the gang. How do you know if she’s just having a bad day or if it’s a sign of anxiety?

Anxiety disorders are characterized by persistent and excessive worry. While a person with generalized anxiety worries about a variety of day-to-day issues, a person with social anxiety typically has “intense or persistent fears or fears of being judged negatively by others,” a explained Rachel Busman, a clinical psychologist and cognitive and behavioral consultant specializing in anxiety in White Plains, New York. “They fear saying or doing something that makes them look stupid or incompetent.”

According to a 2021 study, a fifth of children worldwide have “clinically elevated” anxiety symptoms or worse than what is considered normal. In the United States, according to the Centers for Disease Control and Prevention USA, 9.4% of children aged 3 to 17 (about 5.8 million) were diagnosed with anxiety between 2016 and 2019.

Anxiety symptoms can be hard to spot, but the sooner parents notice the signs, the sooner mental health professionals “can help parents and children understand what’s going on,” Dr. Rebecca warned. Baum, professor of general pediatrics and adolescent medicine at the University of North Carolina at Chapel Hill.

Anxious children may begin to avoid anxiety-provoking situations. This behavior could facilitate a cycle that makes their fears bigger and bigger, Baum added. However, “the sooner we realize the problem, the sooner we can put kids on a path that encourages them to be resilient and helps them face the things they’re afraid of,” Busman said.

Read on to learn more about early physical, behavioral and emotional signs of general or social anxiety and how you can help your children.

Generalized anxiety

According to the UK’s National Health Service, Michigan State University, Baum and Busman, the most common signs of generalized anxiety in children include:

• Difficulty concentrating;
• Trouble sleeping, nightmares or bedwetting;
• Change in eating habits;
• Attachment;
• Lack of confidence to try new things or inability to deal with simple day-to-day problems;
• Avoid everyday activities, such as seeing friends, going out or going to school;
• Inability to speak in certain social situations;
• Need to be reassured (repetition of questions to validate fears and worries, such as the exact time when the parents will pick them up from school or if it will be pleasant to go play outside);
• Physical symptoms such as frequent trips to the toilet, watery eyes, headache, dizziness, sweating, abdominal pain, nausea, cramps, vomiting, restlessness or body aches (especially if they occur before a school or social obligation).

Tantrums, irritability or disobedience can be mistaken for bad manners, but anxiety could be the cause of these attitudes, Busman said. Refusing to do homework may be due to fear of making a mistake.

Kids “don’t necessarily have the tools to say, ‘This is causing me distress or discomfort,'” Busman explained. “So they just act on what they feel.”

social anxiety

Many symptoms of social anxiety resemble those of generalized anxiety but arise in social settings, Busman said.

According to the Children’s National Hospital in Washington, DC, the National Social Anxiety Center and the Mayo Clinic, children who suffer from social anxiety may show these signs:

• Avoiding or refusing to go to school;
• Refuse to speak in social settings or speak quietly;
• Poor social skills, such as being afraid of strangers or not making eye contact;
• Being afraid or having difficulty using public toilets, talking on the phone, making public presentations, eating in front of others, being called to class or being separated from parents;
• Physical symptoms include rapid heartbeat, tremors, difficulty breathing, muscle tenseness and dizziness.

Having conversations that help

Understanding what causes anxiety in your children is important, but it must be done with care and empathy. Forcing responses or yelling can make them defensive and prevent them from talking to you.

Curious and innocuous questions are okay, recommends Busman. Something like, “I noticed that you seemed hesitant to participate in this activity. Is something wrong?” might work better than “were you afraid to come in or don’t you like these people?” Ask your children how an event went, what they liked and what went wrong, and why.

According to Anxiety Canada, young children may not be able to identify more specific fears, so some express these concerns in a way that makes sense to them, such as: “I didn’t want them to see my drawing . or “My voice is weird,” says Busman.

If your children are honest about what makes them anxious, avoid invalidating the experience by saying “it’s nothing to be afraid of” or “don’t be a little kid.” Also, avoid validating your fears, saying things like, “That sounds so scary. I’m so sorry you had to do this” can make a child even more fragile, Busman warned.

A better way to do this would be, “It seems difficult,” followed by words that acknowledge your child’s ability to deal with these difficulties and that you know you’ll be able to get through this together, psychologist Busman added.

If your child is anxious about starting football and can’t kick the ball, use an affirmation like the one above and reassure them that they will get better with practice, but don’t overdo it. ‘he will be the top scorer, because that may not happen.

“Sometimes we worry that our kids will have moments that aren’t perfect,” Busman said, but teaching that imperfection is normal is key. Your child won’t always hit the ball and being liked by everyone is unrealistic.

“The need to understand stress is an important part of childhood,” Baum said. Parents and caregivers can shape this by “talking about situations where they were anxious about something, but they tried to deal with it, even though it didn’t turn out the way they planned.”

If you’re concerned that talking to your child’s teachers might cause stigma or a problem that wasn’t there before, it’s worth consulting with them, as they observe your child daily for many hours in different environments. So “these are usually very good sources of information,” Busman said. “Sometimes children are not at school what they are at home and vice versa”.
A teacher can let you know how your children interact with their peers, whether they are still sad or anxious after you drop them off at school. When these types of concerns persist and “interfere with a child’s ability to do normal activities,” Busman said, “it’s a good time to get more support.”

The best treatment for anxiety disorders is cognitive behavioral therapy, which involves some level of exposure therapy, which can help children feel comfortable doing the things they’re afraid of, Busman said.

Your child’s primary care provider can help “distinguish between what’s typical for the child’s age/development and what might be concerning,” Baum said. “Even if the symptoms are characteristic of the child’s age, families appreciate any form of help with these issues.”

Baum added, “It’s important to reach a child’s comfort zone because that’s where growth happens.”

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