your anxious child
how parents and teachers can help
Some children and adolescents suffer from anxiety. This needs to be differentiated from the normal worries and fears that most children experience as a function of normal development, and from phobias, which are debilitating and extreme fears. Indeed, some anxiety is both normal and helpful; anxiety can be a reaction to a signal that one needs to
- be ready for action,
- pay attention,
- be careful, or
- recognize that there’s a problem to be solved.
This is okay when it’s for short periods, but can be detrimental when it’s ongoing.
Anxiety is normal and expected when a child is going to a new school, moving to a new home, when there is a change is family structure (e.g., new baby, new marriage, etc.), when upsetting things happen (e.g., loss of a friend, when parents are fighting, etc.). It’s also normal to worry about different things at different ages (for example, for preschoolers to worry about being separated from their parents, for older children to worry about whether they will be accepted by friends, selected for a team, their competence, taking tests, etc., and for teens to worry about friends, their future, their health, etc.).
Anxiety becomes a problem, however, if it occurs too much of the time, if it occurs in response to situations that don’t require an anxious response, or if it interferes with daily life.
While anxiety symptoms are quite common, diagnosed anxiety disorders are relatively uncommon (between about 1 and 9 per cent, depending on the disorder). However, it’s important that anxiety disorders be recognized, properly diagnosed, and treated, because left untreated they can lead to academic failure, impaired social relationships, low self-esteem, alcohol or drug abuse, and problems adjusting to work situations.
Symptoms of anxiety, however, are often misunderstood as something else: they are often seen as anger, opposition, defiance, unco-operativeness, and aggression, in addition to the somewhat more expected signs of withdrawal, seclusion, nervousness, etc. Some physical signs to look for include
- racing heart,
- fast breathing,
- stomach aches (“butterflies”),
- muscle tension, and
- feeling constantly tired or “on edge”.
Psychological or behavioural signs include
- worried thoughts,
- being unable to concentrate,
- being irritable,
- thinking the worst,
- and feeling afraid.
Since these symptoms overlap with those of other conditions, a careful and thorough assessment leading to a differential diagnosis needs to be done.
Some of the anxiety disorders of children and adolescents are separation anxiety, selective mutism, school refusal, panic attacks and panic disorder, specific phobia, social phobia, obsessive-compulsive disorder, generalized anxiety disorder, and posttraumatic stress disorder.
Intervention by a qualified mental health practitioner is essential in the effective treatment of anxiety disorders. Pharmaceutical intervention is sometimes indicated. A psychological approach to treatment involves the development of a management program that:
- develops control and confidence (to enable students to increase their ability to control their feelings of anxiety);
- self-assessment (to increase their ability to recognize their signs of anxiety and respond appropriately);
- self-instruction (to enable students to talk themselves through those times when they feel anxious or panic); and
- problem-solving (to explore situations that make them anxious and to help them choose the most appropriate control skills).
Parents and teachers can be very helpful by understanding and supporting their young people, and by seeking out appropriate assessment and intervention. School psychologists can assist with this. It is important, too, as indicated earlier, not to mistake symptoms of anxiety as “bad behaviour”.
Understanding the reason for the student’s anxiety is key to addressing it effectively. If your child is diagnosed with an anxiety disorder, learn all you can about the disorder, through the library, Internet, talking to other parents, etc. Work closely with the treatment provider so that everyone in the family and at school can respond in ways that help the child. Take steps to make the child’s school experience as positive as possible. Determine what accommodations or changes in the school routine are necessary to support the child and increase the chances of academic and social success.
Contributed by Dr. Ian Brown, Durham Catholic District School Board