By Simran Chatha, Psychologist & Outreach Associate, Mpower – The Centre, Bengaluru
It is important to be aware that mild fear and anxiety are a part of normal development for children. Bauer (1976) stated that children’s fears begin with a content that is more global, imaginary, uncontrollable, and powerful, and over time becomes more specific, differentiated, and realistic. It was also observed that as children grow older, the number of fears they experience generally reduces.
Experiencing anxiety is not only normal but also adaptive for children, so it is only considered a disorder when it interferes with the child’s functioning and when the child’s experience of anxiety is much more than expected in any given situation.
Anxiety is multidimensional and it is experienced as physiological symptoms, behaviours, thoughts and emotion. The most prominent behavioural response to anxiety is avoidance, depending on what the child is anxious about.
Here are some signs that can help parents detect anxiety among their children:
- Physiological symptoms include increase in autonomic nervous system activity, diffuse stomach pain, perspiration, gastrointestinal distress and trembling. A lot of children go through a thorough physical examination for stomach pains with their Pediatrician only to find that there is no biological cause explaining the pain.
- Behavioural symptoms include avoidance, crying, nail biting, bed-wetting and thumb sucking. If the child is scared of performing badly on a test, he/she might try to skip the test altogether. Avoidance is mostly viewed negatively by parents/teachers and the child is punished without giving him/her much space to express their fears.
- Cognitive symptoms include constant rumination about a past event or excessive worry about the future. Some children would expect the worst in any situation, whereas many others would constantly worry about specific fears. Regardless of whether it is generalized or more specific, it is important to pay attention if these worries are persistent, excessive and difficult for the child to control.
- Affective symptoms (emotions) include difficulty understanding how to regulate their emotions and using less adaptive ways of coping like reacting with anger and sadness. Parents of anxious children mostly perceive them as inflexible and labile. They experience emotions more intensely and feel like they are less successful at managing their emotions compared to children who are not anxious.
Once these signs are detected, it is very important to meet a mental health professional (mostly a clinical psychologist/psychiatrist) to complete a comprehensive assessment of anxiety. The overall goal is to teach children to recognize signs of anxiety and to use these signs as cues/opportunities for applying strategies to manage anxiety. This includes understanding the nature of anxiety and differentiating it from other feelings, understanding thoughts that contribute to feeling anxious, learning relaxation techniques, learn problem-solving skills to help cope with these thoughts/sensations and test out these skills gradually in situations.
Parents are also actively involved in treatment so that they can help their child practice these skills outside of sessions. Their role is to serve as an emotion coach for their child and help support them through this process.
To help support your child when they are really anxious, try not to immediately distract them, ask too many questions, tell them to focus on the bright side or ignore them. Although seeking professional help is important, there is no replacement to parental support.