Experts advise on anxiety in children
As the pandemic exacerbates mental health issues, many young people are struggling with anxiety amid the mounting stress, uncertainty and fear.
The following advice from local mental health professionals should guide parents, caretakers and others as they try to help children or teenagers cope with anxiety.
What is anxiety and how common is it among children?
Anxiety is a normal feeling, much like happiness or sadness, said Dr. Kelly Banneyer, a child psychologist at Texas Children’s Hospital.
It’s an important one, too, because it keeps people from doing dangerous activities, such as walking in front of traffic, she said. A small dose of anxiety about an upcoming test or performance ensures that kids actually study or practice their instrument, for example.
“It’s an emotion that we’re all supposed to feel,” Banneyer said. “It’s one that keeps us safe.”
But feeling anxious is a step beyond feeling worried or nervous, said Charity Eames, director of clinical services at De
Pelchin Children’s Center.
“Anxiety is when you have worry but it starts to affect you physically,” she said. “It also affects your emotional ability to face whatever it is.”
It can become problematic when it comes up too often or keeps kids from going about their daily life.
One in 5 children may experience an anxiety disorder, Banneyer said, making it a common mental health condition.
The troubling trend has only increased since the pandemic, which exacerbated stress and worry on children and contributed to poor mental health outcomes.
Victoria Williams, a licensed professional counselor with Thriveworks in Houston, said she has seen an uptick in children seeking therapy for anxiety since the pandemic.
“A lot of the children that were in school when COVID hit had to come home,” she said. “Then they went back to school. Then they had to figure out how to be in school with this new normal.”
What causes anxiety in children, and what age does it show up?
Symptoms of anxiety can emerge in children as young as 2 or 3 years old, Banneyer said. More commonly, though, it appears during times of transition, such as starting kindergarten, making the jump to middle or high school, or leaving for college.
Many kids experience school-based anxiety. They may be worried about talking to a new teacher, interacting with other students or giving a presentation in front of their peers, Banneyer said.
In addition, bullying, undiagnosed learning disabilities or pressure to do well can create anxiety among kids at school, Williams said.
“I’ve had kids as young as 8 or 9 who are punishing themselves because they’re not making that high grade,” she said.
Some kids are bullied on social media, too, Williams said, adding that kids face an onslaught of information from social media that can lead to harmful comparisons.
“You barely knew what was going on in the city next to you, let alone clear across the world,” Williams, 49, said about her own generation. “Kids now have the ability to interact with people from all kinds of different situations, and so there’s more pressure on them.”
Meanwhile, other kids struggle with anxiety when they become separated from loved ones, an issue that has become more pronounced because many families spent so much time at home during the pandemic, Banneyer said.
Anxiety symptoms in children: What signs to look for
Some kids might be able to vocalize their fear and worry surrounding a certain event or situation, Banneyer said, while others may avoid going somewhere or doing something that gives them anxiety. Some kids become withdrawn.
It can also manifest in physical symptoms, including stomachaches, headaches or changes in sleeping or eating habits, she said.
Other symptoms include irritability, frustration, acting out or having difficulty controlling emotions, especially among younger children.
“It might be that children are having tantrums every morning before school because they’re feeling nervous about going to school,” Banneyer said.
Parents should also look out for restlessness, fidgeting, nail biting, chewing on pencils or nervously eating as possible symptoms from anxiety. Some kids may become verbally aggressive by snapping and yelling at people or using profane language, Williams said.
How to help children with anxiety: What should I do?
In the moment when a child expresses anxiety, parents should acknowledge the feeling and encourage them to move forward, Banneyer said.
Anxiety makes people want to avoid certain situations or events, Banneyer said, but it’s actually important to do the exact opposite.
Don’t be overly reassuring or allow your kid to avoid something because of their anxiety, the psychologist said.
“They might feel better right away, but the very next time that situation comes up, they’re going to feel nervous or anxious again,” she said.
Instead, parents should first acknowledge the anxiety by saying: “I know this is hard. I know you’re feeling upset or you’re nervous right now.”
Then, Banneyer said, add something like: “I know you can do this. I know you’re really brave. I know you’ve gone to school before, and you can do it again today. I’m proud of you.”
Helping children with anxiety: When to seek professional help
Occasional anxiety is normal, but it may be a bigger issue if the problem lasts for several months or interferes with a child’s daily life, Banneyer said.
An anxiety disorder may prompt a child to avoid certain tasks or keep them from going to school, sleeping and eating, among other daily habits.
Parents should seek help when a child becomes dysfunctional, Williams said. Signs may include dropping grades, withdrawal, aggression toward other kids, unusual eating habits or disrupted sleeping.
Childhood anxiety treatment: Where do I begin?
Banneyer recommends first that families touch base with their pediatrician or primary care provider about their concerns.
Pediatricians can evaluate the child’s symptoms and may refer families to a follow-up consultation with a recommended mental health professional.
Alternatively, parents can reach out to their insurance provider or employee assistance program to find a therapist, counselor or psychologist in their area whose practice is covered by insurance.
Williams said school counselors can be a good resource for kids and families, too, and that people without insurance can seek help from nonprofit organizations or a local mental health authority run by the state.
Some local organizations providing mental health services for kids include DePelchin Children’s Center, the Lucine Center and Bo’s Places.