Helping Anxious Children

Reprinted from "Anxiety Disorders in Children and Youth" Visions Journal, 2002, No. 14, p. 17

In most cases, the tendency to be anxious stays with a person throughout their life. So we need to help anxious children develop coping skills to manage their own anxiety eventually. This starts with parents helping them by going through the following steps. Older children and teens can do some of this for themselves:

  • Assessment: Have a child's general health checked by the doctor. Untreated allergies, anemia, ear infections or other problems make it harder for anxious children to cope. The doctor can also check out whether panic attacks or obsessive-compulsive disorder, which need very specific treatment, are present. For some kinds of anxiety, medicine may be suggested, but in most cases, treatment includes learning new coping skills.

  • Look after the basics: No one copes well when they are tired or hungry. Anxious children often forget to eat, don't feel hungry and don't get enough sleep. Establish bedtime routine (see below) and offer frequent, nutritious snacks. Anxious children rarely eat a large full meal. They are better to "graze" as long as the snacks cover the basic food groups in a day.

  • Establish routines: Routines reduce anxiety. But anxiety tends to disrupt routines. So you need to work hard to build regular patterns so life is more predictable. Have the child help plan the routine. Making an attractive schedule for the fridge gives a sense of control and order. This is not the kind of child who copes well with a disorganized, "spontaneous" family style. Help the child adjust to changes by gradually introducing them and preparing them in advance.

  • Bedtime routines are especially important: Start at least an hour before the planned bedtime, build in a story, a chat time, some warm milk or snack. A warm bath ahead of time may help. The ritual helps the child gradually relax. It is important that parents not get into the habit of sleeping with the child or having them fall asleep in the parents' bed as this becomes a habit which is hard to break. Settle them with some quiet music or a story tape, and check in briefly at planned intervals (5 min. for young child, 10-15 min. with older) so they don't need to worry about where people are. A good routine can take several weeks to establish, but everyone will feel better once it is in place.

  • Plan time for homework and projects: This needs to be a regular part of the schedule, as anxious children tend to procrastinate. Because anxious children become overwhelmed, breaking the job up into small chunks, setting a specific time to work, and rewarding themselves for each bit done are tools they need to learn. Often the hardest part is getting started, so knowing that the TV program is on afterwards, or having computer time to look forward to can help to start.

  • Firm, consistent parenting: Anxious children feel calmer when life is predictable, when they know what is expected of them, and what the consequences will be. Setting limits is a challenge for parents, however, when the child becomes so upset. With practice, everyone can feel more secure, and children are relieved to have adults in charge.

  • Tools to relax: Teach the child a way of relaxing by mental imagery and progressive muscular relaxation, described in the booklet Taming the Worry Dragons.

  • Tools to cope with worrying: "Locking up" worries in an imaginary box or setting a scheduled "worry" time are some tools to control the amount of energy worry takes up. Other ideas are to mentally "pull the plug" on the worry, "take out the worry disk so it's not using up all the RAM," "caging the worry dragon," or whatever image suits a child's interests. Fortunately, most anxious children have a talent for "creative worrying" which can be harnessed for creative problem-solving instead.

  • Taking risks: Anxious children need to try some experiments like making phone calls, talking to a new friend, and encouraging themselves through positive "self-talk" instead of imagining the worst. Parents can model these tools by using them too.

  • Physical exercise: This is helpful not only in relieving stress, but also in triggering a physical "relaxation response." Anxious children often feel "tired all the time" because they are always exhausting themselves with worry, so they don't feel like exercising. But exercise will improve energy and reduce worry. Try to find something fun to do together rather than making this a chore.

For more information

See the booklet Taming the Worry Dragons for more ideas. It can be purchased through the BC Children's Hospital's online bookstore at bookstore.cw.bc.ca or by calling (604) 875-2345 Local 7644. Contact your local mental health centre for counselling and parent support.

Adapted from "Anxiety Disorder in Young People" prepared by BC Children's Hospital's Mood and Anxiety Clinic and the Anxiety Disorders Association of BC. The full pamphlet series can be found at www.anxietybc.com

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