GARDEN ROUTE NEWS - Feelings can be confusing, and managing them is often a challenge, even for adults! It is not unusual for children to experience anxiety, but it can sometimes build up beyond manageable levels. During each developmental stage, young people tend to experience new fears and worries. Being able to recognise when anxiety has become more serious, can help parents learn how to best help their children.

When we are worried, afraid or tense about something, we are feeling anxiety. It becomes a problem when it starts to interfere with day-to-day activities at home, school or play. 

Children who experience persistent and ongoing sadness and fear, could be showing signs of an anxiety disorder.

The difference between stress and anxiety is that stress has a short-term trigger resulting from either positive or negative changes. 

Like anxiety, too much stress leads to behavioural changes such as moodiness or irritability. Persistent excessive worries that occur without a clear stressor are anxiety. Avoidance of specific situations, places or people is a primary sign of an anxiety disorder, the most common mental health issue in children.

What are childhood anxiety triggers?

Children as young as six months of age may begin feeling anxieties, usually due to separation anxiety when they are away from caregivers. This usually stops between the ages of two and three. Then, fears of all kinds, for example bugs, animals, aliens, monsters, water, strangers, burglars or being alone in the dark, weather (thunder and lightning) are also common anxieties for children. These fears usually subside without intervention as the child transitions to new developmental stages. 

Many experts cite the lack of outdoor, unstructured play time as a catalyst for young people's rising anxiety levels. Play is the work of childhood - it is how children work through fears and deal with hardships in a safe way. With so many adult-led activities dominating children' schedules, we are creating a generation of stressed-out children.

Play is the work of childhood - it is how children work through fears and deal with hardships in a safe way.

What triggers teen troubles?

For older children, losing or being separated from a loved one; academic issues such as making a mistake, failing a test, making a teacher upset; social issues such as not being liked, not being included, being picked last; being late; watching and/or playing age-restricted movies and games; and being embarrassed or humiliated, create anxiety in older children and teens. 

Anxious children often wonder "what if" and imagine extreme negative outcomes (no matter how unlikely) to situations. The increasing connectedness of young people - through 24/7 access to technology and social media - leaves many children feeling more isolated and anxious than ever before. 

Children are also constantly plugged in and experience Fomo (fear of missing out) if they unplug. The resulting lack of downtime in children's lives gives them very little time to unwind, decompress and just experience boredom - which can be a very relaxing thing!

Genetic and environmental factors

Studies show that anxiety disorders have both genetic and environmental factors. Like eye colour, children can inherit anxiety from their parents. Environmental factors such as conflict at home, violence, abuse, divorce, pressure from parents to perform, lack of secure boundaries and structure in daily living, illness or death of a loved one, and a stressed-out or perfectionist parent, can also bring about anxiety.

Anxious children often wonder "what if" and imagine extreme negative outcomes (no matter how unlikely) to situations. 

The face of anxiety

Anxiety has many different ways in which it presents. For some children, anxiety looks like classic symptoms of worry, fearfulness, panic, phobias and social withdrawal, and presents itself in the following behaviours/physical symptoms: rapid breathing, sweating, nausea, shaking, a pounding heart, headaches, stomach aches, biting of nails, increased clinginess, tantrums, crying more often and having difficulty sleeping.

For others, it looks more like avoidance, irritability, tenseness and uptightness, and even anger. Some young people manifest their anxiety through compulsive behaviours, fearfulness of making mistakes and/or being excessively hard on themselves when they make an error on a test.
When young people feel so overwhelmed by their anxiety that they stop engaging in normal activities, it could be a sign of an anxiety disorder. 

They may constantly worry about the safety of their families, develop an intense fear of making mistakes, voice obsessive thoughts, exhibit compulsive behaviours and require constant reassurance. 

What most people who experience anxiety have in common is an overwhelming sense of unease and emotional discomfort in specific situations, usually triggered by a cascade of negative thoughts.

Most people experience some level of anxiety from time to time. If you notice changes in your child's eating or sleeping patterns or if they start to withdraw from or avoid activities that they once enjoyed, it may be time to seek professional help. When symptoms such as repetitive thoughts, compulsive behaviours, panic attacks or re-living traumatic memories interfere with a child's ability to function in school or daily living, it is time to seek help.

Fight, flight or freeze reflex

Stress and strong emotions like fear, anger or anxiety take the thinking part of the brain "off-line", and give priority to the part of the brain that manages the fight, flight or freeze reflex that keeps us safe. Dr Donald Winnicott said that "anxious children can't play", meaning that anxiety takes away our capacity to be creative.

Treatment includes psychotherapy (talk therapy) aiming at, among others, teaching children about what is happening in their brains and their bodies when they experience anxiety, skills and techniques for when they are faced with a stressful or difficult situation, play therapy and medication. Medication can be short-term or long-term, depending on results and severity.

Without treatment, young people with anxiety disorders have a higher risk of poor school performance and difficulty developing social skills. They are also more vulnerable to drug and alcohol misuse.

Practical ways to help children deal with anxiety

• Help children label/name their emotions. According to Prof Daniel Siegel, when we can name it, we can tame it! When we use our left brain words to describe our right brain emotions, "our frontal lobes secrete soothing chemicals".
• Help children identify triggers - to become aware of and recognise what causes them to feel anxious.
• Children need a lot of help to manage or organise their feelings. Neuroscience shows that humans develop their abilities for emotional self-regulation/organise their feelings through connections with reliable caregivers. Children calm by experiencing our voice tone and warm physical touch and presence. Stress and trauma break down our capacity to regulate internal states. Therefore, in times of crisis, troublesome emotions are managed with the support and soothing presence of loving caregivers in our lives!
  Research shows that our choice to understand and share these feelings our children have is one of the most important aspects in helping children to learn how to regulate their own emotions.
• Children can only learn to manage their emotions within the context of relationships. We call this "being with". "Being with" children (in the moment) and holding their emotions is our willingness to be with them and feel some of what they feel. This gives them an experience of being safe and connected as they learn about emotions. "Being with" means parents help their children and teens manage difficult internal experiences/feelings by sharing them. "Being with" means I am fully there (not checking my phone!!) and intentionally (by choice!) present. "Being with" becomes more difficult when a child is overwhelmed with emotion. The temptation then is very strong to talk them out of these feelings so that we don't feel upset and helpless. ("Oh no, that didn't hurt so much? There isn't even blood! Calm down now!!") "Being with" is not a technique - it is a state of mind or an underlying attitude of empathy for your child. "Being with" is a state of sensitive attunement (in tune with) where we share in our child's emotional experience, helping our child understand and regulate difficult feelings and staying with him while he gets through it. "Being with" means sitting still - not trying to change your child's experience or want them just to feel better, but accepting it and showing that you are here with them.

"Being with" children (in the moment) and holding their emotions is our willingness to be with them and feel some of what they feel. Photos: Pexels

• Children look to their parents to guide them through difficult situations. If parents deal with situations calmly, their children will learn to do the same. Constant reassurance is generally not effective in preventing anxiety. Teaching children to reassure themselves and solve their own problems can help prevent anxiety in new situations.
• Mirroring - to mirror is to verbally reflect back to your child what you hear they say and mean or see in their behaviour. It is communication that acknowledges and validates your child's feelings and show you empathise with them. We often tend to communicate through loads of anxiety-laden words because of life's pressures. To stop, make eye contact and to listen and explore what children are trying to communicate is crucial in connecting with them. A gentle communication approach, where our supportive presence and caring listening create an emotional safe environment in which they feel heard, is crucial. Responding, and not reacting to what the child says, is the key. Reflecting a child's anxiety when they talk about friends excluding them is more valuable than joining in the fight to defend your child. Responding to the child's feelings and giving the emotion a name is an excellent starting point.
• We need to look at behaviour as communication. So the task is not to change the behaviour, the task is to hear and respond to the message - the unfulfilled emotional needs. This means that most of the time, if we're having an ongoing problem with our children, our relationship with them needs to be the solution. Children are not looking for attention - they are looking for connection!
• Being a safe house to our children - a safe house is where our children experience the love, attention, affection and connection they need when they're scared, stressed, hurting or overwhelmed. And not just our physical presence, but our emotional presence. By being present, engaged and safe with our children in the day-to-day moments of life, is so important! The way we relate to our children actually wires their brains for how they believe, act and feel the way they do about relationships. Whether five months, five years or 15 years old, when children are feeling scared, anxious or stressed, and we consistently respond in a safe and secure way, our children come to believe we are available and capable of loving them. 

Tips to teach children to tell their bodies to calm down

• You can take deep, slow breaths. Research shows that breathing and movement are the two best ways to "reset" our anxious brain.
• You can tense up all your muscles, hold them tense for a few seconds and then relax them.
• You can close your eyes and imagine a safe, calm place.
• You can hug a friend or a pet.

All of these actions send a different message to your brain: I am safe now, I can relax.

• Help children understand the physical symptoms - why their heart races, their tummies feel strange or they feel flushed or shaky, as this can help them to manage their reaction.
•  Challenging unhelpful thinking, practising role play, breaking down tasks and creating structure, are more ways to help young people manage their anxiety.
• Give children and teens extra support and care during these difficult times. Be there to listen and talk. Spend positive time together.

This article was contributed by Neelje Theron, a clinical psychologist with a practice in George.

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