Beyond the butterflies: Recognizing anxiety in children

Originally printed in the pages of Simply Family Magazine’s August 2017 issue. Never miss an issue, check out SFM’s digital editions, here!  article by Erica Shea We were driving to my daughter’s first piano recital when she asked me if I ever got nervous before a performance. I could hear a little shake in her voice and saw in the rearview mirror a wide-eyed, sweaty-palmed little girl yearning for reassurance that yes, it happens to everyone. I could say “It was a piece of cake! You’ll be fine!” and try to dismiss her nerves, or I could tell her about the time my sweaty hands propped a page of music upside down – not realizing it until I was too far in to stop. I opted for the story, maybe added a little extra drama, and got her to crack a smile before we talked about her nerves. It hurt my heart to hear the shake in her voice. Before her performance, she clung to me like an infant, and as I pried her off, finger by finger, I started to wonder if her anxiety was a little more serious than I initially thought. Did she get it from me? Is this a problem? Most of us have felt anxiety – that sense of worry or unease when an event is approaching, or we're uncertain about an outcome. Knowing when to intervene for our kids isn't easy, especially if we are anxious ourselves.

Anxiety In Our Children: Knowing When To Intervene

Dr. Larry Amstutz, a Child and Adolescent Psychiatrist with Billings Clinic believes “A little anxiety helps with performance.” Experts agree there’s a spectrum, or blending, from what’s normal to what might be a disorder. Anxiety becomes a more significant concern when children are unable to do tasks they used to do. If it’s interfering with everyday life and limiting activities, it’s time to seek help. Dr. Laura Nicholson, a Developmental and Behavioral Pediatrician with the Children’s Clinic, works with many young children who experience extreme anxiety. “It’s very appropriate to be anxious about some things – like school or going to the store,” she says. But missing school, struggling socially, or avoiding new situations can indicate a bigger problem. Primary care physicians provide screenings and initial treatment, including referrals to therapists. Dr. Nicholson cites three possible interventions for overly anxious children: sensory treatment, cognitive behavioral therapy, and medication.

Possible Interventions for Overly Anxious Children

With sensory treatment, parents and other caregivers observe what kinesthetic experience the child likes, such as crafting or physically moving. Once we notice what’s calming, we can offer this when the child becomes anxious. Cognitive behavioral therapy involves work with a CBT therapist. In short, parents and children learn self-talk and redirection techniques to utilize during anxious moments. Repetitive phrases like “I’ve done this before” are one tool. Working with a trained CBT therapist provides support on multiple levels – beyond what the most well-meaning parents are equipped to do. Prescription medication can help bring relief to a child dealing with severe, often inherited, anxiety. Combined with CBT, medications can be highly effective in allowing a child or teen to clear some new pathways in the brain for redirecting anxious thoughts. In fact, Dr. Amstutz notes that a National Institute of Mental Health study showed an over 80% recovery over 12 weeks for adolescents using both medication and CBT. Treatment looks different for everybody, and Joe Walsh, an LCPC who has also been a school counselor for 11 years, stresses how important it is to observe children before rushing to a diagnosis. He notes that teachers, coaches, and school counselors all play a significant role in helping parents find resources they need to support their children.

Filling Their Toolboxes: Coping Techniques

The professionals all agree that helping children know what to expect is a great way to reduce anxiety. Kids like to know what’s going to happen, so talking through a day’s plan, visiting a new teacher, or practicing the walk to school can set young minds at ease. Teens transitioning to high school, a new sports team, or first job can also benefit from talking about what to expect or a little practice in a non-stress environment. Remember that a little bit of anxiety is good. “There’s a reason it’s there. It gets us thinking,” says Dr. Nicholson. Ask children questions about why they might be nervous, what they think could help them calm down, or how they’d like your help. Don’t overlook the power of storytelling – remind children of a time they’ve managed their anxiety. Sometimes transporting their brains to a different time and place can help reduce the present worry. Dr. Amstutz recommends, “Converting anxiety into anticipation.” Imagine the fun that could come out of a worrisome situation and shift the energy toward a positive outcome. But be mindful of when it's time to back off. Allowing children and teens to work through complicated feelings and situations in a safe environment is important. It's practice dealing with change and the unexpected. As long as your children are not in harm’s way, validate their feelings and give them an opportunity to work it out. There’s a difference between rescuing our children from their emotions and supporting them during the experience. Joe Walsh uses the quote “Prepare the child for the path, not the path for the child,” when he talks about caregiver support. “The more we talk with our kids the better. It’s when we rescue or do it for them that it becomes a problem,” Joe says. He uses the example of seeing class lists in August. Instead of asking for a classroom change when your child’s friend group is split up, plan some ways to make new friends or feel more comfortable. Helping your children with the situation is far more formidable than removing it from their path. And of course, control your own anxiety. Dr. Nicholson notes, “When parents are calm, kids do their best.” Children are always the first to pick up anxious energy, so meet your sensory needs and talk to your children about how you are feeling. Model the strategies you hope they’ll employ. Our kids need to see that we also feel anxious and need help sometimes. There’s nothing wrong with sharing our sweaty-hand piano recital stories or with recalling our own first day of high school jitters. It reassures our kids we’re in it with them. about the author...Erica Shea is the mother of two young children and a part-time teacher at MSU Billings. She grew up in Colorado, loves sunny days, and enjoys cooking for her family.