The Anxious Child

1 The Anxious ChildA booklet for parents and carers wanting to know more about anxiety in children and young peopleThe Mental HealthFoundation is grateful to the Calouste GulbenkianFoundation for providing a grant towards the research andoriginal publishing costs of by:The Mental Health Foundation7th Floor, 83 Victoria StreetLondon SW1H 0 HWReg Charity No: 801130 Copyright 1997 The Mental Health FoundationCartoons drawn by Simon Whiteman The Mental Health FoundationWhat do we mean by anxiety inchildren, and should parents beconcerned about it? Many parents are unsure about whentheir Child s behaviour is something for them to worry about, or whether itis fairly typical behaviour for childrenof that age. Many parents are not surewhether to be concerned when ausually talkative 8 year old becomeswithdrawn and pre-occupied, when an11 year old feels sick every schoolmorning or when an adolescentsuddenly begins to refuse to leave their can often appear like a minefield forparents, trying to find out whether theirchild s behaviour is expressing realworry or unhappiness, and if so, tounderstand what is behind many years it was believed thatchildren did not experience depressionor anxiety , and that those whoappeared to were merely malingeringor attention seeking.

2 This is no longerthe case. It is now widely accepted thatas many as 8 - 11% of children andadolescents suffer from an anxiety thataffects their ability to get on with theirlives. So what are anxiety disorders amongst children, what are theycaused by and how can parents help children who are affected?Section 1 Children and their emotionsAll children, of whatever age, experience powerful world of young children can be a frightening and uncertainplace, as can that of adolescents, who are facing a time of rapidphysical and emotional parents can remember times in their own childhoodwhen they were very frightened, Anxious , miserable or feelings are part of growing up, and confronting the manychanges being presented to us throughout are sensitive to what happens around them, andyoung children in particular can feel that it is their fault whenthings go wrong at home(such as parents becomingill).

3 This makes them feelworried and guilty. Part this leaflet, examinesthe range of issues thatcan lead to children andyoung people all children s emotionsare logical. Small childrenordinarily have fears aboutthe dark, insects, ghosts,kidnappers and getting lostor abandoned. Such fears1are common and normal in all young children. Usually childrengrow out of their fears but sometimes they persist as the childgrows up - there are plenty of adults who are Anxious aboutspiders or dogs. Only when such fears stop your Child doingordinary activities is there real cause for in young childrenChildren can develop fears and phobias at any age, but they areespecially common during early childhood, and again duringpuberty. Infants can appear to be upset, to be irritable andsleepless, but in very small children, such behaviour is morelikely to be caused by hunger, cold, and physical diseases situation is not so clear cut as children get a little , it may appear to many parents of toddlers that theirchildren are overly Anxious or clinging.

4 All toddlers expressdistress at being separated from their carers, along withoccasional sleeplessness. Parents can help their children byoffering them reassurance that everything is alright. It might feel as if your Child clings excessively. Some childrenare naturally more timid and Anxious than others, and for themthe stress of new experiences is greater than for other in time this behaviour will usually other children, however, excessive clinging is a sign thatthey are extremely Anxious . It is important when deciding whatis excessive clinging in your Child to take into account theirnature, as well as what is happening within the Child simmediate environment. However, if your Child clings so muchthat they are unable to play with other children, if they areunable to sleep alone, or be in a different room from you, thismight indicate that they are overly may worry that other behaviours in young childrenindicate that they are insecure or worried.

5 However, oftenthese are exactly the opposite. For example, many youngchildren constantly carry comforting pieces of blanket orfavourite toys. They do not indicate insecurity and there isnothing to be gained by removing a young Child s comfortobject, in fact there are grounds for thinking that children whohave comfort objects are better able to cope than those who do not develop the are a number of things that parents can do to helpchildren get through this stage of to make sure that small children get a wide range ofexperiences, particularly meeting people outside the homeand playing with other and ensure that your Child is able to make their owndecisions over small things - this will help them grow children to learn how to fall asleep on their own whenthey have a nap in the afternoon as well as at night.

6 Maketheir bedroom a nice place to be, with a night-light. Keeping3to a regular bedtime is often beneficial, as is a set routine ofgetting children into bed. Explain what you want them to do(lie quietly in bed waiting to fall asleep; they can t fall asleepby will-power), return to their bedroom at regular intervals tocomfort them if necessary but leave the room before they fallto sleep and praise them for lying in bed to make sure they spend at least a day away from homeand parents before starting school. By experiencing such aseparation they will be less apprehensive about having tospend time away from and ensure that you are not always worried and up children can be stressful, but, if your Child feelsthat you are always worried, they are more likely to beanxious themselves.

7 Remember to take time out for yourself- to you feel that your Child is over- Anxious , section 3 of thisleaflet, sets out where you might go for age childrenLike young children, some school age children can becomeover- Anxious . This can be a real concern for parents andprofessionals working with them. Signs of anxiety in children of this age include children who:lare extremely shy, timid and clinginglhave real difficulties mixing with other childrenlhave difficulty getting off to and staying asleeplhave repeated nightmares (more than one a week)lhave repeated complaints of headache or tummyache 4lare constantly asking if things are all right or other ways ofasking for reassuranceSome children will have panic attacks in which they feel that itis difficult to breathe and that they are going to children can be irritable and demanding.

8 They can alsobe a source of extreme worry for parents. In addition to this, itoften takes a great deal of patience for parents to see thatbehind the difficult behaviour there is anxiety and parents will respond angrily to their children s behaviour,when what the children want is for their parents to be calm, toknow exactly how they are feeling and why. If parents seemnot to understand, children can feel that the parents areignoring their feelings on purpose, which can in turn exacerbatetheir difficult behaviour. It is important for parents to try and talkcalmly to children about the things that are worrying them, andto reassure them whenever possible. TeenagersThe teenage years can be a fraught time for adolescents andparents alike.

9 It is a time of rapid physical development andemotional change and this can be very uncomfortable. Signs ofanxiety amongst adolescents might be revealed through over-eating or under-eating, excessive sleepiness, and over-concernwith appearance. Some adolescents will experience phobiasand panic attacks may occur. For the majority of young peoplethe feelings of uncertainty, turmoil and unhappiness that are allpart of adolescence, do not mean that they will go on todevelop more serious problems. However, for a minority ofadolescents, specialist help may be can play an important role in helping their children throughthis difficult time. Strategies that parents can develop include:5lsetting clear ground rules for the young person - these shouldbe reasonable and become less restrictive as older childrenbecome more prepared to really listen to your Child - adolescents aremuch more likely to confide in you and trust you if they feelthat you will respond to their worries and not automaticallycriticise support for yourself - many parents feel rejected by theiradolescent offspring and are uncertain how to support to other parents and to your partner can make youfeel less the young person s anxiety is such that it is causingthem prolonged distresss or it is interfering with their lives.

10 Stopping them going out with friends, having relationships orhobbies, for example, then you might want to consider askingfor professional help. For further information on where to go forhelp, see Section 2 Why do children become Anxious ?Reasons for being generally anxiousThere are a range of reasons why children and young peoplebecome Anxious . In most cases, when children are extremelyanxious there is a very real cause to this; perhaps they arehaving difficulties at school, (for example) being bullied. Anxietycan also have no apparent cause, but be very real in its ownright, and cannot be overcome by will-power. However, 6attempts to get children to master their anxiety by telling them not to be so silly will are a number of reasons why children and young peoplemight become Anxious .