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9 Surprising Ways Anxiety Shows Up in Kids

Anxiety in kids is like an iceberg: what you see is often just a fragment of what’s beneath the surface, and that’s especially true for children. While many parents might associate anxiety with intense worry (because that’s part of it), the reality is that anxiety can cause many different behavioral issues and feelings in children.

Below, we’ll take a look at nine surprising ways that anxiety can show up in kids.

1. Trouble Falling Asleep and Staying Asleep

Anxiety and sleep problems are connected in a vicious circle. Anxiety can contribute to sleep problems, and sleep problems can make anxiety worse.  Difficulty falling asleep and/or staying asleep is a classic sign of anxiety in kids. For children with anxiety, an anxious train of thought can keep your little one awake long after bedtime. Some kids even have anxiety about waking up late, missing their alarm or school bus, feeling tired in the morning, or other school-related events.

Tip: Always practice good sleep hygiene and consider using warm-colored lights around bedtime.

2. Anger and Irritability

Anxiety in children happens when there is:

• A perceived threat (e.g., a school project or an upcoming date)
• An underestimation of coping skills (e.g., “I will never pass this math test.”).  

The combination of perceived threats and underestimating coping skills leads to feelings of helplessness, and in many cases, helplessness leads to frustration, which leads to anger.

Interestingly, both anger and anxiety are activated in your amygdala. Your amygdala is the “threat center” of your brain. If your child’s brain perceives a threat (even if it’s overestimated), his or her amygdala activates the flight-or-fight response. This creates a flood of hormones designed to make you stronger and faster. While this helps us flee or fight against threats, it creates issues when the anxiety is chronic. The flight-or-fight response creates rapid heart rate, rapid breathing, and can make you feel on edge.

It’s possible that remaining in this state for a prolonged time can lead to irritability, agitation, and anger. 

3. Defiance

A child with anxiety often feels like his or her life is out of their control. This can lead to your child trying to regain control in any way that he or she can. For example, this could explain a sudden outburst over a red jacket instead of the blue jacket.

4. Chandeliering

Chandeliering is “pushing the hurt down until one day it’s all unleashed at once in a fit of rage (shooting that person up to the chandelier). [Brené Brown]

Sometimes children try to hide anxious feelings, especially if they don’t know how to talk about it. Chandeliering happens when a child has a seemingly out-of-nowhere tantrum or outburst. It may seem out of place, but in reality, the child has been hiding anxious feelings until they all bubbled up over the top.

5. Lack of Focus

Inability to focus is often linked with ADHD, but ADHD isn’t the only mental health condition that can contribute to difficulty focusing. Children with anxiety can also struggle to focus both at home and at school.

6. Avoidance

“I don’t want to go.” Has your child ever said he or she didn’t want to go to school? Or maybe they suddenly don’t want to attend a sporting event? Avoidance can be another sign of anxiety. Avoidance can create bigger problems though. For example, if your child is trying to avoid schoolwork, the continual procrastination can create more trouble when all of the homework builds up. This can lead to even more anxiety about the sheer amount of catchup work.

7. Overplanning

Overplanning can show up as questions. For example, if your child is invited to a birthday party, he may plan what gift to bring, but he may also ask:

• Who else will be there?
• What will they do when they are at the party?
• What time will you be back to pick up him?
• What food will be served?

Overplanning is a coping mechanism to help ease anxiety, and it’s a way that your child tries to find control.

8. Negativity

Anxiety can create negative thoughts, including:

• I can’t do this
• I’ll never pass my history test
• I’m too shy to do this
• I’m not good enough for this

9. Change in Eating Habits

Is your child suddenly nibbling at their food? Anxiety can cause physical symptoms, such as upset stomach, headaches, etc. This can make your child lose his normal appetite.

Treating Anxiety in Kids

Anxiety disorders can be treated, and the right treatments can restore your child’s quality of life. Common treatments for pediatric anxiety include talk therapy, play therapy, counseling for the family, and in some cases, medication. 

NextStep2MentalHealth provides pediatric mental health care, and our multidisciplinary team is dedicated to helping parents and their children with their mental health needs. Call us for an appointment or simply use our online scheduling tool.

 

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Does Your Child Have Separation Anxiety?

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13 Ways to Help Children Cope with Back-to-School Anxiety

An upset stomach. Nightmares. Unrelenting desire to avoid school. Difficulty sleeping. Temper tantrums and crying outbursts. These are all examples of how anxiety can manifest in children. Sometimes, these signs of anxiety are attributed to other causes i.e., a stomachache from eating a rich meal before bed. Anxiety can be hidden in plain sight, but as we enter back-to-school season, you might start to see the signs of back-to-school anxiety.

Mental healthcare providers have noted a 17% increase in anxiety cases in children in the past decade, according to the Child Mind Institute. And the current pandemic has only contributed to the increasing spike in anxiety cases, according to the Centers for Disease Control and Prevention. Anxiety in children is treatable, but because it can be hidden or missed, as many as 80% of children aren’t getting the anxiety treatment they need.

As your child is preparing to go back to school, you might start to see signs of anxiety. Anxiety is more than just worries — it can affect your child’s personal life as well as academic performance.

Children who are worried and anxious aren’t doing it to get out of going to school. In fact, your child’s nervous system functions all on its own, especially when it comes to worry and fear. If your child senses fear, his or her nervous system kicks into action and triggers fight or flight reflexes. This is why phrases like “don’t worry” or “just relax” or “calm down” aren’t helpful — even though they seem like the right thing to say.

With a little practice and guidance from you, your child can learn to slow down his or her anxious brain. Here are a few ways you can help your child manage back-to-school anxiety this fall.

1. Practice Deep Breathing Exercise

When children feel anxious, they may subconsciously take shallow, quick breaths. These chest breaths can increase heart rate, muscle tension, and even contribute to dizziness. Taking slow, deep breaths can help you shift from chest breathing to abdominal breathing. When children slow down their breathing, it helps to shift out of flight or fight mode so their body can relax. Isn’t science cool?!  Slow, deep breaths — that’s the key!

You can do square breathing or triangle breathing, or you can follow along with guided meditations. The following videos are cute ways to introduce the idea of deep belly breathing to young children.

Rainbow Breathing

Whale Breath Singalong

Once your child learns how to belly breathe, he or she can practice deep breaths before bed — or any time during the school day when he needs a quick reset.

2. Spend Time in Nature

Nature is healing, and it can do wonders for easing anxious thoughts. Sometimes children benefit from simply changing up the scenery. This is especially helpful if your child is participating in e-learning and just needs to get out of the house. As your child breathes in the fresh air, feels the breeze rustle his hair, or listens to the birds chirp, his thoughts are gently calmed.

This is a great opportunity to practice a grounding technique. Monica Clark, LPA, explains this technique:

If you find yourself beginning to lose focus, ground yourself in the moment. One effective grounding technique is the 5-4-3-2-1 Game. In this technique, you ground yourself in the physical environment by naming:

• 5 things you can see
• 4 things you can hear
• 3 things you can feel against your skin
• 2 things you can smell
• 1 thing you can taste

Ask your child to describe the smells, find green leaves, describe the texture of a pebble.

3. Talk about What Anxiety Is

“Anxiety is often regarded as something that is bad and should be eradicated completely. However, anxiety by itself isn’t necessarily bad. Anxiety is actually an emotion that helps us take care of dangerous situations — and respond to those situations. If we are aware of a potentially dangerous situation, we can avoid harm,” says Dr. Dan Guy.

In other words, worry and fear is designed to help us avoid potentially dangerous situations. For example, a stray dog charging at your may instill fear, and it’s that fear that ignites flight or fight mode — so you can take flight to safety. Problems arise when anxiety and fear is triggered outside of dangerous situations — like feeling physically anxious even if there isn’t a dog nearby.

It’s tempting to remove all anxiety triggers from your child because — as parents — we don’t want our child to be unhappy, but the goal is to help your child manage anxiety because  experiencing some degree of anxiety is part of what it means to be human. For example, if your child is feeling anxious about this school year, he or she may ask to skip a day of school. While skipping a day of school might temporarily ease his mind, it won’t be helpful in the long-term nor will it help him manage anxiety. Instead, it’s more helpful to teach a child how to manage anxiety.

Explore this great article of what you should (and shouldn’t) do when your child has anxiety.

4. Fit Fitness into Your Schedule

Exercise is good for your body and mind — and that’s true for children too. The above video depicts an easy at-home workout that your child can perform after work, but that’s not the only option. Other good-for-the-brain exercises include:

• Hiking
• Playing sports like soccer or basketball (even if it’s in your backyard)
• Rollerblading
• Biking
• Dancing
• Jump rope

Walking around the block or playing tag in the yard are good options too!

5. Go for a Walk Around the Block

We just talked about the importance of exercise, and this tip combines an exercise (walking) with some quality one-on-one time. If you go for a walk-and-talk with your child, you’ll experience three key benefits:

• A walk around the block removes your child from his environment ( a fresh scenery is always helpful)
• The quality time allows your child to express his or her feelings and frustrations and worries
• The exercise produces “happy” endorphins to lift your child’s mood

6. Think Positive by Introducing a Gratitude Journal

Keeping a gratitude journal is a great way to combat anxious thoughts. In fact, writing in a gratitude journal is shown to improve emotional resilience and reduce stress. There are many ways to keep a gratitude journal, but here are some tips:

• Journal first thing in the morning to start the day on a positive note
• End the day with a quick reflection about things you were grateful for over the course of the day
• If your child can’t write yet, she or he can draw pictures instead

You can download our free printable Gratitude Journal. Print out the journal and let your child explore the concept of gratitude. With 50+ pages, your child will have nearly two months of journaling!

 

7. Focus on Good Nutrition

Good nutrition impacts your mental health too! In fact, there are plenty of tasty brain-healthy foods, such as:

• Salmon
• Yogurt
• Turmeric

Not all kids enjoy salmon, but a yogurt-lemon-dill sauce may make the salmon more appetizing for kids. You can also make salmon loaf, which eliminates the fish texture that children might not like.

TIP: If your child has a stomachache caused by anxious thoughts, she or he may not feel like eating. If that’s the cause, offer more bland foods or a warm cup of chamomile tea.

8. Read a Story

Children can learn important life lessons through reading — plus, reading is a good bonding activity! Review this list of books via WeAreTeachers, and you might discover some great books for kids with anxiety.

9. Create a Safe Space

If your child is feeling overwhelmed, he or she may benefit from a cozy place to unwind after school. From fidget spinners to books to coloring books, this can be a great way for kids to process all of their thoughts after school — rather than jumping right into homework or chores.

10. Ask for Individual Accommodations

For some children, accommodations at school can make all the difference when it comes to anxiety. For example, if a student struggles with performance anxiety, he or she may not do well when taking tests. Some students benefit from individual accommodations such as extended time on tests. For other accommodations for kids who struggle with anxiety, check out this list from The Children’s and Adult Center for OCD and Anxiety.

11. Help Your Child Practice Good Sleep Hygiene

Poor sleep and anxiety often go hand-in-hand. Anxious thoughts can make it difficult to sleep, and poor sleep can exacerbate the symptoms of anxiety. Help your child practice good sleep hygiene, including:

• Going to bed at the same time every night
• Using warm-colored lights during his or her bedtime routine
• Sleeping in a cool, dark room

12. Go Over New Changes

Reduce back-to-school anxiety by going over any new changes with your child. Maybe your child feels unsure about the new rules at school. Be sure your child understands what the new rules are (when to wear masks, etc) to help cut back on some “fear of the unknown.” If your child is participating in e-learning, ask your child if he would like to review any of the technology. Sometimes just a quick refresher on what’s expected can go a long way in feeling confident about the new school year.

13. Reach Out to Your Child’s Mental Health Care Provider

The good news about anxiety is that it can be treated with therapy, medication, and lifestyle changes. With the right support and strategies, most children are able to develop strategies that help them manage their anxiety both in the classroom and at home.

Here at Next Step 2 Mental Health, we provide comprehensive mental health care for children (and adults too!). Whether your child is just now experiencing anxiety for the first time, or is seeing a resurgence in symptoms, we can help your child get the relief s/he deserves. Call 502-339-2442 or send us a message to request more information.

You can also request an appointment easily here. Learn More

5 Easy Ways to Prepare Your Child for a Telehealth Visit

Is your child new to telemedicine?

Here at Next Step 2 Mental Health, we are proud to offer a variety of services through telehealth – and not just for adults. Children don’t have to miss their sessions due to social isolation.
If your child is already familiar with apps like FaceTime or Skype, he or she already has a good idea of what a telehealth session is like. Still, the idea of a virtual appointment can be intimidating for some children. If your child is scheduled for an upcoming virtual appointment, it’s a good idea to prepare your child ahead of time.

5 Tips for a Successful Telehealth Session

As your child makes the transition from in-person visits to online sessions, we want to help you make the change as seamless as possible. Before your child’s next virtual appointment, review these tips:

1. Know what type of session your child is having

At Next Step 2 Mental Health, your child can receive a variety of services remotely. This includes:

• New patient diagnosis
• Screenings
• Talk therapy
• CBT
• Coaching
• Education
• Support

When you know what type of service your child is receiving, it’s easier to answer his or her questions.

Reminder: Virtual sessions are only for non-life-threatening visits. If your child is experiencing a mental health emergency, call 9-1-1 or head to the nearest emergency room.

2. Gather important information before the session starts

Before your appointment begins, make sure you have:

• A list of your children’s current medications
• Your child’s medical history, including allergies, weight, and any previous diagnoses
• A list of questions that your child has (if any)
• A list of questions that you have (if any)

Depending on what type of session your child is having, you might want to write down a list of concerning symptoms that you want to address. Be prepared to answer a variety of questions, including how the symptoms have been occurring, when the symptoms are most severe, and any other related details.

3. Find the perfect location

This is one of the most important steps to having a successful telehealth session. The ideal location is quiet, well-lit, and free from distractions. Consider setting up on the dining room table or in a den. The camera should be eye-level for your child.

If you have pets or other children, make sure they are situated elsewhere so you can focus on the session too.

4. Start with an introduction

You might have a telehealth session with a therapist or pediatrician that you’ve seen dozens of times. But if your child is seeing a new provider, you’ll start with introductions. Let your child know ahead of time if he’ll be meeting a new doctor so he can prepare mentally for the meeting. During the meeting, one of our providers will start by sharing his or her name and title. At this time, encourage your child to introduce himself too! After your child introduces himself, you’ll be asked to confirm a few details too. You’ll already have completed a treatment consent form, but you’ll still confirm your child’s name, date of birth, etc.

Tip: If your child is nervous (which is normal!), practice introductions beforehand!

5. Know your next steps

Before your child’s virtual appointment comes to an end, make sure that you understand the provider’s diagnosis, instructions, and/or advice.

Tip: Keep a piece of paper or notepad nearby so you can take notes during the session, if needed. Don’t hesitate to ask for clarification! We want to make sure your session is valuable and helpful.

Questions? We’re Just a Call or Click Away

At NextStep 2 Mental Health, we’re happy to provide comprehensive psychiatric care and therapy for your children. Whether your child has anxiety, depression, or ADHD, we don’t want him or her to miss out on valuable sessions, and we are here to make sure your telehealth experience is successful.

We’re just a call or click away. Give our Louisville, Kentucky mental health clinic a call at 502-907-5908 or send us a message to request more information. Alternatively, you can also request an appointment with our convenient scheduling tool here.

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