Child Anxiety and What to Do About It

Lots of children can “hold it together” at school. How can we help children lower their buzz and not explode?

I like to think that many children experience anxiety as what I call “the buzz.” They oscillate at a higher level.
They may be sensitive to noises, crowds, and are easily overwhelmed, frustrated, or distracted. They may have difficulty settling down at night, or be fearful and worry about the future or the past (what I call the “what-iffers” and “woulda…coulda…shouldas”). Some have difficulty prioritizing, organizing, or remembering. This buzz is like a little pressure cooker or volcano.
During the day, the pressure increases, but lots of children can “hold it together” at school. When they get home, the slightest increase in pressure will cause an explosion. It’s really the same for adults.
How can we help children lower their buzz and not explode? 

Physical activity

For many children, physical activity may go a long way to reduce the buzz.
One little boy needed to trampoline in the morning before school and after school as well. By using the trampoline before school, he lowered his buzz enough to tolerate the anxiety-producing school day without getting overwhelmed or having a meltdown. By using the trampoline after school, he was able to lower his buzz enough – which had increased substantially throughout the day – to handle his frustration and get his homework done.  
One little girl walked on the family treadmill in the morning before and after school. She had initially come to therapy because she refused to go to school, and even when she went, she refused to do any work. But once she learned to lower her buzz, she was more compliant about going to school and doing her work.

Sleep

Sleep is important in regulating emotions. Many children have difficulty falling asleep and staying asleep. They may get scared in the middle of the night and either wake up Mom and Dad or crawl into bed with them.
Children who do not get restful sleep are unable to regulate their emotions – and the same goes for their parents. They wake up tired and grumpy, and it’s all downhill from there. If they go to bed with anxious thoughts, their sleep will be unsettled, as evidenced by the pillows and blankets on the floor. Sometimes, children even fall out of bed from tossing and turning so much.

Turn off screens

One of the problems that exacerbates children’s sleeplessness is screen time before bedtime. Children should not be watching any screen at least an hour before bedtime as blue screen has been found to reduce the natural production of melatonin, which is required for sleep.  

Worry time

Once it’s quiet and dark, worried thoughts creep in. It may be important to have “worry time” just before bed, so that children can vent their worries and go to sleep feeling relatively worry-free. Or perhaps they can put their worries on a worry tree or in a worry bank so they can free their minds for sleep.  

Yoga

Yoga can be helpful before bedtime to release some of the muscle tension that anxiety causes. It helps to calm and focus the mind. I have children pick a focal point, take three deep relaxation breaths, and then do a pose. I teach children three or four poses to work on – nothing overwhelming or too difficult – such as Tree, Gate, Warrior, and Cobra.  

Deep breathing

Deep diaphragmatic relaxation breathing is a necessary skill for lowering the buzz. Teaching children to calm down through breathing helps them to think things through and challenge any “unreasonable worries.”
It’s important to distinguish between reasonable and unreasonable worries. If you can make a plan, the worry thought is gone. If you can’t make a plan, then it is an unreasonable worry or “garbage” thought.  
These few simple tips can help lower the buzz enough for anxious children to be successful, able to focus in school, and regulate their emotions both at school and at home.
For more tips, visit my website at audreystempel.com where you can leave comments and ask questions.
 

When Life Is Water and I Wake up Drowning

This is anxiety. To give it a name I take away some of its power.

It’s a conscious decision, that first attempt at a deep breath, the one that helps me understand before my feet even hit the floor what the day will bring. Inhaling, I close my eyes and pray for the extended intake, filling my lungs and allowing the rest of my body to relax.

Many days I instead receive the jolt of a sudden stop, my body not able to receive actual life-giving air, fighting what sustains me.

Those latter days, they don’t usually go well.

***

“I feel like I’m drowning,” I tell my husband repeatedly before seeing the trend.  Other declarations come in the form of:

“I can’t breathe.”

“It just feels like I’m going under.”

“I’m sinking.”

But instead of being surrounded by water, I am surrounded by my life, a first-world charmed one at that: supportive husband, four healthy children, work-at-home mom who writes in between raising children. Sinking into this life should not feel like dying, like suffocating. 

Some days it still does.

***

Perusing my past medical records, I doubt the word anxiety would ever be found. That’s why I search everywhere else in my subconscious for a problem I haven’t dealt with, a source for the feeling of impending doom hanging over me. 

Empty handed, I finally look back and see the path. People described me as a nervous child. My irrational fears were like any child’s, but I had nightmares about them that made me wake up screaming. 

In my 20s, I walked the parking lot of my apartment at two in the morning, a building where gunshots, fires, and other lawless mischief occurred frequently. My fear was not that something would happen to me out there, but that if I stayed in my apartment one second longer, I would literally die of a cause unknown, my skin crawling, heart racing, body ready for fight or flight, yet not able to name the actual threat. 

When my first child was born, I passed the postpartum assessment with flying colors because the questions were a variation of do you want to hurt yourself or hurt your child. What they did not ask me was whether I was so afraid something else might hurt my child that I stayed up all night holding her, forgoing sleep for weeks.

They didn’t ask about the first day I dropped her off at daycare, when I cried so hard I made myself vomit then stared at pictures of her until I finally picked her up four hours early. They didn’t ask if I spent most of my time wondering how in the world I thought myself capable of protecting her. Postpartum anxiety was not on the radar back then.

Now I don’t know what I fear, what brings the anxiety on. Maybe hormones, maybe the responsibility of four children I fear not being able to protect. It’s possible the demands of these same four individuals steal my breath as I already know that, even on a good day, I won’t make everyone happy. 

Whatever it is, it creeps in and surrounds me, and I spend many days just trying to crawl back to the surface.

***

“Can you explain it?”  he asks, and I look into my husband’s eyes knowing I have to say the word.

“I think, I’m not sure, but I think I’m having anxiety.” I rush on to explain. “But I don’t want to, and it sounds ungrateful, and it’s not every day.”

“The kids, they’re great, but they are a handful. I can understand feeling anxious,” he offers.

“I’m scared to actually say it, to give it a name.”

“Why?”

It takes some time to explain that the water of my life, the very things that sustain me – kids, schedules, people needing me – also threaten to take me under, bring on the whirlpool that makes the good suddenly bad and a simple day a trap.

There is no way to take one small sip in this phase of life; being a mom means being in the water at all times. With two school-aged kids, who are homeschooled, and two toddlers, treading water in the deep end is what I do with the majority of my time. The anxiety comes when I give out and go under.

How do you explain that it’s possible to drown in the things you love?

***

When I wake up, my intake of breath stops short. My heart rate is elevated. I hear someone already awake and asking for breakfast. I try again.

Still working on my breathing, I walk down the hall determined not to speak anything but cordial greetings until I can talk myself down. The temptation to snap at nothing is too strong when I’m anxious.

The coffee is brewing, and I have a second while the kids start doing art at the table. I name it.

Anxiety. That’s all this is. It’s as awful and real as I always knew, but it’s not going to stay in control. I can fight back, and I finally know what I’m fighting. To give it a name I take away some of its power. 

It’s not a magic incantation, but naming the enemy is like pushing off the bottom of the pool, my body blasting through the water, arms and legs pumping. Sunlight shimmers right above me on the surface, and though I’m not sure when I’ll finally reach it, I know with every second I try, I’m moving closer to the next deep breath. 

How to Help When Your Child is Afraid to Fly

Flying can trigger anxiety in many people, kids and adults alike. Using these childhood anxiety expert approved approaches, you can ease the fears.

My 18-year-old stepson hates to fly. He white-knuckles the arm rests and squinches his eyes shut during take off and landing. The irony of his fear is not lost on him, or on us: his father and two of his grandfathers have been lifelong Boeing engineers (and Boeing managers) who have designed and built planes and rocket ships.

With a younger child, flying can be an adventure. Meeting pilots, getting “wings” and an activity pack from the flight crew, and riding with all of the other passengers can be thrilling for a preschooler. If the loud engine noise or other airplane sounds are scary or stimulate your child, younger children can be easier to distract with games, videos, and noise canceling headphones.

In his book Freeing Your Child from Anxiety: Practical Strategies to Overcome Fear, Worries and Phobias and Be Prepared for Life—from Toddlers to Teens, Dr. Tamar Chansky writes that you can prepare your child for this by discussing and simulating various airplane sounds and turbulence at home. “Have the child make the sounds of the wings, the wheels, etc. Car washes are great approximaters of some of the sounds and sensations of flight.”

But for an older child who is afraid to fly, distractions and simulations may not work. Instead, with our stepson, we’ve followed the approach recommended by the Anxiety and Depression Society of America (and combined a few of their bullet points together):

Figure out what triggers set you off

Understanding them makes it easier to turn them off. Is it the noise? Is it fear of dying in a crash? Fear of crashing itself?

Step onto the plane with knowledge

What ifs can be limited by facts. The Insurance Journal reports that “865 times more people are killed in motor vehicle crashes” than in commercial airplane crashes. (Motor vehicle crash odds are 1 in 112 vs. 1 in 96,566, according to the Insurance Journal.)

Understand how a plane is built and what it’s tested to withstand

My husband tells us about all the tests done to planes so they can withstand conditions they most likely would never encounter, including massive bird strikes, bending of the wings (up to 90 degrees), extreme lightning strikes, and extreme temperatures. This BBC article also summarizes those kinds of stress tests planes go through before they ever make it to carrying passengers.

Anticipate the anxiety

Often, waiting to feel fearful is worse than the actual experience. Label your fear as anxiety and realize it doesn’t correlate with real danger. Try to stay in the moment and not let your imagination create worse-case scenarios.

Know you can ask for help from those around you

I’ve been on planes sitting next to people who fly with anxiety-pets to help calm them. I’ve also sat next to people who haven’t had the comfort of an animal, but who’ve asked to hold my hand during turbulence to reassure them that they’re not alone. Children (and adults) of any age should know it is okay to ask for assistance when they need it.

We have encouraged our stepson to fly. Every flight makes the next one easier. Positive experiences are powerful forces in overcoming phobias.

My Severe Anxiety Threatened to Ruin a Family Trip to the Amusement Park

Grappling with anxiety is hard enough on our own. But we owe it to our kids to parent through the fear and give them the experiences they deserve.

By the time my children were old enough to avoid my watchful eye, I was already worn from battle against a master of war. My opponent invaded me, planting counterfeit cognitions and exploiting vulnerabilities bequeathed to me from generations past.

They detonated when triggered and, upon implosion, destroyed joy and disintegrated achievements. I’ve surrendered to attritional attacks levied by generalized anxiety and succumbed to blitzkrieg strikes of panic. Buried in the rubble were a million lost opportunities and fractured memories.

When I learned about clinical anxiety, how it is both inherited and learned, I vowed to win the war before it carried over into my children’s lives.

Whenever I read about people who transformed their anxiety into productivity, I felt shamed by my pain and wondered why it only crippled me. Its propaganda convinced me my written words were empty, and my spoken words clumsy and unworthy of listeners.

In adolescence, anxiety kept me off sports teams and away from dances. But no matter how severe the battles of my youth, they paled in comparison to the brutal assaults I experienced as a father. Although I have shifted the tide of battle, anxiety spits its spoils in my face when I think of the joy of which I’ve been robbed.

Catastrophic thoughts plagued me upon my children’s birth, so I helicoptered from their infancy on. I shadowed every move – withheld toys I feared would lodge in their throats and gave two-minute baths so they never drowned. I was years away from diagnosis and not yet medicated; ripe conditions for anxiety to declare war.

Irrational thoughts whispered to me during routine days, but they screamed during trips to the Jersey shore where, as a child, I garnered memories roaming beaches and boardwalk planks. I desired something similar for my kids. Shore days should be ice cream stained chins and screams of delight echoed from whirlwind rides. I hoped to experience those delights again through my children, but was foiled by suspicions of poison ice cream and visions of mangled bodies on rides.

Trapped between hope and fear, I acquiesced when my kids asked to go, knowing they deserved to not be restricted by my ghastly thoughts. They shouted names of arcade games and treats while I fought to keep the dread down. Feeling certain of horrors to come and wondering from which direction they would strike, I envisioned an 18-wheeler two lanes over hitting us and exploding on impact. As our car lay on its back in my mind, I emerged from black smoke through a shattered window and left behind the charred remains of my children.

Had I opened my mouth to thank our toll collector, the lump in my throat would have fallen to the road. My kids were aware I always drove the speed limit, but as they whined, they could never know I drove slower to ensure a less powerful impact from an inevitable crash.

When we arrived at the amusement park, Emily and Aedan sprinted toward a food stand whose vendor, I was certain, would serve them old stale pretzels with jagged edges that would lacerate the insides of their throats. I suggested, instead, they eat the fruit I packed and drank bottled water. Of course, they protested and added hamburgers to their list wish, while I grimaced at the thought of tainted beef. I longed to see their smiles as they chewed, but turned away.

Once I saw they had not been poisoned, I zeroed in on the size of their bites and adequacy of their chewing, convinced they would choke. While they sipped sodas, I watched calories barnacle to their bellies and diagnosed them with childhood obesity. After the last gulp, they pined for rides as I insisted they should hold off for fear they would vomit if spun at high speed. Anxiety buried joy under miles of sand and snickered while I dug for it.

As my children raced toward ticket booths, I approached with caution. I handed over money and suggested they purchase their tickets, rationalizing that it gave them a sense of independence, but knowing I was cleansing my hands of a bloody affair. They charged the tilt-a-whirl or roller-coaster as I crept behind and tried to imagined their bliss as I braced myself for cataclysm.

When they boarded and buckled in, I burned the images of their sticky faces into my memory, believing I would never see them alive again. I asked if they were positive they wanted to go through with it, and they answered with eye rolls in unison.

When the death trap buckles clicked and the machine commenced its twists and turns, I slammed my eyes shut as Emily is ejected toward the ocean depths. I saw Aedan dangling by a snagged foot, his head smashing against the cars around him, his blood painting the clouds. I avert my eyes toward the beach, but the ocean is bloodied, too, and Emily is an apparition on the water with a Teddy clutched close where I should be.

Shaking my head, I honed in on the ecstatic screams of safe children who were not mine, stared at seniors licking lemon ice. When the ride stopped, my kids hopped off and ran toward me with smiles wrapped around their faces. I waited for one of them to puke from motion sickness. I endured this through many rides and multiple trips because happy childhood memories are a birthright.

When it was time to leave at sundown, I felt exhausted without ever having exerted myself physically. But as I listened to their backseat recounts of the day, I sensed victory was mine.

Soon after I tucked them in their beds and thanked them for the day they’d given me, I hit the Xanax and Zinfandel to foster accord in my mind. Sailing to sleep, I glued Emily and Aedan’s smiling faces in my mental scrapbook and enjoyed the day in retrospect. I had found a way to shepherd my thoughts carefully and not let them run frenzied throughout the amusement park – a strategy to ensure my children saw a safe and secure world through me.

Anxiety has cost me a chunk of joy as a parent, but I’ve been compensated by my children’s quiet minds. I have shown them what a safe world looks like and refused to allow my war to rage on through them. I may have teetered on the brink on many occasions, but reason won out in the end. There is enough authentic chaos around us. No need to scar our kids with imaginary terrors.

I could not have received greater confirmation of victory than when my daughter flew to Paris on a school trip and my son joined his high school football team. They have surpassed what I accomplished in adolescence, and will continue to do so in adulthood.

I, meanwhile, can revel in my victory over a vanquished enemy.   

How to Parent the Girl Who is Wired to Worry

By age 15, girls are six times more likely to have an anxiety disorder than boys. How do you recognize it? How can you help?

She sat across from me focusing on her fingernails, almost obsessively picking at the same one the entire time. Her eye contact was minimal as the intrusive thoughts streaming through her head seemed to steal every ounce of energy she had left. Her body was trembling and her breathing labored. Fear, I’m sure, was all she was feeling in that moment.

When I asked her why she was so scared to get on the plane to go visit her dad, she looked at me quizzically and whispered, “Don’t you know why I’m so scared? What if it crashes? What if we land in the water and they can’t get the door open to let us out? I am just so tired, but I can’t sleep. I have been up every night this week researching the best seat to have on the plane in the event of an emergency, and no matter which way you look at it, I could die.”

As soon as those words left her mouth, she began to hyperventilate. While I recognized what was going on, she had no idea that she was experiencing her first anxiety attack.

In my role as a secondary school counselor, I’ve noticed a trend in the last 10+ years that makes me wonder if we’re facing an epidemic. Girls are reporting symptoms of anxiety in increasing numbers. The symptoms are showing up younger and younger and, with nearly three quarters of afflicted adults developing symptoms by age 22, the amount of female students I see that are struggling and living with anxiety seems to have increased twofold.

We’re surrounded by people living with anxiety disorders, yet our understanding of this complex mental health issue is still very immature. When I think about the severity of this disorder and the statistics overall, I’m frightened for the families who live with anxiety and continue to be shamed as they seek a diagnosis and attempt to get help.

An interview conducted by Parents Magazine with Dr. Harold Koplewicz (CEO of the Child Mind Institute) states that “17.1 million children in this nation suffer from a serious mental health disorder, and anxiety disorders make up the biggest percentage (31) of that number.”

According to the Anxiety and Depression Association of America, anxiety impacts over 40 million people in the U.S. alone and women are twice as likely as men to be diagnosed with general anxiety disorder and panic disorder. For those of us with daughters, we have even more reason to be concerned. Experts are learning that women may be wired to worry.

Research confirms that women are significantly more inclined toward negative emotion, self-criticism, and endless rumination about problems. Many experts have reported that until age 11, girls and boys are equally likely to develop an anxiety disorder. By age 15, however, girls are six times more likely to have one than are boys.

Even more troublesome is the fact that anxiety is actually under diagnosed among women. Robert Leahy, Ph.D., a clinical professor of Psychology and Psychiatry at Weill Cornell Medical College in New York, reports that the “average length of time between the onset of symptoms – the time a woman starts to feel bad – and when she gets actual diagnosis is between nine and 12 years. And of those who are diagnosed, only a very small percentage get adequate help.”

Experts are learning that women may be wired to worry more than men. Research from the Children’s Hospital of Philadelphia suggests that the female brain may be more sensitive to stress hormones and less able to adapt to high levels of them. Females also have a well-known propensity to ruminate and let problems roll around in our heads. All of this leaves me with one thought: have we created the perfect storm for our daughters, nieces, sisters, and students?

When I think about my own struggles with anxiety and how it took over three decades to finally seek help, I have to wonder if women wait so long because we feel like this is a normal way to operate in life. I’ve lived the anxious life of anxiety for so long – overestimating the risk of danger and underestimating my ability to cope with the fear – that I’m not sure if I even know how to look at a situation without “what if” being my filter.

I find myself thinking a lot about that 16-year-old girl who sat in my office so many years ago. I wonder where she is in that nine- to 12-year cycle that Leahy describes. Did she continue to seek help after she graduated from high school or did she cease treatment like so many women do?Has her life continued to be defined by “what if?”

Female shadow on a wall in a square of light

How to recognize anxiety in children.

According to the National Institute of Mental Health (NIMH), occasional anxiety is a normal part of life. One might feel anxious when faced with a problem at work, before taking a test, or making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The feelings can interfere with daily activities such as job performance, school work, and relationships.

The type of anxiety a parent may see is typically tied to a child’s developmental level. The most common forms of anxiety experienced by children and teens are:

  • generalized anxiety disorder
  • separation anxiety disorder
  • social anxiety disorder
  • panic disorder.

Separation anxiety is the most prevalent in preschool or early grade school and social anxiety tends to show up around puberty.

There are many risk factors that might make a child or teenager more susceptible to experiencing anxiety. Some of the most common risks include:

  • genetic factors — family history or mental health problems (specifically anxiety)
  • environmental factors, such as chronic stress or a very stressful event in a child’s life
  • ongoing physical illness and personality factors
  • precocious puberty (showing significant signs of puberty before age seven).

Anxiety can be considered a serious issue in a child’s life when it begins to interfere with daily activity. Some of the more common things to look for in your child or teenager are:

  • being afraid when there is no imminent danger
  • physical symptoms like racing heart, headache, stomach aches/nausea, and tense/sore muscles
  • displaying constant agitation, restlessness, and worry that seems out of control
  • catastrophic thinking and a decision-making process that is based in fear
  • beginning many thoughts and questions with “what if”
  • avoiding new situations because of new challenges
  • having trouble starting or completing school work (can look like perfectionistic tendencies)
  • sleep problems including difficulty falling and staying asleep
  • compulsive behaviors (need to do a particular action or something over and over again).

Many parents are unsure of how to best support their child who is struggling with anxiety. In an attempt to alleviate their discomfort, many are consequently adding to it. No parent wants to see their child suffer and it’s a natural instinct to protect and do whatever we can to make things better. While this is not always a bad thing, when it comes to anxiety, it can be detrimental.

So what can we do?

All of this research and information leaves many parents wondering what they do at home to help. Here are some helpful tips and strategies for parents with an anxious child:

1 | Teach basic mindfulness and breathing exercises.

Guiding children through deep breathing (in through the nose, out through the mouth) while relaxing all the parts of their body can provide instant relief for many kids. Often times, repeating this pattern of breath until their heart rate slows down and their thoughts are off of what is causing them anxiety is all they need.

2 | Help them manage transitions.

Going from one activity to the next without a plan can be difficult for some young children with anxiety. Developing routines and structure can help your child manage the stress and anxiety that can come from unpredictable transitions.

3 | Focus on the positive by asking your child to share one thing that went right during their day.

Ask them to identify how it felt when they experienced success and build on that feeling when discussing situations that make them anxious.

4 | Encourage your child to face their fears.

Sometimes parents help their children avoid these situations because they’re worried it’s too much for them to handle. In fact, they really need to help them face these fears to reduce their anxiety, according to Amy Przeworski Ph.D. “Avoidance of anxiety-provoking situations maintains the anxiety. Instead, if a child faces his or her fears, the child will learn that the anxiety reduces naturally on its own over time. The body cannot remain anxious for a very long period of time so there is a system in the body that calms the body down. Usually your anxiety will reduce within 20-45 minutes if you stay in the anxiety-provoking situation.”

5 | Remind your child that being imperfect is better than okay.

No one is perfect. No. One.

6 | Make sure they have time to relax in their day.

Including activities that they enjoy can help reduce stress.

7 | Model calmness, self-care, and courage by facing anxiety-provoking situations.

Children learn from us and they will do what we do. Parents (especially those who have anxiety) must practice self-care and approach situations that cause anxiety. By facing our fears instead of avoiding them, we show our children that they do not need to fear situations that are safe. The more we can face situations that cause us anxiety, the more likely they are to not avoid them.

8 | Teach your child that she is not her anxiety.

Professionals who practice Cognitive Behavioral Therapy (CBT) have come up with a clever way to teach kids how to distance themselves from their anxiety. A method used by psychologist Jerry Bubrick is gaining attention as kids are finally feeling like they have some power over their anxiety. He teaches kids to distance themselves from the anxiety by having them conceptualize it as a bully in the brain. He encourages children to give the bully a name and talk back to it. He explains that he is going to teach skills to handle the bully, giving children the idea that they can control their anxiety rather than letting it control them.

photography of a butterfly shape cut into a white sheet of paper.

Anxiety is a normal part of childhood, and every child goes through phases involving worry, anxiety, and fear. But sometimes this anxiety crosses the line from normal everyday worries to a disorder that gets in the way of the things they enjoy and also begins to limit the things they need to do. When those phases stop being temporary and start being more permanent, it may be time to seek help.

Above all, we need to be available to listen to our children when they want to talk about what is bothering them. Being empathetic and letting your child know that anxiety is scary and that they are not alone, is one of the first steps in teaching them how to manage their thoughts and feelings. There is no cure for anxiety, but with a lot of support, encouragement, and education, kids can learn the proper strategies to help them cope with the anxieties they face in life.

   

5 Ways to Calm Your Anxious Kid Before Traveling

For kids who worry, even a fun vacation can be a source of stress. Here are a handful of ways you can ease the what-if’s.

Any time we’re lucky enough to go on vacation for a few days, I tend to forget all of the anxiety my daughter carries with her. 

I get so lost in thinking about what a fantastic time we’re going to have. I spend my time looking at Pinterest to discover the wonderful possibilities our family vacation could hold. And I forget to talk with my daughter about the things she’s worried about during the vacation.

If your child is a worrier, especially if they have the smarts to concoct tons of troubling scenarios in their head, but lacks the communication skills to actually share those scenarios, then you know what a challenge this can become! 

Anxiety can show up in mild forms of worry, to all out panic for some, where the individual can display very different reactions than are typical for her or him. This may manifest as defiance, which is generally the case in our household. 

Family vacations should be relaxing for everyone. Parents can help their little worriers enjoy the trip by keeping in mind a few tips I’ve learned over the years from various books, therapists, and experience.

1 | Preview, preview, preview

Parents can preview the vacation with their children in the weeks leading up to the trip. This type of preview should include a general schedule of the vacation, like dates and times of travel, as well as any big destinations or events. 

When we took a trip to Denver a few years ago, we shared with my daughter pictures of the airport, videos of airplanes landing and taking off (be careful with these videos as they are quickly linked on YouTube to videos of airplanes crashing) and photos of the hotel where we’d be staying. 

Sharing visuals to preview what and where your vacation will look like is an easy way to ease any fears that may creep into their minds. This can also be a starting point for a discussion about their concerns. Even if they’re unable to vocalize the fears they have, they can point to the pictures or videos you’re showing them. 

2 | Social stories

At its heart, social stories are tools that help kids navigate situations that could become overwhelming, work on changing a behavior, or teach a new skill.

Research shows that social stories have been successful for individuals with autism, but they have also been extremely successful for kids who are anxious, struggle with navigating social situations, or are prone to meltdowns.  

Creating a social story for a child’s vacation is like writing the itinerary in a story format. At its most basic level, it lists what someone can expect during a specific event or time. Reading the story over a few times before and during the vacation will help the anxious child mentally prepare for what to expect. 

3 | Ask specific questions

Instead of using open-ended questions, which usually result in one-word answers, ask your child specific questions about the vacation. Asking what your child is most looking forward to or what she thinks will be boring will give you much more information than simply asking if the kid is excited for vacation.

Questions that will give parents more insight into a child’s worries for vacation include:

What are you going to pack for vacation? Take note of any odd items they include, as this may lead to additional insight into any fears or worries. Ask follow-up questions like, “Why do you think you need to bring a flashlight?” This may lead to an interesting conversation about the fear of a possible power outage or bad weather.

What activity are you looking forward to the most? The least?  My daughter refused to swim in Lake Michigan on our last trip because of a fear of alligators. So we studied the habitats of alligators and were relieved to learn alligators do not live in Lake Michigan. When an innocent beach-goer brought a life-sized alligator float to the beach, my daughter did freak out for a moment. She recovered nicely, though, because of our prep work. If we hadn’t studied the habitats, though, and she didn’t share her festering worry, she would have most likely melted down and refused to go near the water.

What do you want to do on our vacation? What do you want to skip? This gives your child another opening to share their own feelings of excitement and worry with you. Sometimes children can get so overwhelmed with feelings, they don’t share their extensive plans clearly.  Giving them multiple paths to chat is another great way to prepare for a vacation. 

Have any of your friends gone on vacation to (insert vacation location)? Questions like this get any preconceived notions out into the open. If a friend has been to the location before and had a great time, chances are your child’s expectations have increased or they are looking forward to the trip. If the friend did not have a fun time, this could exacerbate your child’s worries about the trip. 

4 | Respect your child’s feelings

Be aware of how you respond as your child shares their concerns or even comments on the vacation. My daughter was always very frightened of her great-grandparents. This was odd to my husband and me because they are the sweetest people. Anytime we would ask our daughter why she acted so scared, her response was the same, “They have white hair.” 

What does a parent say to that? We would often squash her feelings down by saying, “That’s not a reason to be scared.” 

One day my daughter was feeling particularly open about her worries and shared with me that what she meant was that the great-grandparents in question were old, very old in fact. So old that what my daughter meant by saying they have white hair, is that she was worried they would die while she was in the room. Each time we told her to not worry about their white hair, we were basically telling her that she shouldn’t worry if an old person would die right in front of her. 

Now when we go to a party with the great-grandparents in attendance, I try to relieve my daughter’s worries by saying that, “Grandma and Grandpa must feel pretty good today. If they felt like coming to a party, they probably don’t feel like they will die today.” 

5 | Avoid surprises

Change is hard, but especially for kids who struggle with transitions. Ease the level of anxiety in your child by giving him lots of time to prepare for the change. Instead of suddenly leaving a fun park, let him know when he has 10 minutes left. Then give him a five-minute warning. As it is nearing time to leave, ask your kids what they’d like to do as their last activity before leaving the park.

The more you can prepare your child for a change, the less likely they’ll feel overwhelmed. This will lead to fewer meltdowns and a more memorable vacation for everyone. 

Posted on Categories Raising KidsTags

How to Manage Your Kid’s Anxiety During Medical Procedures

Medical procedures can be scary for anyone. Kids, especially. Keeping these things in mind can make it easier on everyone.

Our six-year-old fell and broke his wrist while pretending to be a stuntman – jumping from a barstool to a mini trampoline – and needed surgery to align broken and displaced bones.

His pain and fear heightened his intolerance for medical procedures during his treatment course. Certain phrases used by the medical staff brought on extreme anxiety, and calming him back down was agonizing for us as parents. Having a history as a pediatric nurse helped me in this situation but going through medical procedures with my own fearful child brought new challenges.

Overcoming a child’s fear about an impending medical procedure can be an exhausting road for parents. There are several approaches that can help ease this fear.

The initial pain after his fall was extreme and, as parents, we knew we had to put our own anxiety aside to act quickly and rationally. Our pediatrician suggested we go straight to a clinic with an orthopedist. Our son’s wrist did not swell, but it was crooked so we knew it was broken. We knew we needed to go in.

As we waited for his x-ray results, our son’s incessant shrieking fueled our anxiety because we were helpless to relieve his pain. When the staff came in to tell us the news that surgery would be needed later that day, the already shaky floor fell out from under us. Our situation went from bad to worse, a cast wasn’t going to be enough. 

Our son’s fear came roaring at us as the staff set up to splint his arm amidst his tear filled eyes and yelling protests. We pleaded with him, insisting the splint would make it hurt less but he was panicked. I knew holding his hand during the procedure would help reduce his anxiety and make me feel like I was doing something to help. I told him to squeeze my fingers with his other hand while they applied the splint. His screams brought tears to my eyes, and to my husband’s as well.

When it was done, he said, “Squeezing your hand helped, Mom.” Whenever possible, be in physical contact with your child – if you can’t hug, hold a hand. 

Surgery was scheduled for the next morning. We were amazed how well our son did all evening with the pain medication in his system. But sleeping that night became impossible for him, as the medication wore off and anxiety about the impending surgery kicked into high gear. He continued to sleep for twenty to thirty minutes at a time, then he would yell out. Sometimes he was awake when I went in, and sometimes he was yelling in his sleep.

At 2:30 a.m., when he said he couldn’t sleep anymore, we got up and watched TV. He amazed me. He understood he couldn’t have anything to eat or drink, and he accepted it. Around 4:30, we headed out into the cold, dark morning to drive to the hospital. As we drove, he had many questions about what would happen once we got to the hospital. I knew less specific information would be better for him as a six-year-old so I focused on the fact that the doctor would fix his arm rather than stating specifics of how they would fix his arm.

Since the developmental age of a child impacts fear, explanations of the procedure should vary based on the age of the child. Older children may understand more detailed explanations than younger kids, and preparing a child with books about what to expect can help reduce anxiety (KidsHealth)

Certain phrases can trigger anxiety and increase surgery fears (Verywell.com). Once admitted to the hospital our son’s anxiety exploded when the staff began to use the phrase, “go to sleep” over and over again. I tried to catch the staff and ask them not to use the phrase, as it sent our son into hysterics every time. To counter the anxiety triggered by that particular phrase, I repeated a sentence that calmed him: The doctors would use medicine so that he wouldn’t feel them fixing his arm. My sentence took the focus off the word “sleep” which triggered his fear. Some children have negative associations with sleep –they can be fearful about going to sleep and not waking up, so they should be assured that they will sleep during surgery and wake when it’s done. Or they could be thinking about pets – when pets are put to sleep, they die. So, it’s important to assure children that sleep is temporary in surgery.

Each child is an individual and what works for one may not work for another. Offering a choice helped our son. After discussing it privately together, the anesthesiologist presented my son with an empowering choice: he could pick which way the medicine would be administered. Breathing into a mask was one option for anesthesia, and receiving it in the arm was another. He opted for the arm method, which required an IV. A numbing medication was used to ease the pain of the needle used for IV insertion.

What I didn’t anticipate was my own inability to control my emotions when I considered that something could go wrong, creating a complication or even the rare, but real, potential for death. Before he went into surgery I cried in front of him and that scared him, exacerbating his anxiety. I covered it up stating I was sad he got hurt rather than spilling my real fears for his safety. He understood and believed my reason for crying, but stepping out of the room if possible for a minute is also an option when overcome by tears. Staying calm and using calm non-verbal cues can help a child be less fearful.

Accompanying your child into the operating room to ease separation fears associated with impending surgery, is another effective measure for reducing anxiety. Walking alongside his bed as he was wheeled into the OR also helped calm my anxiety. I was allowed to stay with him until he was given the anesthetic – the most dreaded phase for him – and it comforted me to see him fall asleep, as he was no longer crying or in pain.

Even with a short half hour surgery, sitting in the waiting room was torture. As a nurse, I know anesthesia procedures are quite safe today, but the parent in me felt gripped by the potential for complications. When they called to say he was awake and well, and that I could see him in the recovery room, I was elated.

In the recovery room he was sipping apple juice with his arm propped up on two pillows. He smiled and said, “Now there is just one thing left, they need to fix my arm.” I laughed with relief as I told him it was done and they’d fixed him already. He was amazed that he didn’t even remember any of it. Telling a child that they will not remember what occurred during surgery once they wake up is also an important piece to include when preparing for surgery.

A week later the hard cast was applied and the staff told him he was indestructible, which is what every 6-year old wants to hear. He picked out a royal blue color and brought markers to school so his classmates could sign it.

When it was time for the second surgery to remove the pins, he understood more about what to expect. That said, it’s important to accommodate for new and changing fears. Because we went to a different medical center for the second surgery, I found what worked last time didn’t work as well for him this time. The IV hurt more the second time, and the staff had to use the mask as well, but my son was less fearful because of his previous experience. Again, as his guide, I used wording that was less likely to trigger fear, such as “they will remove your cast” vs. “they’ll use a saw to cut your cast off.” As parents, we have to adapt our approach as our children’s fears change. 

Discussion and education are key in easing and overcoming fear and anxiety triggered by medical procedures. Being prepared to guide your child through the steps and phases of surgery fears is an important factor in keeping them calm.

Sources:

http://www.med.umich.edu/yourchild/topics/medproc.htm

http://kidshealth.org/en/parents/anesthesia-prepare.html

https://www.verywell.com/ten-common-questions-before-surgery-3156987

5 Strategies to Reduce Your Kid’s Anxiety You Can Implement Today

As a Child and Family Therapist, the concern I hear most is “I think my child may have anxiety, and I’m not sure how to help.” Here are research-based tips.

As a child and family therapist, the concern I hear most often is, “I think my child may have anxiety and I’m not sure how to help them.”

I don’t need to travel as far as my office to see the various ways anxiety impacts children in today’s world. As a mom of three, I see firsthand how the world incites excessive stress in our kids.

Our children are encompassed in a culture of fear: fear of health and safety, fear of not being the best, fear of not fitting in, fear of failing a test, fear of not making the team, and the list goes on and on.

With 1 in 8 children experiencing anxiety (and many more feeling stressed), it would be difficult to deny that our kids are facing an inordinate amount of pressure in their daily lives. Luckily, there are some straightforward, research-based, hugely effective strategies that you can practice with your kids in order to start lowering their anxiety today.

1| Be a media monitor

Evidence shows that exposure to news programming and fictional media such as video games, movies, and TV shows can cause children to experience fear and anxiety.  When children are exposed to violent or aggressive content, their brains process it in the same way as if it were actually happening to them.

This means stress hormones are triggered, and the amygdala goes into overdrive creating an anxious response in the brain. In addition to this, if children are exposed to mature content that their maturing brain can’t yet process, it will leave them feeling overwhelmed and anxious.  With the barrage of media sources out there today, resources such as Common Sense Media are invaluable for assisting parents in setting these essential boundaries.

2 | Harness the power of helpful thoughts.

Positive thinking has become a cliché, but I assure you, it is a powerhouse in terms of lowering anxiety. The thoughts your child has in any given scenario will shape their feelings and behavior.

You, as a parent, have the ability to pay attention to your child’s language and alert them to negative thought patterns that contribute to anxiety.

Good indicators of negative thinking are the use of exaggerations, extremes (I always, I never), or speculative statements such as “what if…” or “I might…” Assist them in challenging the thoughts that are not based in fact or reason, and collaborate with them to come up with a more reasonable and self-affirming statement.

3 | Become breathing buddies.

Odds are, you will be present with your child in a moment during the day where either of you may be feeling stressed. This is a great opportunity to experience the massive power of a few good quality breaths. Sit up straight, draw your breath into your abdomen, and count to four during each exhale and inhale.

There is no faster way to calm down an anxious physiology (lower stress hormones, lower blood pressure, and increase oxygenation to the front brain promoting problem solving) than taking good impactful breaths.

4 | Engage in beginner mindfulness.

A very practical way to begin sowing seeds of mindfulness with your child is practicing gratitude. Take a minute to each share three things you are feeling thankful for at that moment. When our brains are focusing on gratitude the part of our brain responsible for maintaining anxiety is forced to shut down. You are also helping draw your child’s thoughts into the present moment as opposed to ruminating in the past or speculating about the future.

5 | Be a safe haven.

Many kids work through tough feelings that contribute to anxiety through talking. Demonstrating you are available and present will encourage your child to share their thoughts and emotions. When they are sharing, resist the urge to criticize or lecture them. Repeat back to them what they shared and empathize with how they are feeling. Utilize the powerful listening skills of acceptance, validation, and empathy, and you will demonstrate to your child that you are a supportive resource to turn to when they are feeling anxious or stressed.

Resources

How Finding My Tribe Helped My Battle With Postpartum Anxiety

In finding my “tribe”, the weight on my shoulders became lighter. I wasn’t alone. In fact, I never was. I needed to get out there to find that out for myself. I am so glad that I did. I hope every mom does too.

Getting to that restaurant had become my mission. It was late July in 2012, and very humid in Brooklyn. My two-month old was in his stroller with the canopy up. My two-and-a-half year old walked beside me.

I worried about them being out in the heat, but we had to get there. We couldn’t stay the way we were for much longer.

Just a couple of months ago, on Memorial Day weekend, I had given birth to my third child. Although Owen was an absolute sweetheart, I could feel myself slowly unraveling. After a bleeding scare in the hospital, I came home just “not right.”

I was anxious, worried and very overwhelmed.

I couldn’t sleep. I couldn’t eat. I didn’t know how I was going to handle it all. I was very isolated, and rarely left the house.

I went to see my primary care physician who didn’t understand why I was having frequent heart palpitations. He failed to diagnose me with something that I would later realize that I was suffering from. I was in the midst of severe postpartum anxiety.

I was also still grieving. My firstborn, also a boy, died at nine days old. What if something happened to Owen too? What if something happened to my husband? My other child? Myself?

I was in need of some major support.

While birthing a baby is certainly magical, it can also be quite traumatic. I sought to be around others such as myself. I needed to be around my fellow moms.

Prior to this summer’s day, most of my exchanges with other mothers were from online forums. For a socially phobic woman such as me, they were helpful. However, they also contained drama that I simply did not need. I was in search of something more.

After a thirty minute walk, we finally made it. It was through social media that I had learned of this gathering. It was aptly named “Mommy and Me Lunch.”

As I walked in, I got butterflies.

I am painfully shy, so the sight of a bunch of women that I didn’t know put me into a panic. Who was I going to sit with? All these women seemed to know each other already. Should I just leave?

A woman named Joy, the organizer of the event, saw me and quickly introduced herself. Joy was as cheerful and vibrant as her name. She introduced me around. I calmed down a bit. We could do this.

I made small talk with a few women, and began to feel happier. I did it. It was a great accomplishment.

While there, I overheard a few women talking about a fabulous monthly event that involved reading a book and drinking wine. I vowed to be there for the next one.
I kept my promise. My night’s out were just what the doctor ordered.

The connections helped me realize that I was not so alone. I met other women and we talked. We were all different, yet so alike. Some of us breastfed, while others didn’t. Some of us worked full time, while others stayed home. In this real life environment, there was far less judging. We all sought to help each other. We were accepting. We laughed a lot. We enjoyed the well earned “girl time.”

Getting well was not an overnight process.

I saw a therapist that specialized in post partum issues. I promised to not be so hard on myself. The experience was not without many tears. It was very cathartic.

In finding my “tribe”, the weight on my shoulders became lighter. I wasn’t alone. In fact, I never was. I needed to get out there to find that out for myself. I am so glad that I did. I hope every mom does too.