The first step in helping your child deal with anxiety is to recognize the symptoms of anxiety in children. For starters, they vary considerably from child to child. In addition, they do not necessarily present the way they do in adults. As a result, they often go undiagnosed and/or may cross over into other disorders such as substance abuse, eating disorders, or even academic failure. In general, the symptoms of anxiety in children are characterized by irritability, nervousness, excessive worrying, shyness, sleep problems, and/or physical symptoms, such as headaches or digestive issues.

Social media often has the effect of making today’s children feel drained and isolated Children with anxiety may also have difficulty making friends or participating in other social activities.

According to most experts, the most common symptoms of anxiety in children are:

• Difficulty concentrating.

• Problems with sleep or nightmares.

• Having tantrums or anger issues.

• Being tense or fidgety.

• Frequent periods of crying.

• Complaining often about not feeling well.

• Constant fears or worries about routine aspects of their lives.

• Withdrawal from friends or social activities.

• Irritability or lashing out at others.

• Difficulties in school or sudden poor performance.

• Refusal to go to school.

• Substance abuse.

• Constantly seeking reassurance.

How to Help

Although this may be easier said than done, the first step in helping your child deal with their anxiety is to try and identify the cause or causes. This requires a relationship in which the child feels comfortable discussing problems. Most of us respond to hearing about a problem by offering a suggestion or solution. That usually doesn’t work. In fact, it backfires more often than not as it sets up reactance (where they go in the opposite direction of what you are suggesting.)  Instead of jumping in with a solution I recommend the three E’s: Encourage, Empathize, and Empower. 

1. Encourage them to share their feelings, the good and the bad. Don’t try to correct their thinking or judge what they are feeling. This part is just about starting a dialogue. Respond to their story the way you would if your best friend were telling it. You wouldn’t say something like “Your anger is out of proportion to what happened.” Or “Aren’t you being a little paranoid…worrying too much…over-reacting?” to your best friend, would you? 

   Of course not, even if that was what you were thinking. So why would you say that to your child? The answer is that you believe as a parent it is your job to guide them, instruct them and protect them. With your friend, you are more aware of the potential damage to the relationship by seeming to judge. It’s the same with your child, maybe even worse. They tend to be very sensitive these days to criticism, which is a big part of the problem. 

2. Empathize with them with statements such as “That sounds exasperating….or frustrating….or painful….or embarrassing.” Empathy is likely the most powerful tool we have when it comes to being therapeutic in my profession. It is also incredibly useful in parenting today’s children who do not feel understood or accepted for who they are. Instead, they feel misunderstood and judged. This part of the conversation is all about showing them that you do understand how they feel and that there is no judgment.

   Research indicates that maternal empathy has a significant impact on alleviating distress in children. (Not sure why “maternal” unless they didn’t look at paternal empathy. My experience is that paternal empathy is also key. Indeed early research on the relationship between a father and daughter showed that it was the best predictor of her professional success.)

3. Empower them with statements such as “You are so good at…..You are incredibly resilient…..You always bounce back……You’ve got this.” I was blessed with having a mom who refused to give me advice…..ever in the interest of empowering me. No matter how much I wanted her to do so, she always insisted that I would make the right choice, and come to the right decision. It kind of drove me nuts as a teenager. But looking back it was one of the defining experiences of my life. She was so good at communicating that I had everything I needed to solve the problem. She never wavered in her stance no matter how badly I messed up. I believe that it is what motivated me to become a psychologist.

There are some other things you can do more specifically to help your child deal with their anxiety. 

1. Be cool. Often it is all about what not to do. Do not get upset yourself. Don’t lose your temper. It just won’t help. Stay calm and express a belief in a positive outcome. “It’s going to be ok…not as bad as it seems…you’ll be fine…” Bottom line: it is important for you to remain hopeful.

2. Start a conversation by inviting them to share what worries them. Then remind them that you will be there to support them.

3. Be creative. Some children find it difficult to impossible to express their fears. Try to put distance between them and the fear by having them tell a story, draw a picture, make up a poem, etc. Perhaps it is my imagination, but today’s youth seem so much more artistic than previous generations.

4. Support without trying to control. The key is to empower your child by offering support instead of taking over and just solving the problem. A controlling approach might be to threaten the child having an anxiety attack and refuse to enter the school building. “If you don’t get out of the car and go into school you will lose your phone.” Or negotiating with school personnel to simply excuse your child every time s/he feels anxious and refuses to enter the school, which effectively rewards the child for missing school.

   A supportive approach would be one in which you, your child, and the school counselor come up with a strategy to make it easier for your child to overcome her fear of separating each morning. In a case I had, we arranged for the child to have her best friend meet her in the parking lot and accompany her to her first class. Worked like a charm. It was the guidance counselor’s idea.

5. Show understanding while collaborating to solve the problem. This goes back to the 3 E’s; Encourage, Empathize, and Empower.  Most people are embarrassed to be anxious, this includes adolescents so be sure to let your child know that anxiety is nothing to be ashamed of and that you’re there to help figure out what is making them anxious and how to manage it. Such an approach can create a bond between you and your child that would not otherwise have existed.

6. Facilitate the development of coping skills. Encourage your child to identify goals and pay attention when s/he achieves a goal, no matter how small. Frequent positive feedback improves the chances for success, but it also increases self-confidence and a sense of accomplishment. All too often parents end up helping the child avoid their triggers, which ends up inadvertently communicating that the child cannot overcome the anxiety. Much better to approach the problem head-on in a positive way.  Again, going back to the 3E’s, this is the empowering piece. 

   An example for a child who is anxious about her body might be to have her wear clothes that progressively expose more of her body: first lose the sweatshirt, then the leggings in exchange for a pair of shorts and ultimately a bathing suit.

7. Never miss the opportunity to praise your child’s effort. We are looking for ways to increase their resilience when it comes to facing their fears. If a setback occurs, recognize it as part of the challenge and move on. Remember to reassure your child that a setback is not a failure. Indeed it is often an important learning experience that will help them overcome future obstacles. Always do an analysis to help them figure out what they could change the next time. 

8. Focus on the desired outcome.  Focus when solving a problem is critical. I always ask my patients what their desired outcome is.  This is different than asking what they think the solution is. The solution might be to not feel anxious anymore. The desired outcome, on the other hand, might be to be able to enjoy oneself while spending the night at a friend’s house. You can see that in this example, the solution could be limiting as eliminating anxiety may not be possible which means no overnights. Whereas the desired outcome of being able to enjoy an overnight at a friend’s house might be achieved by simply having plans in place ahead of time for check-in with parents or having an escape plan set up ahead if the situation becomes overwhelming. 

   In several cases of separation anxiety, just knowing that they could go home without upsetting their friend made all the difference for my patient. Most of my teen patients with separation anxiety tell me that their worst fear is disappointing their friends or embarrassing themselves. If we have the option of a return home set up in advance, the pressure is relieved.

9. Be a positive role model for your child. Our children learn from us. So if we model negative behavior we can expect it to show up in them. For example, the way you deal with frustration and express your anger will play a role in the way your child deals with those issues. 

   They are like sponges so be mindful of the values you are transmitting.  As a wellness researcher and writer, I am a firm believer in modeling good hygiene especially when it comes to getting enough sleep, exercising regularly, and eating a healthy diet.

   No body shaming! Not just when it comes to their bodies but also when it comes to making negative comments about your own body. They usually assume it applies to them as well.

10. Promote good sleep hygiene. Most anxious children have trouble sleeping so establishing a predictable and relaxing sleep routine is essential. In general, bedrooms should be cool, dark, quiet, and cozy. In the case of younger children, this is an ideal time to read to your child or let them listen to soft, calming music. Some children may also feel more secure with a nightlight on or having a stuffed animal or soft blanket to comfort them.

11. Turning off the cell phone. Cell phone use is turning out to be a serious hazard when it comes to healthy teenagers. To that end, I recommend that parents establish not only a lights-out rule but also a phone-off rule. Expect pushback but be firm. Some of the worst mental health problems teens face today are the direct result of their time on their phones, especially on social media. That said, instead of simply trying to force your child to put their phone away—which may only add to their anxiety—there are more positive steps you can take:

    1. Set a good example for your child by limiting your own screen time and involvement with social media.

    2. Encouraging your child to socialize more with friends in person and participate in creative activities teaches children how to occupy themselves in other ways. 

    3. Set aside a designated time when the whole family is screen-free from phones and computers. This can be a daily activity for a short period of time, or over a weekend when you’re occupied with family activities.

    4. Explain to teens the deliberate attempts to mess with their self-esteem. Remind teens that the images on social media are often digitally altered and not an accurate representation of real life. Point out that posts about parties or events they weren’t invited to are often made to look more fun than they were.

    5. Encourage your child to cut ties with those who post negative comments about them and urge them to be responsible when posting comments about others. Teens can be impulsive and not realize the content they’re sharing may be hurtful or inappropriate.

Stay tuned for which supplements and vitamins can help rid you of anxiety.