As the Mental Health Foundation marks out Mental Health Awareness...
With anxiety in children on the rise, psychologist Dr Kate Middleton explores some of the ways we can support those we work alongside
Billy is 5, and as far as his family can remember he has always been afraid of insects. Recently, however, this fear has increased to the extent that he refuses to play outside and insists on staying inside with all the windows closed, even on hot days.
Simeron is 10 and a happy, confident child, though she prefers smaller groups of friends and doesn’t like busy, chaotic situations. It is a shock to everyone when out of the blue she starts refusing to go to school, becoming extremely anxious if pushed to go.
Sophie is 8 and was doing really well at school until an argument with her ‘best friend’ seemed to throw her confidence. Now she is anxious and mistrustful about all friendships, and clingy with her mum and teachers, preferring to play on her own.
What is anxiety?
Anxiety is a fascinating emotion. It is an essential part of a healthy mind, but it frequently causes problems. Like all emotions, anxiety is designed to grab our attention, specifically alerting us to things that may have a bad outcome or put something important to us at risk. Anxiety focuses your mind by triggering a body response, which you immediately notice because it feels unpleasant, and a brain response, which gets your conscious mind analysing what is going on. The purpose is to decide whether you need to do something about it. The physical changes set you up so you are ready just in case.
Note that anxiety doesn’t tell you something bad will happen; it tells you it might happen. Only your rational thinking brain can work out if something really is a valid concern. Here lies a classic problem with anxiety: it inevitably alerts us to some things that don’t ever happen, either because we take action to avoid them or because we never needed to worry about them. Anxiety is a bit like a smoke alarm: it can become too sensitive and go off unnecessarily. Some people are more prone to anxiety than others.
Another very common problem with anxiety is that our instinctive response to it can actually make things worse. Imagine you have a bad experience when you are stung by a wasp. Next time you are near a wasp your brain immediately triggers anxiety because last time it ended badly. So you leap up and run away. In fact, you avoid all wasps from that moment on. The problem is that at a brain level this reinforces a belief that it is only by running away that you stopped yourself getting stung again. Surely, your brain deduces, if you ever don’t run away you are bound to get stung. So while in the moment running away makes you feel better, over time it makes you more anxious, and the belief that avoiding wasps is essential if you are to avoid disaster becomes stronger and stronger. You become what is called ‘hypervigilant’. Your brain is constantly on the lookout for anything that might signal that a wasp is near. Having any insect near you makes you panic, as does any buzzing sound. You can’t even begin to relax if you are in an environment where wasps might be present.
Anxiety tends to grow as we try to make ourselves safe. But the real sting in the tale is that often the thing we are scared of would not have happened anyway. In fact, the fear is usually much worse than the thing we are afraid of, and it is much more likely to restrict our lives.
Anxiety is triggered when something we value is at risk, so the more we can put our trust in God the more secure we will feel
Anxiety in children
Anxiety in children operates in a very similar way and problems in this area are very common. Children’s emotions are more basic and powerful, and it is entirely normal for children to have mild fears and phobias. However, anxiety can become a concern if it stops children from enjoying their usual activities, or if it triggers difficult and challenging behaviour. Young children respond instinctively to anxiety. This can be expressed in tantrums, crying or general ‘naughtiness’ if they are unable to voice what they are feeling.
Many everyday fears like spiders, dogs or the dark are just as anxiety-provoking to children as they are for many adults. Unexpected things can be hard for children too: anything that challenges their security or things that happen without warning. Children are not as good at reading emotions as adults, so a parent struggling with anger and suddenly shouting can be terrifying for a young child if it happens regularly.
One of our main roles as adults supporting children is to help them understand, talk about and manage their emotions
Chaos is also very unsettling, and much as children might challenge boundaries and rules, life without safe limits is even more difficult.
The way we react to fear also matters. Children take many of their emotional cues from the significant adults around them, so if something bothers you it is more likely to unsettle them.
With all this in mind, here are some top tips for supporting children who are struggling with anxiety:
While anxieties generally diminish as children grow, problematic anxiety is unlikely to just go away, and is much more likely to grow. Act early and you may be able to avoid it becoming a bigger issue.
Don’t avoid the thing they are scared of
This is really hard if your child is suddenly terrified of something. Your instinct, as well as theirs, will be to remove it from their world. But every time you do this you reinforce their belief that there really is something to be scared of. This doesn’t mean you can never take a spider out of their bedroom or waft away a wasp, but be aware that the more focused you are on these things the more they pick up the message that there is a problem.
Talk about anxiety
Even young children can learn to recognise the feelings anxiety triggers and understand it better. One of our main roles as adults supporting children is to help them understand, talk about and manage their emotions, so don’t wait until these feelings start to cause problems.
Explore anxiety with children as something that can be overcome
Find opportunities to experience anxiety differently, for example in the way you feel just before jumping off a diving board. Investigate the things children are anxious about in calmer and safer moments rather than in a moment when they are scared. A child who is afraid of wasps or spiders might find reading and learning about them helps in overcoming their fear.
Get help if you need to
Anxiety is common and can often be managed at home, but if your child’s anxiety is restricting them, seek advice early. A GP can advise on sources of support, and others who are involved with your child can also help. If anxiety is affecting them at school, talk to their teacher. It can be tempting to hide things, but if anxiety is causing absences from school it is important that they know what is going on so they can be part of the solution.
Some situations are sufficiently urgent that they require instant action. In these moments your anxiety system has a way of dialling down your thinking brain, so that an instinctive ‘gut’ response happens almost instantly. This means that when your anxiety is strongest it is very difficult to think clearly. It is almost impossible to rationalise with someone in these moments, child or adult. The only thing that helps is finding somewhere quiet and calm so their anxiety can drop to a level where they are more able to think clearly.
Panic attacks are increasingly common, even in children. These happen when the physical symptoms of anxiety feel so alarming that people are afraid of them, worrying that something bad is happening or about to happen, for example a heart attack or that they will faint or be sick. This fear triggers more physical symptoms and swiftly becomes a vicious cycle. Panic attacks look dramatic, but managing them is about dropping anxiety levels.
Breathing exercises work because they quickly reduce physical symptoms. But don’t waste time hunting out a paper bag – which used to be a commonly advised approach to resolving panic attacks – as anything that helps the young person breathe more slowly and deeply will work. One great trick with younger children is to get them humming a familiar and comforting tune. Humming naturally slows down our breathing and helps us feel calmer.
The Message version of Philippians 4:6-7 says: “Don’t fret or worry. Instead of worrying, pray. Let petitions and praises shape your worries into prayers, letting God know your concerns. Before you know it, a sense of God’s wholeness, everything coming together for good, will come and settle you down. It’s wonderful what happens when Christ displaces worry at the centre of your life.”
Did you know that the most common command in the Bible is “fear not”? But this is easier said than done. Anxiety is a normal emotion, so we will never get rid of it entirely. However, it is clear that God wants to help us and our children with this all-too-human struggle. Anxiety is triggered when something we value is at risk, so the more we can put our trust in God the more secure we will feel. Helping our children hand their worries over to God can be a great way to process them and help us find peace. Why not make a prayer wall or box where children can share their worries with God? This will help their minds let go so they can find some peace.
Helpful links for further reading
• Check out mindandsoulfoundation.org for more information about mental and emotional health and the Church. Search ‘anxiety’ (or any topic) for useful articles and resources.
• The Mental Health Foundation has produced a booklet called The Anxious Child, which is all about anxiety in children: mentalhealth.org.uk.
• Mentally Healthy Schools links to a number of resources for those supporting anxious or worried children: mentallyhealthyschools.org.uk.