How parents can recognize, reduce, and manage anxiety in children and teens
As the coronavirus pandemic continues, anxiety levels continue to run high for children and adults alike. Both anecdotal and research evidence point to increasing levels of anxiety for children and teens during this difficult period. In my clinic I am seeing many more children and adolescents who are experiencing significant anxiety symptoms, and their parents are concerned and even frustrated about how best to support them. And, I am far from alone – other clinics, hospitals and emergency rooms have noted an increase in mental-health related visits for children under 18.
The ongoing upheaval of life routines, education, and relationships has taken a toll. We also need to consider the prolonged nature of the uncertainty, as children remain in limbo without answers about when their lives will return to some semblance of normal. Combine that with exposure to fear-inducing media coverage, extended time in front of screens, and lack of access to social support and other healthy coping options, and it’s no wonder children of all ages are more worried, scared, and distressed than ever before!
What is Anxiety?
Anxiety is the feeling of nervousness, tension, fear, or worry we experience during times of uncertainty. It’s a normal emotion that all humans experience, and often is situational. Some common examples for children and teens include feeling anxious before giving a presentation in front of the class, going to a friend’s house with parents for the first time, or being alone in the dark. Anxiety that occurs more constantly and intensely, and is out of proportion to the situation, may be diagnosed as an anxiety disorder. The key to anxiety is the presence of uncertainty – we can’t be sure how things will turn out. The more prolonged the uncertainty, the more anxious, distressed, and even hopeless we may become.
It makes sense, then, that children and teens are experiencing higher levels of anxiety during this pandemic period. One of the challenges for parents is understanding that anxiety in children and teens can look very different than it does in adults. It often shows up in their behavior, as I’ve experienced very often over the years with both patients and my own children. This requires us to observe and check in with them to find out how they are feeling, as the root of their behavior may be fear and anxiety.
Some symptoms of anxiety in children:
- Increased behavior challenges such as tantrums or resistive behavior
- Night time fears or other sleep issues
- Increased crying
- Repeated questioning
- Clingy behavior or not wanting to separate from parents
- Physical complaints of headaches or stomach aches
- Increased whining or irritability
- Isolating more and retreating into devices and/or social media
If you’re seeing signs of increased anxiety in your children, there are many things you can do to provide support to them. It’s important to help them identify and acknowledge their feelings, and then take steps to reduce their feelings of worry and stress so they can feel calmer and in control.
How to help children and teens reduce and manage their anxiety:
- Validate their feelings – Ask your child how they are feeling, and let them know what you are noticing. Be a good listener, let them know that their feelings are ok, and empathize with them. It can be helpful to acknowledge things that you are feeling anxious about as well, in an age-appropriate way. Make sure they know that anxiety is a normal human emotion that we all experience at times.
- Model calm communication and behavior – Children look to parents and other adults in their lives to determine how anxious or distressed they should be about things. That’s why it’s so important for parents to strive for modeling calm behavior and healthy coping strategies. I know when my kids see me focusing on staying calm, breathing deeply, and using other tools to keep myself calm it goes a long way to helping them do the same thing.
- Structure the day – Children thrive on structure and routines because they are predictable and allow them to feel safe and in control. Involve your children in creating a schedule for their day so they know what’s expected and when they get to do things they enjoy. Be aware that a consistent lack of structure feels unsafe to most children, and leaves more time for worry.
- Focus on what they can control – Instead of trying to constantly reassure kids that they don’t need to worry, help them focus on what they can control when they feel anxious. They can control what they think about and focus on. It’s also helpful to choose activities they enjoy and that relieve stress, such as riding their bike, blowing bubbles, listening to calming music, or talking to a friend.
- Use mindfulness and mediation strategies – These approaches help children and adults become more aware of the present moment so they can calm their anxious minds and bodies. They can be used for general and specific stressors, and can even help with falling asleep at night. There are many websites and apps that support children and families to learn and practice mindfulness and meditation approaches. Some of the online tools and apps I use and recommend are Headspace for Kids, Calm, Moshi, and The Tapping Solution.
- Regulate screen time and online activities – Research has shown that excessive screen time is linked to increased anxiety for children and adolescents. It’s important to avoid exposing children to fearful content on any type of media, as they often are not at a developmental level to make sense of what they are seeing and hearing. Limiting and monitoring screen time is also critically important. This helps ensure that they aren’t spending an unhealthy amount of time on screens and digital media, and also allows them to have ample time for healthy activities that reduce stress and support coping skills. I use and recommend Qustodio for a simple and effective way to help children develop safe and healthy device habits.
When to get professional help?
While there are many strategies parents can use to support children with anxiety, there are times when professional help is needed. If persistent worry and fears are getting in the way of your child’s functioning in any area of life, including things like eating, sleeping, participating in school, or engaging with other people, getting support from a mental health professional skilled in working with children and parents is appropriate. If at any point you feel like you’ve tried everything you know to do, and your child is still struggling, then talking with your child’s physician or a mental health provider can help you determine if treatment would be appropriate. I’m a firm believer that parents know their children best. If you have a concern about your child’s wellbeing, it’s always a good idea to talk with a trusted healthcare provider to get additional insight and support.
Our children’s anxiety levels may be higher than ever before, but by using these practical strategies we can support them to learn skills that reduce their worry and help them cope in healthy ways now and for the future.
- Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations (NCBI)
- Mental Health–Related Emergency Department Visits Among Children Aged 18 Years During the COVID-19 Pandemic — United States, January 1–October 17, 2020 | MMWR (CDC)
- Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews (British Medical Journal)
Further reading on online safety and digital wellbeing:
- 17 Mindfulness Activities for Children and Teens (Dr. Nicole Beurkens)
- Games to Reduce Anxiety in Children (Dr. Nicole Beurkens)
- How to Manage Parenting, Screen Time & Digital Wellbeing During COVID-19 (Georgie Powell)
- What’s the best way to ask your child to disconnect from screens?(Maria Guerrero Moya)