Helping Children Cope with Fear and Anxiety
By Dr. Anand Prabhu, Psychologist; Team Leader – Mood and Anxiety Team, CHEO
Dylan is afraid of the dark. Tricia hates to eat in front of other people. Eric becomes sick to his stomach and throws up if he has to speak aloud in class. Fears and worries are a very normal part of life for children and adults. However, if these worries become cause for concern because they are affecting day-to-day functioning significantly, we refer to these excessive worries as anxiety.
Anxiety disorders are the most common psychiatric disorder in children and adults. It is estimated that roughly 13% of children and youth suffer from anxiety disorders with more girls than boys receiving this diagnosis.
Understanding what your child is going through and being equipped to help him or her is an important part of helping children work through their anxiety. Rather than ask yourself whether or not a worry is “normal,” it may be more helpful to consider whether your child is suffering excessively from his worries.
What are some of the signs that I should watch for?
Is your child showing excessive avoidance in terms of participation in activities or attending school? Is he easily upset and is his distress out of proportion to the situation? Do you spend a lot of time comforting your child and urging your child to participate in regular activities? Are you feeling that your family functioning is being disrupted by your child’s fears and worries?
Symptoms can vary quite broadly from one child to another. Some children have physical symptoms such as stomach cramps, headaches, vomiting and diarrhea in relation to their fears and anxieties. Others may complain of feeling faint, tingling in their hands or face, weak or rubbery knees, and light-headedness. The constellation of symptoms is quite different from one child to another.
Emotional and behavioural symptoms:
Fears and anxieties may also manifest themselves through sleep difficulties and nightmares. Your child may demonstrate anger, sadness, frustration, hopelessness and embarrassment, which is out of proportion to the situation. She may begin to worry about things such as hours, days and even weeks ahead of time. He may want to avoid friends, activities or situations altogether, as a way of dealing with his fear and anxiety. There may be repeated requests for reassurance or unnecessary apologizing to others.
What can parents do to help their children deal with fears and anxious feelings?
- Help your child to maintain good physical health and regular routines. Ensure a balanced diet, good sleeping habits, and fitness through exercise. Set time aside for leisure and relaxation with your child.
- Be patient and reassuring. Talk to them and be positive about their ability to handle the anxiety-provoking situation. Keep the lines of communication open.
- Reward your child’s coping behaviour. Praise your child’s “brave” behaviour and recognize and praise successes, even partial successes; the focus should be on your child’s efforts in confronting and managing their worries.
- Manage your own anxieties and don’t allow your worries in the situation to influence your child. Be a model for your child and show him how you do everyday things without being fearful or anxious.
- Instead of avoiding the issue that is causing fear or anxiety, reinforce exposure. If your child is afraid of spiders, you can start to read a book about spiders. If your child is afraid of speaking out in front of a group, perhaps he can talk about his favourite toy at the next family gathering. Give your child opportunities to work through his fear, by reinforcing exposure and allowing small victories along the way.
- Teach your child positive “self-talk”. Like the little engine that could, teach your child to repeat a positive phrase that will help her face her fear. “I know I can do this” or “I’m brave and I’m not afraid” can help them be strong when they are feeling afraid or anxious.
- Teach your child to imagine being in relaxing or pleasant places, places where they feel safe. Distraction can work wonders when trying to deal with anxiety-provoking situations. Children can also learn how to manage anxiety by learning how to calm their breathing and how to reduce tension in their muscles; techniques for learning these are easily available through the Internet (see websites below).
- Children can begin to feel insecure and anxious if there is conflict between their parents. Difficult conversations between spouses should happen when children are not present.
Where should I turn to for help if I think my child’s fears and anxiety are cause for concern?
Despite your best efforts to help your child cope with his fears and anxiety, there may come a time when your child’s thoughts and feelings begin to overwhelm him to such an extent that you do not feel that you can handle it on your own.
You should also think about:
- Talking to your child’s teacher and other adults (coaches, instructors) who are interacting with your child. There might be an issue you are not aware of.
- Finding books and websites that might help everyone including you, your child and other family members to better understand what he/she is going through.
- Contacting your family doctor or pediatrician. It might be time for a check up and a good time to talk about what is causing these symptoms in your child. Your physician can help you to decide if your child should see someone, such as a child psychologist, to help her deal with her fears and/or anxiety.
Chansky, Tamar. Freeing your Child from Anxiety. Broadway Books, 2004.
Webster-Stratton, Carolyn. The Incredible Years. Incredible Years, 2006.
Where can I get more information?
CHEO has a number of excellent books and other resources through its Family Resource Library, located on the first floor of the hospital. A reading list by topic can be found at http://www.cheo.on.ca/En/anxietyandstress
You can also reach them at 613-738-3942.
Your local library may be able to get these for you if you can’t make it to CHEO.
Freeing your Child from Anxiety. By Tamar Chansky. Broadway Books, 2004.
Keys to Parenting your Anxious Child. By Katharina Manassis. Barron’s, 2008.
Taming Worry Dragons. By E. Jane Garland and Sandra L. Clark (2002). Ideal for children 4-17 years.
Worry Taming for Teens. By E. Jane Garland and Sandra L. Clark (2002). Ideal for children 12-17 years.
Hole in One: A tale from the Iris the Dragon series. By Gayle Grass. 2008. A children’s book dealing with anxiety disorder.
The Child Anxiety Network
Anxiety Disorders Association of Ontario
Anxiety Disorders Association of Canada
National Institute of Mental Health
American Academy of Child and Adolescent Psychiatry
National Institutes of Health
New York Online Access to Health