Childhood anxiety disorders impact one in eight kids, making this a condition many families grapple with. But despite how common they are, anxiety disorders in kids aren’t discussed a lot, leaving plenty of parents feeling unprepared and even helpless when it comes to raising an anxious child.
“Kids with anxiety disorders can often be clingy, may have difficulty doing things independently, and can have angry outbursts,” says Tyanna Snider, PsyD, a pediatric psychologist with Nationwide Children’s Hospital. “It can impact the entire family.” Parents face the tough challenge of trying to set limits for a child while also validating their emotions, Snider says.
But psychologists say they regularly help kids with anxiety disorders, and part of that treatment is teaching families how to respond to symptoms of the condition. While none of them say that parenting a child with an anxiety disorder is easy, there are tools they’ve discovered that can make life with an anxious child a little more seamless. Here’s what they recommend all parents of kids with anxiety disorders keep in mind.
Anxiety can look like behavioral issues
Tantrums are common in all kids of a certain age, but they can also surface in children with anxiety disorders. “Anxiety can manifest as yelling or fighting you on something,” says Thea Gallagher, PsyD, a clinical assistant professor at NYU Langone Health and a cohost of the Mind in View podcast. “Sometimes it can be difficult to figure out if this is normal kid behavior or if it’s caused by something bigger or deeper.”
Those tantrums “might be really hard for the child with anxiety to control, but it’s still really important to set limits and have boundaries,” Snider says. Meaning, you don’t want to chalk a temper tantrum up to your child’s anxiety and assume you can’t do anything about it. When your child settles down, Snider recommends reminding them that you have rules and expectations, and that there are consequences when they’re not followed. “You still need to provide discipline and consequences in a matter of fact way,” she says.
It’s important to acknowledge your child’s feelings
Validating your child’s emotions is an important step when they’re upset, says Izabela Milaniak, PhD, licensed psychologist in the Anxiety Behaviors Clinic within the Department of Child and Adolescent Psychiatry and Behavioral Sciences at Children’s Hospital of Philadelphia. She recommends practicing something called “developmental empathy,” which is when you don’t dismiss worries that may feel like a big deal for your child’s age. “A child’s worry may seem silly to an adult, but it is proportional to their world,” she says. “Avoid making comments like, ‘It’s not a big deal’ or ‘You have nothing to worry about.’” Instead, Milaniak says it’s important that your child knows that you understand they’re upset.
She recommends saying something like, “I know mornings before school are rough for you. I can see that you’re scared and would rather stay home. I get that: Sometimes I want to stay home from work because I’m nervous too.”
Gallagher stresses that “feelings are always real,” even if you don’t understand why your child is having them in a particular moment. “We can always acknowledge how awful anxiety can feel,” she says. Gallagher recommends talking to your child about “bossing back the anxiety,” stressing that they can be in charge of their emotions and not let anxiety take control.
Staying calm is crucial
Ammon says it’s important to try to stay level-headed with your child. “Sometimes it can be difficult to keep your cool when your child is distressed, screaming, or crying,” she admits. Gallagher agrees, but stresses the importance of being calm. “If you can, stay as calm as possible,” she says.
Gallagher points out that moods can be contagious. “If you’re in a crisis situation and someone else starts freaking out, your fight or flight response is going to go to that, too,” she says. If you find that you’re struggling to stay calm when your child is elevated, she recommends talking to their therapist for tools you can use or considering therapy for yourself. “The best thing you can do with your child when they’re getting worked up is to be as calm as possible, reiterate their options, and talk about the choices they can make,” she says.
Sometimes you have to let them ride the wave of anxiety
Anxiety can be tough to stop, especially when a child is really worked up, Snider says. “If your child is at peak anxiety—a 10 out of 10—sometimes we need to ride that wave,” she says. “You’re probably not going to make an effective change if they’re already at that high of a level.”
That can mean just being there for your child, hugging them, or giving them space to be by themselves until they calm down, Gallagher says. “If a child is having a tantrum or anxiety attack, we want to get them to a safe space so they can express those feelings,” Snider says. This is a good time to help them practice the skills they’ve learned in therapy, like taking five deep breaths together, counting backwards by threes, or any other techniques their healthcare provider has shared. “That can distract them for a moment, relaxing their body and calming their brain,” Snider says.
Don’t completely avoid the things that cause your child’s anxiety
If something makes your child anxious, it’s understandable to want to do what you can to help them avoid it. But experts say this can actually make things worse. “The main mechanism that grows anxiety symptoms over time is avoidance, where a child escapes the experience of anxiety, embarrassment, uncertainty, distress, or other negative sensations,” Milaniak says. “By the time an anxiety disorder develops, a child has repeated patterns of avoidant behaviors, like not raising their hand in class, not attending school, and not speaking.”
But repeatedly avoiding a situation can make anxiety worse, says Hillary Ammon, PsyD, a clinical psychologist at the Center For Anxiety & Women’s Emotional Wellness. “You may have the instinct to protect them and allow them to avoid whatever is causing them to feel fear or anxiety,” she says. “Unfortunately, this decision to aid them in escaping sometimes exacerbates those fears for the child.”
Instead, Milaniak recommends that parents “compassionately foster bravery skills” with anxious kids. That means reiterating expectations by saying things like, “I know this is hard for you and going to school is one of your responsibilities, like going to work is mine. What can we do to make going into school easier today?” Milaniak says it’s important to stay firm, even if your child starts to escalate. “Remain calm and repeat a steady mantra to show that your child’s emotions don’t scare you,” she says. That can include saying something like “You’re having a big feeling response because you are scared. I am not afraid of your big feelings. We will get through it together. Emotions don’t last forever and this one will be over soon.”
If your child does things like throwing objects, hitting others, or running out of a car, it’s important to have consequences for their behavior, Milaniak says. “Emotions are always valid, but we must be accountable for what we do with them,” she stresses.
Highlight the good stuff, too
There’s a lot to manage when you have a child with anxiety, but doctors say it’s important to praise your child when they’re doing well. “Highlight it when things are going well—don’t just focus on the things that didn’t go well,” Gallagher says.
Snider agrees. “You still want to do typical parenting and let them know that you’re proud of them,” she says. Open-ended questions can be helpful, too, like asking your child to share the best and worst parts of their day when you’re eating dinner or riding in the car together. “It opens the door about communication and feelings if something is not going well,” she says.
Overall, Snider recommends reminding yourself that you’re doing your best. “Oftentimes, parents of children with anxiety are really stressed, frustrated, and unsure of what to do next,” she says. “But it’s important to remind yourself that you’re a good parent and caregiver, even if things don’t feel like they’re going well at that moment.”
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