Helping Kids Manage Anxiety

Ask Dr. Bronwyn

Helping Kids Manage Anxiety

Q: Sophie has become such a worrier. She’s always asking me about bad things happening. And now that she's learned about natural disasters in school, she keeps asking me questions like how our building would hold up in a hurricane, etc. I’m getting frustrated with all the freaked-out questions on repeat. How is it that her sister is as cool as a cucumber, yet Sophie can’t stop worrying? —Nervous Nell

Written By Dr. Bronwyn Charlton of seedlingsgroup
Photography Victoria Will

Dear Nervous Nell,

Who among us hasn’t walked into a restaurant after a white-knuckle Uber ride and said, “Somebody get me a tequila,”? That may be your very adult coping mechanism, but it is probably not the best behavior to model in front of your child. Instead, one of the gifts that we as parents can give our children is a toolkit of healthy strategies for handling anxiety.

A good place to start is to understand the causes and the factors that make some kids unflappable and others nervous wrecks. Research shows that a child’s ability to manage anxiety is a combo of nature (sorry about that) and nurture (the more you portray the world as a scary, dangerous place, the more it becomes that for your child).

Anxiety is hard-wired into all of us. There’s an alarm in your brain that goes off when it detects a threat, triggering anxiety and the flight-fight-freeze response to avoid it. It explains why when you’re driving on a snowy night, you put on the unflattering glasses that you almost never wear (but are supposed to) turn down the music and pay extra attention. The alarm that goes off signaling a threat and triggering anxiety is exactly what compels us to act in ways that will protect us. But in some children, that internal alarm begins to interfere with everyday life, such as a boy who refuses to go to birthday parties because he is afraid of balloons popping, or a girl so worried about the possibility of not getting a part in the school musical that she decides not to audition, even though singing and acting are her favorite things.

With children, anxiety isn’t always easy for a parent to detect because it is internal and thought-based. As a result, it is easy to mislabel, such as when a kid takes hours to finish a homework assignment that should have taken 30 minutes and is considered “unmotivated.” Or when a child rejects every physical activity her mom proposes, from ice skating to indoor rock climbing, and is labeled “the difficult one.” Lots of anxious kids look happy enough on the outside, despite the fact that they are constantly on heightened alert. Sure, they might be considered cautious, perfectionistic, risk-averse or apathetic, but most parents just assume that that’s the way they are. Some indicators that anxiety may be getting in a mini’s way are irrational statements like “That math teacher hates me,” or “She’s never going to invite me for a playdate again!”

There are many different ways your child might seem anxious. Fortunately, whether it be generalized (“I’m worried about everything.”), attachment-related (“I’m worried no one will come to pick me up.”), social (“I’m worried that I’ll be the last one picked.”) or physical (“I’m worried that if we talk while we’re crossing the street, we might get hit by a car.”), there are plenty of ways to help her manage her worries and get control of her thoughts.

Avoid avoidance. Thanks to the flight part of the flight-fight-freeze response, primitive instincts make your child seek cover from threats that sound her alarm (e.g., dogs, clowns). And it’s natural that you, as her parent, similarly strive to protect her from these kinds of upsetting situations. Although helping your child avoid things that scare her makes her feel better in the short-term, avoidance exacerbates fear over the long run, which can even morph into phobias. Think of it this way: How will your toddler ever learn that most dogs don’t bite if she never pets one?

Set mini-goals. Taking baby steps to help your child approach the source of his anxiety helps him learn to manage his fears and worries. As he becomes used to the threats in each step, his anxiety will diminish, making it easier for him to take on bigger challenges. For example, if your child is afraid of the water, you can break down swim class into more manageable steps such as first sitting by the pool to watch a swim class, then moving to sitting with his feet in the water and so on.

Steer clear of thinking traps. How we think about something affects how we feel. So, when people get caught in a cycle of false beliefs, their anxious thoughts become overwhelming. These take different forms: black and white thinking (“They’ll think I’m stupid if I speak up in class.”), filtering (“It was the worst day ever!” even after a mostly awesome day), catastrophizing (“Now everyone thinks I'm a loser.”) mind-reading (“I just know the teacher hates me.”), and overgeneralizing (“Thanks to that grade, I’ll never get in to a good college.) Help your child take control over her anxious thoughts by learning to think more accurately with the three C's:

1. Catch a worry floating around in your head.
2. Collect the evidence to support or negate the fear — don’t judge accuracy on feelings.
3. Challenge your thoughts.

For example, if your child constantly worries about being late for school, ask her what she fears. Help her start to collect evidence that supports or negates her fear: “I’ve seen other people arrive late and nothing happened.” “The teacher says she understands that sometimes being late is out of our control.” “When kids come in late, my classmates hardly seem to notice.” Now get her to challenge the worry: “I don’t like the feeling of being late to something, but if I am late, I will not be laughed at by my peers, fall behind or get yelled at by my teacher.”

Talk back to the bully in your brain. Logic doesn’t make anxiety disappear since it’s very resistant to reason, but another way to help your child challenge anxious thoughts is to get her to view them as separate from who she is as a person. One way to accomplish this task is to label her worries as the “bully in her brain.” Encourage her to name the bully, and to talk back to it, in order to help her feel more in control, instead of controlled by her thoughts. For example:

Child: “So, what if I’m late, it happens.”
Bully: “But what if when you’re late the class has already started?”
Child: “It’s just not a big deal. Kids are late all the time, and no one even gives them a second glance.”

Create a coping toolbox. Empower your child with coping strategies for managing his anxiety when it does pop up, so he can continue to function. Let him know that if he can learn to tolerate things that make him anxious, his anxiety will eventually decrease or even disappear. Various strategies include mindful/deep breathing, worry journaling, talking back and getting help from an adult.

Fortify your child. Anxiety is exacerbated when your child is run-down and spread thin, so make sure she stays well rested, makes healthy food choices and carves out time for exercise, fun activities and unstructured downtime.

Empathize. Anxiety can be paralyzing for your child and cause her to struggle with things that you just can’t comprehend (e.g., looking a person in the eye, jumping in a bouncy castle). At the outset don’t focus on the legitimacy of her fears; instead, empathize with her fears saying, “I know it makes you scared.” Empathy opens the door to critical thinking and problem solving through connection. When you empathize with your child, you make her feel like all fears are valid and that you’re there to help her get better at managing her worries, whatever they may be.

Be realistic. Sometimes what your child fears may be a possibility. I mean, you can’t promise her that she’s not going to fall when she ice-skates, or that she’ll definitely get an A on the test. Express your confidence in her that whatever happens, she will be able to manage it, and that every time she faces her fears, her confidence will grow and the anxiety will decrease.

Don’t ask leading questions. When your child expresses anxiety, listen, but don’t be the leader of The Search Committee for Fear (“Are you scared about the sleepover on Friday?”). Doing so might inadvertently exacerbate your child’s anxious thoughts. Instead, stick with open-ended questions like “How are you feeling about the sleepover on Friday?”

Watch yourself. Be careful that your tone of voice or body language don’t accidentally corroborate your child’s exaggerated fears. If she takes a tumble off her scooter, try not to unintentionally send the message that scooters are incredibly dangerous and that she should be scared to ride again because you’re now anxious.

Cut the anticipation period short. Much of the time, what exacerbates anxiety is the anticipation of an event. If, for example, your child has to get a cavity filled at her next dentist visit, it’s probably best to tell her just before your arrival, not the week prior.

Model healthy anxiety strategies. Let your child see you being your best self when it comes to your own anxiety. If there are specific areas where you admittedly don’t manage your anxiety well, then it’s best to leave them alone when it comes to your child. If you get incredibly anxious at the playground watching your child climb the monkey bars, consider letting your partner be the playground buddy.

Encourage a growth-mindset. Kids with fixed mindsets, who tend to exhibit all-or-none thinking — “I’m good at soccer, but I’m terrible at math.” — are more prone to negative self-talk and anxiety over making mistakes and taking risks.

Set aside time in a day to worry. Similar to carving out time in a day for a gratitude journal, create a daily ritual of “worry time,” lasting around 10 to 15 minutes. Encourage your child to release all of her worry thoughts on paper, such as in a journal or a worry box that you create together. There shouldn’t be any rules for what counts as a worry; anything goes. When the timer goes off, that’s it. Say sayonara to today’s worries.

Bronwyn Becker Charlton, Ph.D. received her doctorate in Developmental Psychology from Columbia University and is currently on the faculty at the Icahn School of Medicine at Mount Sinai in the Department of Pediatrics. She is also the co-founder of seedlingsgroup.