How to spot anxiety in kids and what to do about it.

by Delvin Yasa, Interview with Georgina Manning

Lucy* is only eight years old but she’s never been a big sleeper. Lying in bed at night, thoughts of death, failure and world injustice (her words) keep her sweating under her quilt until the early hours of the morning. When sleep does claim her, if only for a couple of hours at a time, she dreams about her family dying, her cats going missing, or her favourite toys being broken. It’s been that way since she was a baby, says her exhausted mother Pat*, who reveals they’ve been to no less than three psychologists, two counsellors, a host of GPs and one incredibly expensive psychiatrist to get to the bottom of what’s troubling her daughter.

“They’ve tried to put her on medication to reduce her anxiety, but I don’t want her to be medicated,” says Pat.

“I just want her to be happy and untroubled like other kids her own age.”

What Pat may not realise is that while she may want her daughter to be ‘untroubled’ like other kids, the number of Lucy’s peers who would be classed as ‘carefree’ are rapidly decreasing – so much so that studies now show that almost one in seven 4 – 17 year olds are battling or have battled a mental health disorder in the past year (equivalent to approximately 560,000 Australian children).

And while anxiety is largely hereditary (most experts agree inherited anxiety is linked to 30 – 40 per cent of anxiety disorders), counsellor and director of Wellbeing For Kids, Georgina Manning, says much of it is learned by watching mum and dad.

“Families today are stressed and busy, with no time to slow down and relax together and that frantic pace can set a dangerous undercurrent,” she says. “Through our behaviours and reactions to events and situations, kids today are growing up believing the world is a dark place and something to be frightened of.” A culture of little-to-no boundaries, a reinforcement of non-resilient behaviour and having too many choices help to create the perfect storm, she adds.

It’s worth noting that having a little bit of anxiety – particularly during stressful times such as exams, changing schools or teachers, or having a friend move away – is normal. A survival mechanism evolved over thousands of years to identify possible threats and prepare the body’s ‘fight or flight’ defence, a little bit of anxiety helps keep us safe. It’s only when the body’s panic response gets stuck and floods the body with adrenaline (panic) even though there’s no threat in sight that the anxiety can quickly turn into an anxiety disorder, which can present in one or a few of the following ways:

Generalised anxiety disorder
One of the more common anxiety disorders, children with generalised anxiety will worry excessively about everything, like Lucy. Physical symptoms often play their own role and can include regular headaches, stomach aches, muscle tension or tiredness.

Obsessive Compulsive Disorder
For kids with OCD, anxiety takes the form of obsessions and compulsions, such as counting, washing hands or rearranging toys in a particular way. They often become upset if their behaviour is interrupted or their routine changed.

Panic attacks
Often occurring for no apparent reason, panic attacks can strike anywhere and at any time, with sudden physical symptoms which can include fainting, a shortness of breath, dizziness, numbness, sweatiness and a pounding heart.

Phobias
Phobias are when your child develops intense fears of something that wouldn’t normally be classed as dangerous, such as dogs, gaps in curtains, heights, flying or particular objects such as buttons.

Social anxiety
This is a fear of social situations or speaking and interacting with others – particularly if a parent is not with them. In rare cases, kids with severe anxiety can also suffer from selective mutism which is where kids refuse to speak in situations they find too overwhelming.
Studies show early assessment and professional support is hugely beneficial for children suffering from an anxiety disorder, so keep an eye out for one or more of the following signs:

• Excessive worry crossing over all areas of life
• Sleep issues, whether it be falling asleep or staying asleep
• Restlessness or fatigue throughout the day
• Irritability
• Trouble concentrating
• Withdrawing from people
• Avoidance of anything anxiety-provoking​

If you notice your child is suffering from one or a few of these, Manning suggests starting an honest dialogue in your household about what anxiety is and what it feels like. “Your child might have noticed that they feel a little differently to other kids he or she plays with so you want to reassure them that a little of bit of worry can actually be normal and helpful,” she explains.

“Ask them about the thoughts they have when they’re feeling anxious, so that you’re both turning towards what’s causing the anxiety rather than turning away from it.” The idea is to talk with your child in a supportive and non-judgmental way so that they always feel safe and free to share.

Helping your child face their fears rather than becoming an avoidance enabler will also assist them in the long-run, says Manning who explains gradual exposure holds the key in conquering fears and phobias. “If a child is terrified about speaking at a school assembly, for example, many parents will keep them home that day so that they don’t have to,” she says. “It’s short-term relief, but over time you’re just teaching them avoidance rather than developing confidence, resilience and strategies on how to cope with the difficulties of life and one thing we know is that children who build resilience tend to have lower anxiety levels in the long-run.”

Role modelling confident behaviours yourself is also important as ‘an anxious parent is an anxious child’, she says.

“If a parent is worried about exams or whether their child is going to get bullied, the child will soon follow suit and even if you’re not talking about your thoughts in the company of your child, rest assured they will still pick up on how you’re really feeling.” For this very reason, first-borns – often the product of much fussing and mollycoddling - tend to be more anxious than their younger brothers and sisters. “Parents are far more easygoing with the subsequent offspring and it shows in their demeanour.”

Listen to your kids and ask lots of questions about how they’re feeling. If their worries or behaviours continue for a number of weeks, or begin to affect their day-to-day activities, sleep or schooling, contact your GP to get a referral to speak with a children’s mental health specialist. “Sometimes your fears may not be warranted and your appointment can merely help reassure you on what is normal and what is not,” Manning says. “But if further investigation is needed, you’ll know your child is in very safe hands.”

If you require assistance with childhood anxiety, please call Kids Helpline on 1800 55 1800 or Lifeline on 13 11 14.