Acknowledging and validating the experience of anxiety in children and teens.

“You’re young, what do you have to be anxious about?”

As a young adult, we constantly are told that anxiety came with life experience and massive responsibilities. Because we were young and “only had to worry about” school, we didn’t have stress. If you had to take care of a family, finance a house, worry about repairs on your car… THAT is when you could feel “stressed”. As I grew older and became interested in learning about psychology and mental health, I realized that anxiety doesn’t just affect adults with “adult worries”, it also affects children, teens and young adults.

With the huge changes to our daily life happening recently due to the Coronavirus outbreak, the news and social media being filled with reports of protests, police brutality, and death, and now the unknown of going back to school and work during a pandemic, anxiety is a reality to many people.

Children and teens have anxiety and stress just like adults, and as a parent or adult in a young person’s life, it is not your job to stop or take away their stress. But you can listen non judgmentally, validate their anxiety, and help them learn and practice the tools they need to cope with and work through their anxiety.

What is Anxiety?

Anxiety is a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome. This can look different for everyone, for example:

• panic attacks
• avoidance of situations or things that cause fear
• trouble sleeping
• racing thoughts
• tantrums
• hyperactivity
• aggression
• poor concentration
• physical complaints (pain, bedwetting, headaches, tense muscles etc)

Society has given anxiety a bad connotation, but the truth is that anxiety in moderate amounts is designed to protect us from danger. This can also enhance performance and wellbeing, perhaps pushing you to work hard at your jobs to be able to pay your bills and provide food for your families. For example, think about your job – if you did not have a small amount of anxiety about being able to pay your rent/mortgage/bills at the end of the month, or having to provide food for yourself and your family, you might not work as hard.

*** Note: We don’t need to help our children get rid of anxiety (there is no magic button, and if there is I’m sure you’d love to use it on yourself just like I do!). But we can teach them that anxiety can be a helper and keep us safe, and that when it gets too big and scary, we can create a toolbox of coping skills to help deal with it.

Understanding our Brain

Before we dive deeper into anxiety, let’s take a quick tour of the brain so we can understand how it is affected by anxiety! In our brain we have the limbic system, which is a part of our brain that makes us anxious (we can call this the EMOTIONAL BRAIN). This part of the brain will match what you are experiencing to a stressful memory and then start a threat response (ex: if you got attacked by a cat as a child, chances are your next encounters with a cat might cause you to panic)

The prefrontal cortex is our THINKING BRAIN, which we use for problem solving. This part of our brain is still growing until we are 30 years old – so often this part of the brain is not able to rationalize our anxiety or understand if someone else is trying to talk you through an anxious time.

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In the early days of quarantine, I took a webinar through the Institute of Child Psychology on anxiety experienced by children and teens, and they laid out a few tools to help your child/teens and yourself with their anxiety. An important message I always focus on as an occupational therapist is that it is important to create/learn and practice coping tools/skills when you and your child are CALM. When you are working together to practice coping skills in a calm/good frame of mind, the skills will be easier to use and to remember when they need them. So here are the 5 tools this workshop suggested (including a few of my additions)

Be patient and empathetic

When a child (or family member or friend) is feeling heavy emotions, we want to be empathetic; even if we don’t understand their stress/anxiety. We need to connect with them, validate their emotions and let them know it is ok to feel this way. Brene Brown has a wonderful video on Empathy (below) that talks about the difference between empathy and sympathy. By connecting with our children through empathy, we allow our children to feel that they can explore their world so they can grow, but that they will be supported if things get tough.

When children feel heavy emotions, we can help them label their emotion (ex: I see you’re worried about going back to school after so many months) and label the feelings in their body (ex: I see your muscles are pretty tense right now, I can see you’re getting nervous). This will help you show them that you understand they are having a hard time, and will give them space to talk about what they are feeling. This is when you can use the strategies that you and your child have worked on and set in place.

Learning together

When everyone is calm, talk about anxiety and what it might feel like in your body. This includes the physiological symptoms (heart rate increases, upset stomach, dizziness, sweating, shaking etc.. remember everyone is different) and then provide reassurance that even if these things seem scary, it’s ok to feel this way!

Youtube has lots of videos to help you learn about anxiety, and it might be a nice activity to watch them together to learn!

Breathing Exercises

Deep breathing is the quickest way to help calm down during a fight or flight response, but in order for it to work, we need to breathe for more than 10 breaths! This can be hard for children to do on their own, so during stressful times, do the breathing with them.

The key to deep breathing is to practice these breaths when your child is calm – perhaps make it a game, practice before bed, and make sure you talk about WHY deep breathing might be helpful! Youtube has lots of videos to help with teaching your child or teen, and there are plenty of different styles to deep breathing including square breathing, balloon breaths, and my personal favourite (pictured up above) the Hot chocolate breath. Here are a few more – get creative with visualizations that will help your child/teen remember these breaths when times get tough.

Using the body to calm

Stress can create physiological effects, so sometimes changing the way we move our bodies can help to manage stress and anxiety.

Exercise helps to turn off stress hormones and can help us feel calmer. Movements like jumping, dancing, walking or running, or stretching can all help. They work by tricking the brain into thinking it is having a fight response, and can trigger the stress response to cease

Physical contact like hugging, massages, or deep pressure can help with stress. In addition to providing a sense of support, physical touch can actually help to release hormones associated with triggering our “relaxation response”. Be cautious though, that for some people, touch might actually create MORE of a stress response – if your child doesn’t like touch on a regular day, don’t rely on touch to help calm stress.

Working with the THINKING Brain

After you have tried working with the body and the breath, try to bring the child to use their thinking brain to work through stress. Use these prompts to help children break up negative thought patterns that occur during stressful times.

• Have them tell you 5 calming things or 5 nice things they see
• Use the 5,4,3,2,1 Grounding technique:
  1. Name 5 things you can see around you
  2. Name 4 things you can touch
  3. Name 3 things you can hear
  4. Name 2 things you can smell
  5. Name 1 thing you can taste

Use distraction or rest

Sometimes anxiety can be so intense and long lasting that no matter how many coping skills you try, it doesn’t help. I have experienced anxiety where I decide to just take a short nap instead of pushing through these feelings. If none of the calming tools in your child’s toolbox are working, a distraction from the trigger might be a nice options – lying in bed with blankets, taking a warm bath, blowing bubbles, watching a show, going for a walk etc … whatever it might be, provide time for your child/teen to think about something else.

Here are a couple physical tools you can add to your toolbox

Children and teens have anxiety and stress just like many adults, and it is not the job of the parent/caregiver to stop that or take away their stress/fix them, but you can listen to them, validate their anxiety and help them find and practice coping tools so they can manage and work through their anxiety. Sometimes that is something you can do together, and sometimes reaching out to help is needed!

If you or someone you know need help or want to find out more about how to cope with anxiety or stress, please don’t hesitate to get in touch with myself, or seek out a local therapist, occupational therapist or other mental health worker.