What to do about an anxious child

Robbie’s life is unlike that of most ten-year-old boys.

Although a good student and a well-behaved youngster, Robbie constantly worries about doing something wrong. When his mom causally asks if he finished his homework, Robbie leaves the breakfast table immediately to recheck his assignments for yet another time. When the kids at school invite him to play a game at recess, Robbie makes up an excuse as he knows he’ll only fail or do something embarrassing. His days are filled with unreasonable fears that make it difficult for him to function or enjoy his childhood.

Evenings offer no respite, and in some ways are actually worse as he has more time to think and worry. He goes to bed at 9 pm , but doesn’t fall asleep until around midnight. Robbie can’t shut off his brain from recounting all of the things that could have gone wrong, as his fears continue in an indefinite loop he can’t control. He awakens in the morning to a long menu of anxieties about the upcoming day.

These worries aren’t valid in that they rarely if ever happen. However, they are intensely real to Robbie.

Like approximately three percent of the pediatric population, Robbie struggles every day with a serious anxiety disorder. Youngsters like Robbie are difficult to identify, as they take extraordinary efforts to conceal their fears. They are very good at making excuses to avoid detection from family or friends. They typically have a very difficult time expressing their thoughts and feelings, and that’s a major reason why they don’t get referred for professional help.

Kids’ behaviors are often the way they communicate their inner life. Youngsters with anxiety disorders are more likely to have a variety of physical symptoms, such as stomachaches, headaches, and toileting or sleep problems.  They make excuses to avoid activities, and their anxieties can gradually lead to childhood depression.

Here’s the good news. These kids generally respond very well to therapy, which typically involves both individual and family sessions. Medication can sometimes be of great benefit.

It doesn’t help for a parent to tell an anxious child not to worry. The solution involves helping kids change the way they think about stuff, which in turn results in changes in their feelings and behavior. This means combating irrational fears and challenging youngsters to think differently about ordinary events. I typically give homework assignments designed to help kids make small steps in overcoming their fears.

For parents, the key is to express understanding of the anxieties without making accommodations in family life that inadvertently encourages the child’s anxieties.

The first step in getting help for these kids is to identify this disorder. If you have any concerns about your child, speak with your family doctor.

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