Anxiety in Children

Anxiety is a common mental heath condition characterized by changes in mood, behavior, and functioning that persist for at least several weeks and cause difficulties in functioning. For children this might mean academic or behavioral difficulties at school, difficulties interacting with peers, or withdrawing from family. Anxiety is more than simply being in a bad mood, feeling sad, or having a negative attitude and includes other significant psychological, biological, and behavioral changes.

Anxiety Signs in Children

Anxiety Signs and Symptoms

  • Feeling angry
  • Frequent mood swings
  • Feeling worthless
  • Frequent crying
  • Social withdrawal
  • Loss of energy or fatigue
  • Low self-esteem
  • Thoughts of death or suicide
  • Difficulty sleeping
  • Difficulty concentrating
  • Academic  difficulties (e..g, drop in grades, not doing school work)
  • Behavioral issues (e.g., getting into trouble at school, or refusing to go to school)
  • Change in appetite
  • Low self-esteem
  • Thoughts of death or suicide

Anxiety Treatment for Children 

Psychotherapy (i.e., talk or behavioral therapy) is an effective treatment for anxiety in children and for mild to moderate anxiety is recommended as a first-line treatment. For more severe cases of anxiety a combination of medication and psychotherapy is typically recommended.
Cognitive-behavioral therapy
Cognitive-behavioral therapy (CBT) is the most researched and scientifically proven psychotherapy for treating anxiety in children. CBT is a very practical and easy to understand treatment approach that emphasizes the here-and-now and the development of effective coping skills and strategies. In children, more emphasis is typically placed on behavioral interventions than on the development of insight.
Certain medications (i.e., SSRIs) are commonly used to treat anxiety in children and like psychotherapy have been proven to be effective. While the use of medication to treat anxiety in children has grown steadily over the past couple of decades there remains concern regarding the safety of some medication use in children. For more information regarding the use of medications in treating depression in children click here to visit the NIMH website on the matter.
Family therapy
Family therapy is also commonly recommended for children who are experiencing anxiety. Family therapy aims to help parents and caregivers learn how to more effectively provide support create a less stressful environment for the child. Individual therapy with children is more effective when parents and/or caregiver take an active role in treatment.

Anxiety Therapists for Children

How Holiday Stress Effects Children

The holiday season is a very busy time. Between shopping, parties and school functions, the hustle and bustle of the holiday season can be exhausting for children.

Routines are often disrupted and bedtimes pushed back in an effort to attend every function and cross off every item on the lengthy to-do list. Although the holiday season is fun and exciting, stress among children is a common occurrence.

Many children struggle to understand and verbalize feelings of stress. They internalize it instead. For children, stress tends to manifest as headaches, stomachaches, sleep disturbance, changes in eating habits and irritability.

 It’s important to watch children carefully during the holiday season. They might not say what they’re feeling, but they will show it.

Parents can take steps to help children avoid holiday overload throughout the season. And with holiday preparations beginning earlier each year, it’s essential to put a stress-less plan into place as soon as possible.

Tips on Planning Ahead to Avoid Stress

^ Maintain routine

Most families follow a routine throughout the school year to ensure that kids get enough sleep, get enough exercise and get up and out the door on time each morning. But when the holiday season rolls around, routines tend to be the first thing to go.

Maintain your normal routines as much as possible throughout the holiday season. Routines combat exhaustion and provide a sense of control for kids. When they know what they need to do and when to do it, kids don’t have to stress about what comes next. Try not to push back bedtimes by more than 30 minutes on any given night, and feed your kids a light meal before a party if you know that dinner will be much later than usual.

^Promote healthy choices

We all love holiday treats.  But you can have too much of a good thing. For an adult, that might mean an upset stomach for a day. For a child, it can change behavior, cause stomachaches and/or headaches and even trigger feelings of anxiety and/or sadness from the constant ups and downs of a diet heavy in sugar and treats.

Focus on healthy eating throughout the holiday season. Add in a few treats here and there, but be sure to balance them out with healthy snacks and balanced meals.  Try to remember that your kids will get their cues from you. Make healthy choices in front of your kids to inspire them to do the same.

^Just say no

Although it’s tempting to attend every holiday party on the list, it isn’t necessary.

Set kids up for a positive experience by feeding them before the party and setting a time limit.  Parties tend to involve few boundaries and lots of running around, with a side of holiday treats. While parties can be a lot of fun, they can also lead to increased stress. When kids are used to a certain structure, a complete lack of structure (or less structure) can be difficult to process.

Limit the parties you choose to attend with your children. Consider timing (keeping a toddler up too late rarely ends well) and other activities on your agenda. Set kids up for a positive experience by feeding them before the party and setting a time limit. Watch your child for signs of exhaustion and stress, and plan your departure accordingly.

^Focus on family

It helps to take a step back from the constant holiday-themed activities and remember what the holidays are truly about. Focus on spending time as a family. Do a good deed for a neighbor. Cuddle up and tell stories of your family holidays as a child and read your favorite holiday stories.  Too often we get caught up in what we think we need to do to create the perfect holiday, but what our children actually crave is time with us.

^Manage your stress

You have a to-do list a mile long.  Parental stress is also common during the holiday season, and stressed out parents lead to stressed out kids.

Be sure to focus on your own stress management throughout the holiday season. Prioritize sleep, exercise and healthy eating along the way, and avoid taking on more commitments than you can handle. A little “me time” can go a long way toward keeping your stress in check.


Parenting tips for managing holiday stress

  • Strengthen social connections – Strong, supportive relationships help us manage all kinds of challenges. We view the holidays as a time to reconnect with the positive people in our lives. Accepting help and support from those who care about us can help alleviate stress.  Also, volunteering at a local charity on our own or with family can be another way to make connections; helping others often makes us feel better, too.
  • Initiate conversations about the season – Have conversations with your kids about the variety of different holiday traditions families, friends and others may celebrate.  Use this time as an opportunity to discuss how some families may not participate in the same holiday traditions as others. Not everyone needs to be the same. It is important to teach open-mindedness about others and their celebrations.
  • Set expectations – Set realistic expectations for gifts and holiday activities. Depending on your child’s age, use this opportunity to teach about the value of money and responsible spending.  Remember to pare down our own expectations, too. Instead of trying to take on everything, we need to identify the most important holiday tasks and take small concrete steps to accomplish them.
  • Keep things in perspective – On the whole, the holiday season is short. It helps to maintain a broader context and a longer-term perspective. Ask yourself, what’s the worst thing that could happen this holiday? Our greatest fears may not happen and, if they do, we can tap our strengths and the help of others to manage them. There will be time after the holiday season to do more of things we’ve overlooked or did not have the time to do during the holidays.
  • Take care of yourself – It is important to pay attention to your own needs and feelings during the holiday season. We can find fun, enjoyable and relaxing activities for ourselves and our families. By keeping our minds and bodies healthy, we are primed to deal with stressful situations when they arise. Consider cutting back television viewing for your children and getting the family out together for fresh air and a winter walk.  Physical activity can help us feel better and sleep well.