Anxiety Disorders in Children and Parenting Styles

Anxiety runs in families and is increasing in children in South Africa.  Anxiety falls on a continuum with worry being a lower level and panic being the worst:

Anxiety in children can present as worry, fear or shyness and this can lead to children coping by avoiding certain situations.

Physical Symptoms of Anxiety are:  heart palpitations (irregular beat or racing heart); sweating; tension and pains; heavy and rapid breathing; dizziness; fainting; indigestion; diarrhoea; and, stomach aches and sickness (especially in young children).

Psychological signs of anxiety include:  mind going blank; fear that something bad is going to happen; catastrophizing (mother arrives 10 minutes late and the child thinks she may have died in an accident); inability to control thoughts or to relax; feeling out of control; difficulty falling and staying asleep; and, perfectionism (need for everything to be perfect).

A child needs to be carefully assessed to ascertain whether the child is suffering from an anxiety disorder.  Symptoms of anxiety often overlap with ADHD, Autism spectrum disorders, bi-polar disorder, obsessive compulsive disorder and even depression (amongst others) so a thorough assessment needs to be conducted.  

There are different types of anxiety disorders: Separation Anxiety Disorder (developmentally inappropriate fear or anxiety regarding separation from someone to whom the child is attached. Separation anxiety is normal in children from 8 months to 3 years so long as they settle quickly when the parent returns); Selective Mutism (consistent failure to speak in certain situations); Specific Phobia (such as fear or anxiety about flying, heights, animals, injections, blood or even using lifts – these fears are normal in pre-school children); Social Anxiety Disorder (fear or anxiety around social situations with adults and peers – speeches, eating or drinking, having a conversation); Panic Disorder (surge of intense fear reaching a peak within minutes); Agoraphobia (fear or anxiety of using public transport, being in open or enclosed spaces, standing in queues or in crowds, being outside of the home alone) and, Generalised Anxiety Disorder (excessive anxiety lasting more than 6 months about work or school performance).

The parenting style of the anxious parent can include representing the world as dangerous to the child, the parent conveying to the child that they are not sure if the child is up to the task, saying that a child’s best efforts are not good enough or doing everything for the child (let Mommy or Daddy do that for you).  All these methods can lead to the child becoming anxious, however there is good news! Parents of anxious children are more compliant than with other conditions. With anxiety disorders it is important to first look at behavioural changes before moving onto pharmaceuticals as behavioural changing methods are mostly effective with anxiety disorders.

It is important to treat severe anxiety in children as this can affect their confidence, self-esteem and emotional well-being and lead to negative coping mechanism being adopted which can affect their ability to function.

Anxiety should first be treated with therapy for the child and support for the family.  Involving the child’s teacher is crucial. Medications can also be considered if necessary.

Parents can assist their children by sticking to a routine which is very comforting for children.  They can help children identify their worries and anxiety symptoms and problem solve fears with the child.  Instead of saying it is OK to not go to the party, the parent could ask what would make you feel safe, for example having a predetermined message the child could text you if they want to be collected.  Place a worry box in the house and ask your child to draw or write the worry down and post it in the safe box. Parents also need to prepare children for changes such as a house move or new guests arriving for lunch or to stay.  Tell them what the new situation is, when it will happen, what it will be like, so they expect the changes rather than having to endure them. Teach the child breathing techniques or counting techniques to distract them or play games with them in the car on the way to a party to alleviate anxiety.  Other techniques are available on MoodCafe: http://www.moodcafe.co.uk/for-children-and-young-people/relaxation-for-children.aspx

Should any of the above resonate with you and you are not sure where to turn, please contact the intake social worker at JCS Tel: 021 4625520. After an initial assessment of your situation, appropriate support services and professional interventions can be put in place as indicated.

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