How to help children with anxiety
Q: My 11-year-old son gets physically sick due to worry.
His concerns can range from worrying about forgetting something for school, going to a camp and someone not picking him up (he has never been forgotten), when he stayed at his uncle's house (he had to come home) and about going to secondary school which is a year away.
What should we do?
A: A child this bound up with worry needs help as soon as possible. Children, like adults, are susceptible to anxiety difficulties.
Sometimes they have a relationship to the family history. In families where there is a pattern of adults with anxiety difficulties all the children born into the family are at risk.
Being "at risk" does not mean a child is definitely going to have the problem but the odds increase. If certain environmental triggers occur then the child could develop a genuine anxiety disorder.
The sorts of things that can trigger excessive anxiety in children are varied and difficult to predict and usually impossible to control.
They can range from serious trauma such as the death of a parent or loved one (even a family pet) to things seemingly more trivial such as a harsh and critical classroom environment.
Complicating matters even further is the fact that some children are born more sensitive than others.
They respond more seriously to things such as childish name calling, losing games or not being chosen as a play partner.
No parent can control for all the upsets a child will have at home or at school or in the community. Sometimes things just happen.
The interesting thing about anxiety in children is that it usually starts off in the smallest of ways.
The child starts worrying about darkness or the dangers in the streets. It can even be a small worry.
Most children are easily reassured and calm down quickly and that is the end of the matter. Some children, however, are hard to calm and persist in their worry.
Gradually, over time, one worry leads to another and then to another. The worries become more severe and when they are serious enough physical symptoms appear such as vomiting, feeling sick, aches and pains, headaches and dizziness.
When the physical symptoms of anxiety appear it is time to get help. If assistance is not sought soon the problem will get worse and can overcome the child.
This is the point at which separation difficulties occur and school refusal can begin.
The good news is that anxiety difficulties in children, as in adults, are among the easier mental health conditions to treat.
My advice is not to ignore the symptoms. Go talk to your GP and get a referral to a therapist skilled in dealing with anxiety disorders in children.
If left untreated it will only get worse and your child could become overcome with fear and anxiety, refuse to attend school and not want to leave the house.
Act now, seek help, and you are most likely to see a successful outcome achieved quickly.
Q: I was diagnosed with a serious illness a year ago and my nine-year-old daughter is very worried.
I have been quite unwell since the diagnosis and was in hospital last week. She is very anxious and gets fearful whenever I talk about it.
I've kept her well informed but am now worried I've given her too much information that's scaring her?
A: I am sorry to hear of your illness. When a parent gets seriously ill the children will of course be fearful and upset.
It is important to keep the child informed but not to inform too much. Too much information at that age will overwhelm a child and cause unnecessary distress.
You need to stick to the facts, keep it simple and use langauge your child can comprehend. Medical terminology is confusing and frightening so avoid it.
Also remember that your daughter, no matter how "mature" she may seem, is a nine-year-old, not an adult.
I think it will be helpful if you speak with one of your medical practitioners. It doesn't have to be your physician; it could well be a nurse.
You can ask them if they would spend some time with your daughter, answering her questions.
It is vitally important for her to know that you are being cared for by a team of people who work hard to get you well. It is not necessary to make false promises to her. The facts about your current status are enough for her to know.
She may need to know that your condition will improve at times and you will be your old self. She may also need to know that there will be times you won't feel the best.
You can't take all her worries away. After all, she is a human being and entitled to worry about a loved one. These are human emotions. Be gentle, take it slow and keep it simple. You won't regret it.
Her life should continue as much as possible as business as usual but there will be times she needs someone to sit with her, to listen to her, to read her stories and to play with her.
I hope you make a full recovery and remember to take care of yourself at this time in your life. You are obviously a good mother and concerned about your daughter.
Let her be with you and near you when she wants and be understanding if there are times she prefers not to visit or be near you.
Patience and understanding, combined with love and quite listening, are all that is required at this time.
David is a psychologist; send your questions to firstname.lastname@example.org