parents should never never tell their
child that it's not okay to have a
negative emotion and you know what that
leads to that leads to avoidance
strategies feelings are temporary no
matter how discomforting it is it's like
a wave in the ocean it comes and goes
why
does anxiety and phobias
need a separate conversation when it
comes to kids than
adults because developmentally it looks
different in children and oftentimes
children are misdiagnosed
a lot of times because children are
growing they have these very short
periods of time in which they appear to
be struggling with something and that's
actually developmentally normal so we
also don't want to pathologize these
children needlessly we don't want to
make it look like everybody has a
disorder because it's just going through
some growing pains and so i think that's
why the separate conversation is needed
because there is a lot more sensitivity
to how long they have to be suffering
with something before it really does
warrant some professional intervention
so let's start with
what life looks like for a child who has
anxiety particularly as a child you need
somebody to take care of all of your
business you can't support yourself
that's the way that mammals work and as
children their attachment develops based
on whether or not they feel secure when
they're with their primary caregivers
when they're in their environment do
they feel safe and anxiety can develop
when there's a very chaotic environment
when your primary caregivers aren't
always consistently there to support you
especially when you fall or have a fear
or have something bad happen to you so
sometimes it's environmental and if
there is structure and if there's an
establishment for safety then the child
can come back from anxiety pretty easily
too or is it more just a predisposition
that they have from birth anxiety does
show some predispositions so we know
that even from birth that there are
differences in temperament so for
example some babies are just harder to
soothe they're a little bit more
sensitive to noises and lights and other
types of sensory information usually
that's a precursor for having a little
bit more of an anxious temperament
doesn't mean that you'll develop a
full-fledged anxiety disorder but just
means that under pressure or under
stress you are more likely to develop
some anxiety symptoms
anxiety manifests in a
type of difficulty with going to school
with pretending that they're sick so
that they don't have to go to school
oftentimes there's issues with
separation so part of their not wanting
to go to school isn't necessarily that
they don't like school or that they are
being for example bullied in school but
that they don't want to be apart from
their primary caregivers and so
oftentimes for children anxiety
manifests in bodily symptoms they'll say
that they have headaches they'll say
that they have stomach aches and they
can't go to school and oftentimes they
also complain of other types of things
like being easily distracted and so
sometimes you can see how that could
lead to misdiagnoses is it time to take
them to the primary care doctor is it
time to see if they have adhd but all of
the time you have to make sure that
you're considering that anxiety might
really be the explanation for it so when
i was young probably between the ages of
three and eight uh when my specifically
my mother when she would leave for the
night and i had a babysitter oh my gosh
you would have thought that i had been
stabbed in the back i could not believe
that my mother was gonna leave me and
then it was just something i grew out of
i didn't exactly see the treatment there
was no my mom just go well i'm leaving
you know you're going to eventually get
over it and i did
so
but that i i'm for a parent how would
they know if it's something they're
going to get over or something that
could actually be detrimental long term
i think oftentimes for children we look
about the span of three to six months if
it doesn't go away in about that period
of time then it's time to kind of look
at that a little bit more in detail and
to see if there's something that needs
to be done
also some children from a very young age
do show a proclivity towards being extra
conscientious so they want things to be
in their place they want things to be
organized they're a little bit of a
control freak even as a little child and
when you see that that also tends to
correlate with anxiety symptoms as they
grow you mentioned earlier about
somebody or a child exhibiting
anxious traits but not having the
disorder right what is the definition of
a child under the age of 10 having
anxiety disorder or whether
or compared to just having anxious
traits i think there's two very major
things to look for one is is it
clinically impairing them
on a variety of tasks in their daily
life is it impairing them at school is
it stopping them from being able to
develop good friendships is it hard for
them to function in the home is it hard
for them to do self-care activities like
get up get dressed shower put your
backpack together get on the bus that's
one area the other area is that the
individual perceives
a huge amount of distress
so if they themselves say i'm very upset
about this i'm upset by my own anxiety
i'm upset that my stomach hurts so much
i'm upset that i can't go to school
that's the other criteria for knowing
that it's a disorder how does a
four-year-old do that and that's part of
the problem with children they don't
necessarily say
this is bothering me this much so as a
parent or a teacher or an adult that is
in this child's life it's kind of your
responsibility to check in to see how
they're doing to ask very specific
questions and i think with children
especially because they're not usually
mature enough to spell it out with their
own words it's important to ask them
very very pointed questions about it
because when you ask you do get an
answer
so for a child who goes three or six
months
with in a child being
we're calling a child what anyone under
the age of 10 18 yeah any well i guess
you know if we're talking about a minor
yeah anybody under the age of 18 i guess
we've been focusing a little bit more on
the younger children so let's start
there yeah let's do that so with the
younger children let's say under 10
they are getting out of school talking
about how anxious they are going to
school faking being sick so they can
avoid it it's been going on three to six
months
what's happening on a neurological level
so often times with children what they
notice is just that they have a
difficult time handling and managing
their environment so if they feel like
there's too much stimuli
or that there's too much of a focus on
them individually individuals who have
anxiety sometimes don't like when other
people are looking at them paying
attention to them and so if they feel
like there's too much going on in that
direction they'll oftentimes start to
feel not only the bodily symptoms but
just
worries fears about what's going to
happen next and in fact anxiety wouldn't
even exist if we didn't have the
the ability as human beings to think
into the future
because if we're being mindful and we're
just staying in the present moment
nothing's happening except that we're
sitting here and having a conversation
on a couch
it's when your mind races to what do i
have to still do for the rest of the day
what's going to happen when i have to
give that school presentation
when i go and play on the school yard am
i going to get bullied again it's when
you think in the future that anxiety
happens and so children who sort of have
that future forecasting ability and tend
to attribute negative outcomes to the
future are more likely to have anxiety
this is really good i like that this is
so good because it's anxiety
only can occur
because we have the ability to think
about the future yes which
immediately tells me a way to combat
anxiety and this is higher level not
just with kids but for anybody
being in the moment being mindful being
present however you get there meditation
whatever right could be a way to treat
is a way to treat the anxiety absolutely
and i think it's interesting because
most children have a hard time thinking
into the future because they're so
present-minded you know the minute they
don't get a toy they're like my world is
over they don't think that in five
minutes they won't even want that toy
anymore but i think sometimes children
who are a little bit more beyond their
years that way they their brains are
sort of accelerated in terms of thinking
into the future and projecting sometimes
that actually leads to anxiety and
there's been a number of studies
actually looking at people who are more
conscientious more ambitious and whether
or not more anxiety occurs and we're not
talking necessarily about one that's
diagnosed the disorder but just anxiety
symptoms in general also anxiety can
have a very physical manifestation for
people so when people say that they're
having an anxiety attack they may mean
that they are having a panic attack it
means that they're having all these
physiological reactions quick and
heartbeat heart pounding maybe sweating
maybe just feeling like you're crawling
out of your skin so that would be just
some of the examples of how anxiety can
manifest in the body
and
for a child is that the same thing
for children i think they don't have as
many emotion words to capture how
they're feeling but
they oftentimes will talk a little bit
more about things hurting so headaches
and stomachaches they sometimes will
just say that they don't feel right
because their vocabulary is a little bit
more limited sometimes it's hard to know
exactly what it is that's going on but i
have found that with children oftentimes
they'll talk about pains in their body
is a temper tantrum a panic attack for a
child not necessarily
yeah so i think sometimes with children
who have temper tantrums it is because
they're over stimulated and they need to
kind of gain control of their
environment again
other children are just having temper
tantrums maybe because they need to have
limit setting maybe because they have
another type of issue like an
externalizing behavioral problem such as
adhd or oppositional defiant disorder so
it can really vary are there red flags
that would tell a parent all right stop
asking questions get this kid into a
psychologist or therapist or
psychiatrist asap
well there's a couple of things that we
would look for i mean oftentimes
children who are anxious they cry
and so if you see that they're crying
multiple times a day sometimes being set
up by things that are just really at the
drop of a pin it's time to see if they
need some professional intervention
especially if the teachers are already
pointing it out if they're having
difficulties even just maintaining eye
contact i mean just things that feel
kind of basic but are important for our
social functioning that's another reason
to go and consult with a professional
i think oftentimes when children are
really anxious because they can't really
speak about it there's so much agitation
so every once in a while you will see a
child acting out
and this goes back to your earlier
question about temper tantrums that
sometimes you will see that and if it
happens all the time especially around
stressful events like going to school
finishing a homework assignment being
around too many people at one time
that's another clue that perhaps it's
actually anxiety and you need some
professional support phobias phobias
we've talked about anxiety yes
what's a phobia
phobia is an irrational fear
against something that probably doesn't
have the proclivity to harm you as much
as you think it does so it's not a
phobia to be afraid of a saber-toothed
tiger if you're in a cage with them
that's not a phobia that's a very
realistic fear and you should be afraid
for your life a phobia would be being
afraid of
a tiny spider that is not poisonous but
you just don't like spiders and then it
makes you not even want to be in the
room with them run away cry right it's
irrational because they're actually not
going to do anything to you so phobias
are irrational fears yes with children
under the age of 10 what are their
common phobias common phobias are
monsters underneath the bed um lots of
monster types of phobias they oftentimes
also have phobias interestingly younger
children have phobias of germs
and so it almost looks like ocd it
almost looks like obsessive compulsive
disorder but again children can grow out
of that so don't be afraid if all of a
sudden your child is afraid of germs and
they're young maybe in a few months it's
gonna go away
so objects monsters um and i think
cleanliness are three of the biggest
ones and
do you see common phobias in teenagers
common phobias and teenagers are sort of
run the gamut a lot more i think at that
point they've had a little bit more life
experience and they actually sometimes
start to develop phobias from watching
other people if they see other people be
afraid of something like their own
parents their friends then they all of a
sudden start to be afraid of the same
thing yeah i i they're i see so many
parents who are afraid of dogs
and then their kids who are five are
afraid of dogs cause they just go this
mom and dad are scared of this so i need
to be scared absolutely and yet again
you know you look to your caregivers for
how you should be navigating your life
and your social world so that doesn't
surprise me at all so that that covers
the tin and under i would imagine it's
maybe a little easier to have these
conversations maybe with a child who's
10 to 18. yes how does anxiety manifest
differently in that demographic
i think oftentimes with the preteens and
the teenagers it manifests more sort of
in like a decreased zest for life
because they are so anxious it actually
limits their ability to go out and do
new activities and meet new people and
put themselves up to just the kind of
new opportunities that sometimes can
actually make you feel really happy and
really confident about yourself so i
think with pre-teens and teens you see
them kind of isolating themselves don't
like i'm not a parent but don't all
preteens and teens isolate themselves i
feel like they all go home lock
themselves in the room listen to music
like leave me alone like that's just
what they do i think mostly that's a
really good point i think mostly it's
about friendships if they're isolating
themselves from their peers who they're
supposed to want the love and support of
the most at that age yeah that's when
you know something's going on that's
important to note yeah yes definitely as
a parent yes i mean that they want to go
and lock themselves in their rooms and
talk to their girlfriends that that's
not really as much of an issue but if
they're locking themselves in their room
not talking to anybody and at school
they're isolating that's a big issue we
oftentimes also see that their grades
start to drop again they lose motivation
for what they used to like doing so they
stop participating in extracurricular
activities and they stopped working in
school and that's another thing to look
for in those uh pre-teen to teenage
ranges
why is it so important to watch this
series
i think it's important because anxiety
is such a big problem and it's a big
problem that a lot of times people don't
talk about or they throw it around very
flippantly like i'm just anxious
well are you serious about that is it
actually impairing your life and if it
is we need to do something about it and
with children because they don't have
that developed vocabulary it can impact
their life in so many significant ways
and yet they can't talk about it and
that's why it's so important as parents
as caring adults to know the signs of
anxiety and to know that it's not
something else sometimes people think
it's adhd so i think people will think
that there's a medical condition it's
not it might be anxiety so make sure you
know the signs and be able to delineate
that for yourself
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