Understand the diagnosis, know what to do next and access resources
Anxiety is a natural part of life. Parents will encounter children working through emotions of fear and anxiety while growing up however when these emotions and concerns become too difficult for a child they may need additional help. The following instances should be considered:
- When the fear or worry are more than temporary
- When the anxiety does not go away
- When the anxiety gets worse over time
- When your child is unable to function doing tasks that are age appropriate
- When the anxiety affects eating, sleeping and other normal functions for a child
We encourage parents to discuss these issues with the child’s physician before seeking out mental health services in order to rule out other conditions. Other conditions may include low blood sugar, certain medications a child may be already taking, thyroid problems, etc. The attending physician can usually make a good recommendation for mental health services that meet your child’s needs.
Parents should also be aware if they are causing the anxiety or if they exacerbate the anxiety. Parent’s should not trivialize or minimize the anxiety of their child. If a child is anxious it is very real to them. Minimizing and trivializing their anxieties, even if you believe they are not real, may create more problems. Be aware of how your behavior as a parent is influencing their anxieties.
Anxiety diagnosis information
There are various anxiety disorders. Some of these include: General Anxiety Disorder, Panic Disorder, Obsessive Complusive Disorder (OCD), Post traumatic stress disorder (PTSD), Phobias and Social Anxiety Disorder. Here we cover anxiety in general. Parents should know that anxiety can coexist with other psychiatric disorders, including, but not limited to major depression, bipolar disorder or substance abuse problems. There are similarities with anxiety and depression. If anxiety exists with other disorders there is a heightened risk of suicidal tendencies and impairment.
- Excessive anxiety and worry, occurring more days than not for at least 6 months, concerning a number of events
- The individual finds it difficult to control the worry
- The anxiety and worry are associated with at least three of the following six symptoms (only one item required in children):
- Restlessness, feeling keyed up or on edge
- Being easily fatigued
- Difficulty concentrating
- Muscle tension
- Sleep disturbance
- The anxiety, worry or physical symptoms cause clinically significant distress or impairment in important areas of functioning
- The disturbance is not due to the physiological effects of a substance or medical condition
- The disturbance is not better explained by another medical disorder
Diagnosis is confirmed. Now what?
Once the Anxiety diagnosis is confirmed you can begin to learn strategies to help your child. Become familiar with the treatment approaches and understand their strengths and weaknesses. Take the time to consider what would work best for your child. Most therapeutic approaches can be adapted and combined to provide your child with various tools to address the issue.
In addition to getting help it is always recommended that parents and children learn additional skills at home to help treatment work more effectively. These include some of the parenting skills and lessons on this website. By implementing them in your home you and your child will be able to move more quickly through the process of treatment and your child will improve.
The most effective treatments
Anxiety is typically treated using either psychotherapy, medication or a combination of both. Parents should work closely with their physician to determine which approach is best. Parents should also advocate for the treatment they feel would best help their child. Physicians have a great deal of knowledge about the techniques but parents are the ultimate authority on their children. By combining both parties in treatment will lead to longer lasting success.
Cognitive Behavioral Therapy (CBT)
In terms of psychotherapy, cognitive behavioral therapy (CBT) tends to be especially useful in the treatment of Anxiety. This approach works by teaching different ways of thinking, behaving and reacting to certain situations. If successful, the result is that the patient is then able to feel less anxious and/or worried. The Smarter Parenting skills and lessons are CBT focused and can help address anxiety issues. A variety of CBT interventions have shown promising results. These approaches vary widely in the type and combination used. Some examples include: self-monitoring, relaxation training, cognitive therapy, worry exposure and the practice of newly learned relaxation and coping skills. A review of the scientific literature showed that nearly half of patients treated with CBT showed a positive clinical response to treatment. Further to that, patients undergoing CBT were more likely to show a reduction in anxiety and depression. So, although CBT is generally accepted as the most effective treatment, there is not consensus on which specific CBT approach is most effective in the treatment of Anxiety.
If medication is used, prescribers typically rely on either anti-anxiety medications or anti-depressants. Anti-anxiety medications are potent, and although they may begin to work immediately, they should not be relied on for long term relief. Anti-depressants may also be helpful in the treatment of Anxiety. Patients who are prescribed these medications should be aware that they can take several weeks to begin working and can lead to side effects such as difficulty sleeping, headache or nausea. Parents should also ask questions about long-term effects of medication on their child and if research has been done on whatever medications they choose to use. Newer medications will not have enough information about long-term side effects. Parents should be informed before making a decision.
Additional support can be found by joining a support group, discussions with a good friend, stress management techniques, meditation, exercise. These can be coupled with therapy and medication in order to help strengthen the overall effectiveness of treatment. Do parent’s anxiety cause their children to have anxiety. This study says yes.
Customizing Decision Making for Anxiety
Use this skill before doing any task or activity that may cause Anxiety for your child and show them options on how to address those feelings. Watch the following video and learn more by visiting the Decision Making (SODAS Method) page.
Tips for parents when using this skill for Anxiety:
- Work on the SODAS assignment together with your child. Even though you are working together, let your child take charge and make the suggestions for options.
- Practicing (role-playing) the chosen option is very important. Start simple and as your child is able to adapt, increase the intensity of the practice to as close to the situation as possible.
- Be patient. If your child struggles too much evaluate if the practice is too intense. If not, the option is not correct. You may have to do SODAS again. Even though it looks good on paper it may not be effective in real life.
- Practice multiple times.
Customizing Preventive Teaching for Anxiety
The most effective thing a parent can do for their child who is struggling with Anxiety is to prepare them for what is to come. Watch the following video and read the tips below on how to customize this skill to address Anxiety.
Tips for parents when using this skill for Anxiety:
- As much as possible, parents can prepare their child for what is to come before it happens. Doing this helps immensely. Parents want to mention the upcoming event before earlier than the event and prepare them by reminding them of what they can do.
- Avoid telling your child what NOT to do. This only encourages them to remember what they should not do. Focus on what they should do instead.
- Decide how early you want to prepare them. Often, telling them too early may actually increase anxiety. As the parent decide on a time frame that will work with your child as you are the expert on their behavior.
There are additional tips, activities and skills accompanied with these lessons to help you and your child improve your relationship and learn these strategies.
The following resources may be helpful
The National Institute of Mental Health has specific information on Generalized Anxiety Disorder, Panic Disorder and Social Anxiety Disorder.
Pamphlet about Generalized Anxiety Disorder covers basic information and treatment options.
PDF of Statistics of Anxiety Disorder in children from the National Institute of Mental Health.
Smarter Parenting blog posts
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