Anxiety is a normal part of children's behavioral and emotional development. Your child may be worried about starting school, learning to kick a ball, or wetting his bed at night. These anxieties are common, even signs that your child's development is on track.
Why is my child so anxious?
As your child moves out into the world around him and takes new risks, he has not only wonderful, exciting experiences but hurtful ones, too. Some of his discoveries involve things that could harm him. His imagination is also becoming more vivid, leading him to concoct scary scenarios. He may worry that you'll forget to pick him up from daycare or that the big dog next door will come over and bite him or that other children will tease him. Increasingly, your child also may react to stresses within the family, unemployment, marital tension, a car accident or even the nightly newscast can trigger feelings of distress, fear and helplessness. Your child may have a nightmare after watching a movie in which a child is in danger, or he may refuse to go to playschool if you're ill. Most children let go of the more fanciful anxieties in time. If your child is reacting to strains in your household, encourage him to talk about it with you and reassure him of your unconditional love.
Are there specific kinds of anxiety that children experience?
Yes, here are some types of anxiety common in children of this age, along with their possible causes.
- Separation anxiety. Although this fear probably peaked at 18 months, it may resurface for occasional stretches of time until well beyond kindergarten, leading to difficult moments when you drop your child at school. He may also get upset when you leave him with a babysitter, or he may call you to come and get him during a sleep-over. Your child's struggle to establish a separate identity naturally gives rise to such moments of trepidation.
- Phobias. Your child is terrified of certain things or situations, such as a neighbour's dog or riding in the car. The fear may have its root in an actual incident, such as being cornered by a dog or seeing a car accident. It's also common for children to have a phobia about one animal in particular, such as snakes or lions, even if they've never seen one; a book or movie may put such an idea into your child's mind and then his imagination seizes upon it.
- Shyness. Your child becomes fearful in new situations, such as joining a play group or starting a gymnastics or music class. If your child is naturally timid, he may feel a great deal of anxiety before trying an activity or going somewhere for the first time. Even if he's normally outgoing, remember that children in this age group are going through so many new experiences that they may sometimes feel the need to withdraw.
- School phobia. Your child refuses to go to school, crying and pleading with you not to make him or throwing tantrums as you depart. He may plead illness, usually with such vague complaints as, "My tummy aches." This may be a manifestation of separation anxiety, or it may arise from a more specific fear, such as that of being bullied or teased. If you reassure your child and give him opportunities to talk about his feelings, he can leave all of these anxieties behind him, with the possible exception of shyness.
How can I tell if my child is overly anxious?
Generally speaking, you should be concerned if your child's fears or constant worrying begin to hamper his ability to participate in preschool, family, or social activities. Pay attention, too, if you reassure your child repeatedly yet his fears don't seem to dissipate.
When should I get help for my child's anxiety?
You should seek help from your general practitioner if your child's anxiety is:
- Interfering with family life
- Preventing him from making friends
- Becoming an excuse for him to stay home from daycare or school
- Disrupting his sleep habits
- Resulting in compulsive behavior, such as repeatedly washing his hands, counting, or checking again and again to see if his teddy bear is still on his bed
Children with severe anxiety may also worry about upcoming events or fret constantly about school, friends, or participation in sports.
Your general practitioner will examine your child to see if an underlying physical problem such as poor hearing or vision could be making him anxious. The doctor may refer you to a family counselor or child psychiatrist, who can look for a behavioral, emotional, or learning disorder. If necessary, your general practitioner or the child psychiatrist may prescribe medication to calm your child and ease any compulsive behavior.
What can I do?
When your child becomes anxious or fearful, follow your instincts: Cuddle and reassure him. But don't stop there. Overcoming anxiety takes imagination -- yours and his. These tips can help:
- Acknowledge the fear. Some of your child's worries are entirely normal and denying them would be denying reality. If he's afraid of losing you, for example, tell him that this idea scares you as much as it does him and that's why you watch him so closely. Remind him that when you drop him off at the babysitter's, you always pick him up again. And assure him that you look after your own safety, too.
- Talk it out. Simply discussing a fear can usually take it down a notch or two -- even bring out its humorous side. Your child may start to giggle as he relates the plot of his latest nightmare about the one-legged giant with the orange nose. Listening to your child talk can also give you the details you need to banish a specific fear. You might discover that his dread of the water is really a fear of great white sharks, which, you can explain, don't live in swimming pools.
- Write or act it out. A 5- or 6-year-old child may be able to write down his fears in a journal, which can do wonders to dissipate them. Children can also incorporate their fears into their imagination games; if your child is afraid of pirates, he can work it out through an imaginary battle.
- Practice separation. Teach your child how to leave you -- willingly -- through a little role-playing. Set a kitchen timer for one minute and go out of the room while your child stays behind with the "ticktock clock." When the bell rings, come back. Or you can stay in the room and he can leave. As he becomes more comfortable, increase the time you're apart. This peek-a-boo exercise develops an understanding of sequence, so that he'll know what to expect when you say, "I'm going now, and I'll see you later."
- Don't demand toughness. Your child already is tough, in ways you may not appreciate. For example, how many times a day does he pick himself up after falling down? Some parents believe they need to discourage "clinginess," not realizing that its more important at this age to build up childrens' confidence and self-esteem. Forcing your child to swim when he doesn't want to or pet a dog that's twice his size will only make him fear you and doubt himself. Let him conquer his worries at his own pace.
- Create a comfort zone. Suppose your child is irrationally afraid of the neighbor's dog and won't go near the fence that separates his garden from yours. Tell your child that you're going to play a game, and you'll be "home base." Ask him to take a few steps toward the fence and then run back to "base" -- where you can hug him. Do this several times, adding a step or two if he's willing. Over time, work with your child to expand this zone of comfort and his sense of independence.
- Ease nighttime fears. Your child may worry that monsters are hiding in the closet or bad dreams are waiting under the bed. Reassure him, and make his room as inviting and comfortable as possible. You might even post a funny sign on the closet that says, "No monsters allowed." Get him a cheerful night-light so he won't feel disoriented if he wakes in the middle of the night. Establish a bedtime routine and stick to it, making sure he has enough time for a bath, a story and some quiet moments before the lights go out. Avoid arguments and battles before bed, so he goes to sleep feeling calm. And don't let him watch TV at bedtime. While it may appear to lull him, it can have the opposite effect; unexpectedly disturbing images may stir up anxiety when he tries to fall asleep.
- If your child wakes from a nightmare, tell him that it was a dream and not something real, then stay with him until he's relaxed enough to get back to sleep. If your child has a recurring bad dream, talk with him about it, preferably during the day when he won't find it as frightening. What is the dream about? Is there something he can do in his dream to help himself? For example, a child who dreams about being chased by a scary person might "get" a dog, who can then chase the person away. If your child believes that the bad guy who's coming to get him can fly, walk through walls, and do other things that defy your child's abilities to protect himself, you can use his magical thinking to your advantage: As you wave a magic wand or spray him with a magic potion (water in a spritz bottle will do), tell him he's now shielded from harm.
- Prepare for new situations. If your child has a shy attack as you head out to join a party or group activity, talk to him beforehand about where you're going. Mention that some new people will be there and that the location itself may be new to him. Ask how that makes him feel - shy, sad, fearful? Is there is anything you can bring along, such as a favourite stuffed animal or toy, to keep him company? Also talk to your child about what he might need and how you will take care of it. Is he anxious about finding the toilet in a strange house? Is he worried about being teased by bigger children? Try to get him to express his fears. Finally, once you get where you're going, give your child some time to adjust, even if that means you spend the first half of the party watching from the sidelines.
- Lower the stress level. At this age, your child may be simultaneously dealing with several developmental challenges, such as trying not to suck his thumb or wet his bed or cry out for you when he goes to sleep. Bring down the stress level by spending a little more time with him, easing up on a few of your expectations, and giving your own worries a rest.
American Academy of Child and Adolescent Psychiatry. Facts for Families: The Anxious Child. http://aacap.org/cs/root/facts_for_families/the_anxious_child
American Academy of Child and Adolescent Psychiatry. Facts for Families: Children Who Won't Go to School (Separation Anxiety). http://aacap.org/cs/root/facts_for_families/children_who_wont_go_to_school_separation_anxiety
Nemours Foundation, KidsHealth. Anxiety, Fears, and Phobias. http://kidshealth.org/parent/emotions/feelings/anxiety.html