May 9, 2024 | Page 4 of 4 | Child Anxiety Support

When should I be concerned about my anxious child?

The research shows that the family system needs to shift in order for your child's anxiety to shift.

Dawn Friedman MSEd

This is an interesting question because generally people don’t ask it unless they’re already concerned and they’re wondering if they’re overreacting, which obviously points to some anxiety on the part of the parent.

I do sometimes hear from parents who are concerned about their child’s anxiety and then a thorough assessment shows that their child doesn’t have anxiety or at least not clinical levels of anxiety. Because of course we all have anxiety or at least we should, because anxiety is part of being a healthy functioning, human.

Think about it, it’s normal to get anxious before a big exam or before a big presentation or before you’re going to run your first 5k or before your first date with someone new. Anxiety is just part of life.

Clinical anxiety is when that anxiety is interfering with life. So if you’re throwing up before a big exam, or if you’re having panic attacks before your big presentation.

Or if you want to run a 5k, but you never sign up because you’re so sure you’re going to fail.

Or if you want to go out on dates and you never do because you’re too nervous.

Now those would be clinical levels. But back to that worried parent who is maybe worried even though their child isn’t showing clinical levels. Well, I think that worry needs attention too. And again, it’s not uncommon.

Let me break this question down a little more. Instead of asking when you should be concerned, let’s change it to two different questions.

The first would be when should I get help for my anxious child? And the second would be, what do I need to do to take care of my own concern, unrelated to whether or not the child meets clinical levels?

So the first question, when should I get help for my anxious child, that down and dirty answer is if your child is stuck or you are stuck.

If their anxiety is limiting their life or your life, then it’s time to get help. If they’re missing out on social or educational opportunities; if they seem unhappy or frustrated with themselves; if their self esteem is tanking because of what they can’t do then it’s time to get help.

And if you are missing out on social or educational or work opportunities; if you can’t go have coffee with friends because your child melts down; or if you are having to miss work because the school is calling about your child’s anxiety; or if you are just so nervous about them that you’re losing sleep then it’s time to get help.

But what if your child is managing pretty well and you’re still worried about them? What if they’re able to do the things, all those things I listed, but you see them struggle and the struggle is upsetting to you or scares you?

Well, then we’re talking about your anxiety and it’s time to get help.

One of the things that we know about anxiety is that anxiety occurs when people have a more negative outlook or look at a neutral situation and interpret it in negative ways and sometimes this is happening with parents. So again, they’ll tell me that they’re concerned about their child’s anxiety and we do an assessment and the child is not actually anxious.

But it’s clear that the parent is experiencing them as anxious because the parent has anxiety. So they’re reporting things more negatively.

When we look at the child from an objective clinical point of view, we see the kid’s functioning is fine, but they are struggling because to struggle is part of being human.

The child might be anxious before they have to speak in front of the class and they maybe get a tummy ache and they’re worried about it and they fret a little bit but they’re able to do it. However the parent is seeing them fret and struggle and it’s upsetting the parent and that’s the parent’s anxiety. That doesn’t mean it’s not real because of course it’s real it’s just real for the parent and that deserves attention

Happily anxiety treatment is a family affair. So if you’re concerned it makes sense that you should get help. As I’ve said in previous posts, research shows that when you get help, it will help your child. So I’d say the first step is for you to get help and then in the context of you getting help, you can start to figure out if your child needs their own individualized support.

I’ll talk about finding a counselor for your child in a future post. But let’s focus on what you getting help can mean for your family.

This is the wonderful thing about a parent getting help for their child’s anxiety: Your child is part of the family system. The research shows that the family system needs to shift in order for your child’s anxiety to shift. The shifts we recommend in anxiety treatment really come down to helpful boundaries that support instead of accommodate anxiety. I know in order to set up and hold those boundaries parents need to work on their own coping skills because setting boundaries with anyone — let alone our kids — is hard. At first we’re sure to feel anxious about it but feeling anxious is how we overcome anxiety.

I’m simplifying things a lot here, but I hope you catch my drift. When the parent changes, the family system changes. And when the family system changes, the other family members change. It’s just how it works. In short, if the child’s anxiety is an issue the parent getting help will help. And if the child’s anxiety is not an issue, if it’s the parent’s anxiety, that is an issue the parent getting help will help. Which is all to say, when should you be concerned about your child’s anxiety? The answer is when you’re concerned. Then it’s a concern.

It’s either a clinical level of concern for your child, or it’s a concern for you because if you’re worried that worried, deserves attention.

I think it’s really important that we acknowledge that when it comes to family systems, that parents are part of the system, the child is part of the system. And any time we introduce more supports and information and interventions into one part of the family system, the whole system shifts.

You are the most powerful person in the system (although I know sometimes when we’re dealing with child anxiety, we can feel pretty powerless) and you’ve got the power to shift things in your family. You just need the information. So you know how to shift things and the support so that you’re able to shift things and I promise you that things will change.

Have a question?

When should I be concerned about my anxious child? Read More »

How can I make my anxious child feel heard and understood?

Podcast

Now the tricky part is trusting the hard work we’ve done and in the resiliency of the relationship. What I’m saying here is that we need to be prepared to disappoint and even anger our kids.

Dawn Friedman MSEd

This week’s question comes from Facebook.

“How can I make my anxious child feel heard and understood when she feels anxious about going to schooL. I know that skipping school will actually increase the anxiety AND Exposure to school lessons it but it kills me to nudge her to go when it’s so scary for her.”`

I really appreciate that what we have here is a parent who understands that helping anxious kids means helping them face their fears, which is NOT easy.

I’ve talked in previous episodes about the difficulty in shifting things in the moment when the child is actively afraid. In those moments we’re helping them cope with that feeling so they will learn that this feeling — as terrible as it is — won’t kill them and it will get better. So much of that work is done when they are NOT anxious. We exercise those coping tools, those calm down tools, when we don’t need them so we have access to them when we do need them.

It’s the same with feeling heard and understood. We help our children feel that way by practicing respectful, thoughtful, compassionate parenting throughout the rest of our days together. We don’t have to do this perfectly, of course, we just need to do it.

When you ask your child how their day was and really listen, you’re helping them feel heard and understood.

When you remember to get them the kind of squeezie yogurt they like for lunch, you’re helping them feel heard and understood.

In our everyday parenting we are establishing a relationship where heard and understood is a given. It’s just part of the day to day give and take of being with them.

Now the tricky part is trusting the hard work we’ve done and in the resiliency of the relationship. What I’m saying here is that we need to be prepared to disappoint and even anger our kids.

This is extremely important with anxiety work because our children are tuning into us to get a better picture of what’s safe and what isn’t safe and — importantly — what they’re capable of doing.

Here’s a story to illustrate this. It’s a version of something I’ve seen in my clinical practice.

A parent is driving their child to a birthday party. The parent knows that the child is nervous about going because they only know the birthday kid; they don’t know anyone else there. The family has talked about it and the child wants to attend and has been gearing themselves up for it. Perhaps this is what we were working on in therapy, making plans to deal with the discomfort, figuring out how to get out of the car and walk into the party in spite of their fear.

Anyway, the parent pulls up to the venue with the child and the child is sitting there taking deep breaths, preparing to go in. Then the parent says, “Do you want me to walk you up there?”

Boom! Child melts down. Why? Because without intending to, the parent has just undermined the child. They meant to convey support but the child heard, “I don’t think you can do this.”

It feels sometimes like we can’t win for losing with the anxious child. They want our help but they may also resent our help. That’s just how it is. We help too much and they don’t feel capable. We don’t help and they’re angry that we’re leaving them alone. So let’s give up on the idea that we can parent an anxious child without bumps and bruises to the relationship.

When we do push them to face their fears, we are saying, “You can do this.” Our children may not like to hear it but they need to hear it. And we need to have faith in them before they are able to have faith in themselves. We are the training wheels on their facing anxiety bicycle.

That doesn’t mean that kids like the nudging; Anxious children like the accommodations because they think they need them. The child’s goal is to avoid the things that make them anxious and accommodations allow them to do that. When we remove the accommodations they aren’t going to like it. They may feel like we’re not hearing them and we’re not understanding them. They may feel that if we WERE hearing and understanding, we would be accommodating. They may even feel betrayed in that moment.

But we don’t stop accommodating out of the blue. We don’t just launch our children into an exposure without talking to them first. There is a process and a preparation for it. We create a plan not just how we’re going to move forward but how we’re going to come back together afterwards.

The reason accommodations happen are complicated but generally we may believe our children can’t handle what’s making them anxious without our help or we’re concerned about the damage to the relationship since most anxious kids are pretty free about telling us the many ways they’re disappointed in us when we stop accommodating. They may say things like, “You don’t care, you don’t love me.” Right? That’s hard to hear and it can be scary to hear. Are we doing real damage to the relationship?

I wanted to talk a little about rupture, which is what we’re really describing here. Rupture is what the literature calls the inevitable conflicts between parent and child.

Rupture is inevitable and it is also necessary. Ruptures in the parent-child relationship are more frequent in times of tremendous growth on the part of the child, which is to say sparring with your toddler is built into your child’s developmental trajectory. You can expect more ruptures whenever your child is growing in complex ways so adolescence or when you’re working on helping your child overcome their anxiety.

The flip side of rupture is repair. Rupture is when the relationship is torn or damaged in some way and repair is how we come back from that. Every close and meaningful relationship will have rupture as disagreements and conflicts are simply part of intimacy. In the paper Repairing the bond in important relationships published in The American Journal of Psychiatry, the author writes ‘Growth is facilitated when a strong affective bond is established with an important other and the inevitable disruptions of this bond are repaired’

Did you hear that first part? Growth is facilitated. What this means is that ruptures are not bad; they are neutral and part of parenting. Repair happens before the rupture in the ways that we establish a base of respect, compassion, empathy and presence and it happens after the rupture, too, in the way we process the conflict.

Back to the original question. Let’s reread it. “How can I make my anxious child feel heard and understood when she feels anxious about going to schooL. I know that skipping school will actually increase the anxiety AND Exposure to school lessons it but it kills me to nudge her to go when it’s so scary for her.”

I feel like what the questioner is yearning for is a way to avoid rupture or to repair in the midst of rupture. Instead let’s shift our goal to creating a culture of repair that can tolerate the inevitable ruptures. Let’s shift our thinking so that we see ruptures as necessary catalysts for growth and know that our relationship with our child can and will withstand the strain and can even grow stronger through it.

Have a question?

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Can children have panic attacks?

Podcast

Intervening early is always a good idea when it comes to kids. They don’t need a full blow anxiety diagnosis to benefit from the skill building that comes with recognizing their worries and helping them shift their thinking in ways that empower them to face those fears.

Dawn Friedman MSEd

Can children have panic attacks? Short answer YES.

But first let’s define panic attacks.

Diagnostic Criteria for a panic attack per the DSM-V requires that the person experience at least four of the following symptoms:

recurrent heart palpitations or increased heart rate;
sweating;
trembling;
shortness of breath;
chest pain;
feeling as if their choking;
nausea or stomachache;
dizziness;
chills or feeling hot;
numbness or tingling;
derealization or depersonalization (feelings of unreality, feeling outside of oneself);
fear of “going crazy” or losing control;
fear of dying.

Understandably panic attacks can add to anxiety, meaning they can become an anxious event unto themselves. For example, a child with a social anxiety disorder who then has a panic attack at a social event, may now worry about having a panic attack along with their worry about the social event. Panic attacks complicate matters for sure.

That said sometimes panic attacks can seem to come out of the blue and not have a connected or predictable trigger. Sometimes they just happen and for many children and adults, those are scariest of all. For one, it really can feel like you’re going crazy. It’s one thing to have a panic attack because an angry dog leaps out at you barking but it’s entirely different to have one for no discernible reason at all.

There is some discussion about panic attacks and children arguing that they are very uncommon in young children. Some experts argue that children cannot be diagnosed with panic disorder. The DSM itself reports that they rarely occur in children under 14. I’d say that doesn’t reflect my observation. I hear reports of panic attacks in younger children often enough that I think they may have been previously under reported.

I recently read some research about that and there was an argument made — an argument I agree with by the way — that children may be experiencing panic attacks and just not have the language to describe them. They may know that their tummy hurts but they may not have words to describe feeling shaky or sweaty. They are very unlikely to be able to describe feelings of depersonalization or derealization. And then there’s a whole argument about what a child is capable of developmentally. In other words, if a child is too young to have a strong sense of self, are they capable of experiencing depersonalization? Can a preschooler who is still learning the difference between fantasy and reality experience derealization?

My guess is that a panic attack in a very young child may look like a meltdown. It may look like fear. And isn’t that ultimately what a panic attack is? Would we view a panic attack differently if we thought of it as a fear attack?

That said, generally panic attacks in children and adolescents are less likely to be related to panic disorder — panic attacks that come out of the blue, seemingly unrelated to another anxiety diagnosis — but they do exist in kids.

Children who describe more somatic symptoms — those tummy aches, headaches, dizziness, etc. that we talked about at the beginning of this episode — seem to be at higher risk to develop full blown panic attacks. This may have something to do with perceived sensitivity to bodily changes.

What this means is that a child who is highly sensitive to feeling heart palpitations, or noticing sweatiness may be more likely to interpret that as rising anxiety. This may also explain why there is a strong genetic component to panic disorder, speaking to brain differences. Also — and this certainly makes a lot of sense — asthma is associated with panic disorder not just that children with asthma are more likely to experience panic attacks but children with a family history of asthma are, too. Again, this might be traced to a family sensitivity to subtle differences in breathing.

This leads me to something interesting that I read in the DSM under their discussion of cultural issues related to diagnosing panic disorder. There is a Vietnamese concept of “hit by the wind,” which describes having a panic attack after walking out into the wind and having it take your breath away. I’ve had so many parents tell me that their children get anxious or meltdown on windy days. They perhaps also feel “hit by the wind.”

Children who report panic symptoms are also more likely to have separation anxiety. There’s been some research that shows that parents who have a panic disorder or who have panic attacks are more likely to have children with separation anxiety disorder. What’s the connection there? Well, we don’t know but I think it points to a need to acknowledge that anxiety disorders are complicated and that it makes sense to consider the presentation and the needs of the entire family.

Treatment for panic attacks is the same as treatment for other forms of anxiety, which is cognitive behavioral therapy and sometimes medication. The particulars for that treatment will depend on the presentation and age of the child or teen. But in general we work on helping the child to calm their body and increase their distress tolerance and limit their avoidance of the things that scare them.

This discussion we’re having today about panic attacks, panic disorder and diagnosis I think is useful because it helps us see the limits of our understanding of individual experiences. We can’t climb inside a 6-year old’s brain to see what they’re experiencing and their ability to tell us is limited. Looking at the criteria can help us know what questions to ask, what diagnosis to consider, and how to case conceptualize in order to create the most effective intervention. But people — including children — are complicated and rarely fit neatly into any prescribed categories. I think it makes the most sense to look at the research but always be open to tweaking what we know if the individual in front of us is a little bit outside of the guidelines. So if a child is telling us that they have three symptoms of a panic attack, why refuse to label what’s happening to them if acknowledge their feelings of fear and their bodily sensations with the words “panic attack” will help us help them.

Intervening early is always a good idea when it comes to kids. They don’t need a full blow anxiety diagnosis to benefit from the skill building that comes with recognizing their worries and helping them shift their thinking in ways that empower them to face those fears.

Have a question?

Can children have panic attacks? Read More »

Should I homeschool my child because of their social anxiety?

Podcast

Pulling a child who is socially anxious out of school or letting them stay home because they’re afraid to be away from us may make them feel better in the short term but we need to consider how that’s going to benefit them in the long term.

Dawn Friedman MSEd

The question this week is a big one and it’s specific. Should I homeschool my child because of their social anxiety? I have also heard this question as should I homeschool my child because of their separation anxiety and these are the same question. Separation anxiety in young children if left untreated tends to turn into social anxiety in older children and teens. In either case, my answer is going to be the same.

Before I give you my answer, I want you to know that that my husband and I homeschooled both our kids. Our son, who is now an adult, went all the way through as a homeschooler until graduation. And our daughter, who is going to graduate this spring, decided to drop into school starting in 7th grade. In other words, I am a fan of homeschooling. We loved homeschooling and I know that it can be a great fit for some families.

That said, people should homeschool because they want to homeschool. If you want to homeschool your kids, go for it! But if you are considering it because your child is struggling in school and you’re feeling trapped, then let’s stop a minute and consider your situation.

If you are thinking about homeschooling because your child is struggling with social anxiety or separation anxiety let me tell you that homeschooling is NOT going to cure that. In fact, it might make it worse. At least you’re going to have to plan ways for them to confront their social anxiety and separate from you in other ways.

Anxiety drives avoidance and anxiety disorders are diagnosed when the avoidance gets so bad that the child is missing out or struggling to function. A child who is homeschooling to avoid social interaction or separating from caregivers is by definition suffering from an anxiety disorder. That that anxiety disorder is not going to get better unless the family is committed to creating ways for that child to get social and separate.

Our goal as parents needs to be to push for our children’s lives to get bigger and more expansive as they grow. We want them to become more independent and better able to function without our help. Our decision making needs to remember that. It’s not just about coping in the here and now. Pulling a child who is socially anxious out of school or letting them stay home because they’re afraid to be away from us may make them feel better in the short term but we need to consider how that’s going to benefit them in the long term.

Again, I’m a big fan of homeschooling and if a family decides it will be easier to handle the anxiety by homeschooling and creating different kinds of opportunities then that’s fine. But if the plan is that the child will come home and not have to deal with peers, or friends, or other adults then that’s not going to serve them well. I have met families who have decided to homeschool temporarily, hoping their child will grow out of their anxiety, but without a plan to confront the anxiety, this doesn’t work. And in fact, the anxiety gets worse or starts showing up in other areas of their lives.

If the anxiety is severe enough that you are thinking about homeschooling, then I encourage you to reach out to a therapist. You’ll want a therapist who understands the value of homeschooling and isn’t going to just knee-jerk tell you it’s bad for a kid because that’s not necessarily true. But you also need one who can help you figure out if what you’re offering is an accommodation or a support. An accommodation is something that sinks your children more deeply in their anxiety and a support is something that’s meant to help them grow out of it. But it’s not always easy to tell the difference especially when we’re in it with our kids. Oftentimes we need an outsider who understands anxiety and anxiety treatment to help us come up with ways to lift the child out of their anxiety.

The right therapist can also help you figure out whether or not your child’s anxiety is caused by a poor fit educational environment that can be changed in ways to make it more appropriate for your child. Anxiety often shows up with other diagnoses like ADHD, learning disabilities, giftedness and autism spectrum disorders. Those things need to be appropriately diagnosed and addressed. If they’re not then of course that’s not going to be a good environment for your child and we shouldn’t be surprised if the result is school refusal.

If you are in the United States, and your child has a formal anxiety diagnosis or one of these other diagnoses then they may be eligible for a 504 plan or IEP or individualized education plan. 504s are a plan for how schools will support children with a diagnosed disability. IEPs focus on special education so, for example, a pull-out program or an aid. How these might look depend on the needs of the child and the policies of the school district. Getting an IEP or 504 can be challenging and if that’s something you’re interested in exploring, I encourage you to reach out to your child’s school counselor and again a therapist may be able to help you navigate that. Although most likely you will need a thorough assessment by a neuropsychologist. Sometimes masters level counselors or social workers are trained to do this work but most often it’s a doctoral level psychologist.

I’ll be doing a future episode about working with your child’s school that will go into this in more detail. But for now I want you to know that there may be options that can keep your child in school even if they have a social anxiety disorder, separation anxiety disorder or school refusal.

But back to homeschooling. it may be that the anxiety is not the primary issue or not the only issue that’s leading you to consider home education, which may mean it is the right choice for your family. Maybe the issue is not avoidance but creating a better experience for your child. That’s certainly possible. It may be that your school options just aren’t a good fit for other reasons. You may not like the culture of the school, or want to travel during the school year, or feel that your child would be better served with a different kind of educational experience. Those things might be what is bringing you to homeschooling and your child’s anxiety may just be part of it.

In that case I encourage you to consider what your child might need in order to support them in learning to manage and grow through their anxiety.

Remember anxiety is about avoidance so anxiety treatment is about confrontation. That doesn’t mean you’re going to take your socially anxious child and enroll them in toastmasters, the program for public speaking. But you do need to look for social opportunities and opportunities for them to separate from you and learn to be around other people.

Fortunately many communities have options and resources for homeschooling families. Rec centers and libraries may offer classes. There are group tutoring programs. Churches, mosques and synagogues have activities for young children and teens. Or you might look for a social skills group through an occupational therapist or counseling practice. You can also look locally for homeschool co-ops. Connecting with local homeschool families on Facebook or on other social media may help you find these resources. Also programs like 4H, Girl Scouts, or Junior Achievement may be open to homeschool students.

Homeschooling is a lot of work for parents and while it can be a wonderful gift for kids, there may be other more appropriate answers for the children who’s struggling to stay in school because of anxiety.

I welcome your thoughts and questions on this topic. Reach out if you have something to share or something to ask! See you next week!

Have a question?

Should I homeschool my child because of their social anxiety? Read More »

How do I help my anxious child?

Podcast

If you're parenting an anxious child, I'm sure you've already been subjected to the advice that is rarely asked for rarely helpful. And often critical and leaves you feeling worse.

Dawn Friedman MSEd

This is a version of a question I get in so many different forms. Sometimes it’s about a specific age, like how do I help my four year old? Or how do I help my 14 year old?

Sometimes it’s about a specific symptom like how do I help my child who gets anxious stomach aches? And sometimes it’s about a specific diagnosis like how do I help my teen who has social anxiety?

Those all might make future posts, but for this one we’re going to stick with the bare bones question, which is how can I help my anxious child.

Because no matter how your child is experiencing the anxiety or how you’re experiencing your anxious child there are a couple things that you can do across the board.

The first thing you can do is something you’re already doing by reading here and that’s to get educated about anxiety.

The more you learn about anxiety, the better you can understand your child’s experience and your own experience, too. So listen, you’re amazing. Thank you for doing that. Getting educated about anxiety will help you make better decisions for your child and better decisions for yourself. That’s great.

Now the other thing you can do is to start putting together your village. You know that “it takes a village to raise a child” motto? Yes, absolutely and every parent needs a village. But the parent of a child who has special needs — like a child who has anxiety — well, we need a special village.

This might include grandparents and other loved ones; friends you made at the park; or other parents at the daycare center. It might include your childcare provider or your child or teen’s teacher, or coach.

And I really hope it does. I really hope that those people are there for you and your child. But sometimes it doesn’t include those people.

Anxious kids are harder to parent. Anxious kids either act out with meltdowns and arguments and big behavior, or they act in with depression and perfectionism and stomach aches and headachesAnd of course some anxious kids do both. Big loud, difficult behaviors and dark, scary thoughts and feelings.

Not everyone understands this. If you’re parenting an anxious child, I’m sure you’ve already been subjected to the advice that is rarely asked for and rarely helpful yet is often critical and leaves you feeling worse. I can’t tell you the number of parents who have reached out to me after being knocked around a bunch, being sent to parenting classes that don’t address what their child’s issues really are, being told, “It’s a discipline issue” and being handed behavioral charts. Or told to read certain books that don’t really seem to make any sense for what they’re going through.

If you’ve ever had to drag your sobbing child out of an event or had to cancel at the last minute because they won’t let you leave or admitted to being exhausted because your 12 year old won’t sleep alone, then I’m sure you know how it feels to be judged or criticized by the people you turn to for support.

If this has happened to you, I am truly sorry. Please know that those people may be your friends and they may be your family, but they are not your village. Your village is the people who will hold you up and cheer you on. So if people can’t do that, they’re not your village.

Having a child whose needs are different means you might have to look harder for that support system. For one thing, you might have some practical barriers. You might not get to chat with other parents very often because your child refuses to go places or refuses to leave you once you get there. Look around at the playground and the moms who are standing on the edges, trying to negotiate with their little kids, they’re not getting to talk to friends and connect.

Or your child may be so quiet and well-behaved at school that their teachers don’t even know who they are let alone that they’re having meltdowns when they get home over homework.

Grandparents and other relatives might see your struggles but decide to tell you that it’s all your fault. And of course it’s NOT all your fault.

If you spend time with people who make you feel bad then those are the wrong people and we need to find you the right people.

So, where do you find them? You can start asking around. If you’re a member of a neighborhood Facebook group or a mom’s day out group, or you volunteer with the PTA then instead of asking about behaviors, ask about anxiety.

Anxiety is incredibly common, but we don’t always talk about it. According to the Anxiety and Depression Association of America, anxiety disorders impact 25% of children between the ages of 13 and 18. Twenty-five percent! Now that doesn’t mean that every child who meets criteria is going to get diagnosed (because there are lots of barriers to getting diagnosed, which I’ll probably talk about in another post).

But if you start speaking to parents about anxiety, with a goal to find your people, you can find them.

One reason you need to do this, and this is probably obvious, is that going it alone is hard and emotional. Having friendships that support you is just hugely important. But there’s another reason too, which is that parents are the best resource for other parents.

If you need to know who sells the underwear that are most comfy to sensory sensitive kids ask another parent. (And by then way I hear it’s Hanna Andersson). If you want to know which therapist has a special gift working with teens struggling with social anxiety, ask another parent.

That’s going to be a lot more useful than browsing Psychology Today listings.

Parents who have been there and done that parents who are a little further down the road. Parents who make it a hobby of over researching can make your life a whole lot easier. And if you are the parent who has been there and done that, if you were the parent a little further down the road, or if you’re the parent whose hobby is over researching then getting to be the expert for a parent who needs your help can make a real difference in your self-confidence.

We all do better when we don’t have to go it alone. As a therapist, I’ve worked with a lot of anxious children and it’s their parents who inspired me to build Child Anxiety Support.

Over and over again, those parents would tell me, “I just feel so alone. I feel like the only one. I feel like a bad parent.”

I built this program so that parents who are struggling can find each other. I wanted them to be able to come to a safe, private space and be able to talk about the challenges and know they are with people who get it. And who aren’t going to judge and aren’t going to criticize but are going to hold each other up.

I wanted a place where parents could brainstorm and come up with solutions that make sense for their families, but without feeling pressured to do any particular thing, any particular way.

The membership is an unasked-for-advice-free zone. I’m explicit about this because every parent — whether they have an anxious child or not — should be able to vent without getting an avalanche of well-intended, but unasked for advice.

But at the same time, I wanted a space where parents could do more than just commiserate. I wanted there to be a culture of growth and change and progress. I wanted parents to be able to learn about anxiety, how to manage it, how to help their children face their fears and grow through it. I wanted them to be able to help each other as they moved to a better place but also to still be able to complain, cry, laugh, and to share.

If you are feeling alone in the big work of parenting a child or teen with anxiety I hope you will come and check the site out

Have a question?

How do I help my anxious child? Read More »

How do I calm down my anxious child?

Podcast

Let me right here right now say that if your child's anxiety is out of control, this is not because you have somehow failed to calm them down.

Dawn Friedman MSEd

This week’s question is how do you calm down an anxious child? Actually, it was much more specific. So I’m going to read the whole thing. “How can I help my anxious child calm down when they get upset? I remind them to practice their breathing tools and mindfulness and try to reason with them. But instead things escalate, they insist that only getting rid of the perceived source of anxiety will help.”

With this question we’re starting with the assumption that we should calm down an anxious child, which is not always true. That’s not always our job, but we’ll get to that in a bit. There’s also another assumption, which is that we have the ability to calm down an anxious child, which is absolutely not true, or at least not always true.

Sometimes we know just the right thing to say or do, and sometimes we don’t. Sometimes our child or teen is just going to spiral beyond where we can help them. Let me right here right now, say that if your child’s anxiety is out of control, This is not because you have somehow failed to calm them down.

So let’s reconsider the question. First hat’s off to this parent for teaching their child coping tools. Because that’s certainly part of what we need to do as parents. We can’t make them use them, but we can teach them those tools and encourage them to use them. We can create a family climate where people are practicing calm, and it is a practice.

Meaning we need to be doing it on the regular and not just when it’s needed. Remember last week, we talked about ways to model anxiety, but we can also model calm that’s in our control. We can choose to learn those things and to model those things and to overtly teach those things. Calm shouldn’t be a separate event that happens only when people are anxious.

Calm needs to be built into the everyday functioning of our families. So when you’re sitting with a cup of tea, listening to your favorite podcast, that’s you modeling calm. Good for you.

Or when you say, “Listen I had a bad day at work so I’m going to need to go for a walk.” That’s you modeling calm. Fantastic.

Or when you’re having a conflict with your child and you stop and take a deep breath, there you are modeling calm like a boss again.

(As an aside, one of the arms of my Child Anxiety Support membership is CBT family, which is a collection of ideas, resources, and activities to bring those cognitive behavioral tools to your family. So I encourage you to check that out if you’re interested.)

Okay. Back to the question. So this parent is already doing the most important thing, which is empowering their child.

The other piece of this question is the part that says, and I quote, “They insist that only getting rid of the perceived source of anxiety will help.” Yes, absolutely. And this is what we mean when we talk about accommodations.

Think about it. If there’s a tornado coming, you want to get away from it. You run down to the basement and you hole up. That’s how healthy anxiety is supposed to work. It’s supposed to protect us from danger.

Unfortunately, if we are sensitive and prone to see danger when there is no danger then that appropriate want to get away from danger isn’t inappropriate. It’s not working for us and we need to learn how to tolerate feeling like we’re in danger so that we can assess the situation and make a more accurate decision.

The way we learn to live with anxiety is twofold. One, we learn how to tolerate it long enough to acclimate to it. Two, we learn how to tolerate it long enough to acclimate to it so we can think our way through it. Basically, we need to hang in there long enough to get out of our survival brain that’s got us in fight flight or freeze so that we can access our higher order thinking brain.

A child who is prone to anxiety will probably always be someone who is sensitive to the idea of danger, but they will get better and better at accessing their higher order brain so that when they’re feeling scared, they can think, is this a tornado? Or am I just worried about tomorrow’s work presentation?

Of course, this sounds a lot easier than it is. When your child is in fight flight or freeze, that’s just where they are. And they’re expecting us as their parents, their protectors, to protect them. I want you to know, and to remember that you are protecting them, okay? They are safe. They don’t feel safe, but they are safe. You may need to tell yourself that and to sit on your hands. So you don’t react.

When we take action we’re telling them that they’re right to be afraid because we’re matching their level of urgency.

I encourage you to remember that your presence, your literal presence, if you’re able to tolerate enough to stay in the room with them. Or your figurative presence– because you have been a loving, supportive parent all of their lives– is a help. You are helping. Doing nothing is helping even if they don’t think so.

If you can stay calm, then you are helping by raising the level of calm in the room. If you are able to practice your own CBT tools, then you were helping by modeling practicing CBT tools. Please remember that. In other words, you don’t always need to do more; doing more when kids are already agitated can add to the agitation or prolong it.

Again, doing nothing can be a help.

I’m going to add here that sometimes in my therapy practice when I feel the urgency of my anxious clients and they want me to do something, fix their pain or worry, I picture a big sign behind them that says, “Don’t just sit there, do nothing!” as a reminder that being present and calm is my job in the moment.

You can tell that doing nothing is doing something because it’s so hard, it’s work. Right?

Now there are nuances in the answer to this question, depending on your child’s age, what’s upsetting them and what you’re trying to do, like if you’re trying to get out the door and you’ve got a timeline that you’re stuck with.

But right now for this episode, I really want to give you a new way of looking at support. Next time your child is flipping out and you feel the urge to calm them. Take a step back, even if it’s just for a few seconds and remember that sometimes the only way out is through and learning to tolerate the distress of anxiety is a skill that our anxious kids need to learn and that we need to learn. We also need to learn to tolerate the distress of their anxiety.

Let me know your thoughts!

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How do I calm down my anxious child? Read More »

Does an anxious parent make an anxious child?

Podcast

I think when parents are asking this question, what they’re really asking is is it all my fault? My answer is no, it’s certainly not all your fault.

Dawn Friedman MSEd

Hi, everyone. Thanks for tuning in. This week’s question is one I get asked a lot, probably more than any other question. Does an anxious parent make an anxious child? Short answer. No. Twin studies show us that you can take two children who are the same age, who are growing up in the same family, and who are having more or less the same experience and one may have anxiety and the other won’t.

This is because you can’t force someone to be anxious who is not prone to be anxious. I think when parents are asking this question, what they’re really asking is is it all my fault? My answer is no, it’s certainly not all your fault. I know that historically the psychiatric community blamed parents, particularly moms, but we’ve evolved beyond that. Right?

I don’t blame parents, and I don’t want you to blame yourself. Blame is not helpful or useful, and it has no place in helping parents figure out how best to support their anxious kids. Now the research does tell us that anxiety disorders can be inherited. If a parent has a brain that is prone to anxiety, that is a brain that is already predisposed to spot potential danger, because that’s really what anxiety is. They’re more likely to have a child whose brain is also prone to anxiety.

Now anxious brains make evolutionary sense. If we’re all hanging out together in the zombie apocalypse, we are absolutely going to want some anxious people on our team.

They’re going to know not to go down into the dark basement. They’re going to remember to pack a can opener with their end of the world supplies. They’re not going to take foolish chances. We know our Darwin, right? We can see why anxious brains have stuck around. So, yes, anxious parents are more likely to have anxious kids, but that’s because that’s how genetics work.

A better question might be: can an anxious person influence an anxious child. And that answer would be yes, absolutely. Parents influence their kids. So then we can ask how can an anxious parent influence an anxious child? That’s a much more useful question. One thing we need to understand is that anxiety is catching.

If you find yourself tensing up around certain nervous people then you already know this. I know for myself, I can often diagnose a client with anxiety just by the way I feel around them. When I’m sitting across from an anxious client, I catch their anxiety. I notice myself worrying that I’m not going to do a good job for them.

That my interventions are going to be useless. That I’m going to fail them as a therapist. And. That tells me. They’re anxious and I’m tuning into it. You yourself might find yourself getting irritated or annoyed or just more on edge around certain people, including your anxious child.

Or you’ll notice that your child acts up more with one parent than the other. And maybe it’s the more anxious parent. Maybe they’re catching anxiety from us and we’re catching anxiety from them. And we’re all revving up together. Children rely on their caregivers to tell them when it’s safe and when it’s not. And so they’re highly tuned into how we’re feeling. Think about it.

Children are literally dependent on us for their survival. No wonder that some of them are extra tuned in to make sure that their surroundings are safe.

Sometimes our modeling is subtle and sometimes it’s more overt. An example would be, if you jump, when you see a spider, while you’re teaching your child to jump, when they see a spider. That’s explicit modeling.

In the same way they watch us say, please, and thank you. And they learn to say, please, and thank you. Or they watch us carry a dish to the counter and they carry their dishes to the counter, or at least we hope they will eventually. And so in the same way, if they see us be afraid of something, then they are learning that thing is scary. That thing is dangerous.

But in a more subtle case, we might just maybe tense up a little bit when we’re talking to a person in authority, say, or a boss, a landlord. And our children, especially our most sensitive children. Will note the change in our voice and in our posture. And they’ll file that away. Oh, Okay. They’ll say to themselves, I need to be on my toes with that person.

Note that I said our most sensitive kids. Not all of our children are going to be as highly attuned. And that’s why I’m saying again, that you can’t cause your child to have anxiety. Your child is either prone to it or not. And then we may influence them through our own behavior.

If you have a highly sensitive anxious child and if you were a highly sensitive and anxious person, Again, you are likely passing some anxiety back and forth. It’s doesn’t make it your fault. It doesn’t make it your child’s fault. The patterns that appear in anxious families appear because it makes sense at first to accommodate your child. The child without anxiety will grow out of those accommodations naturally. Those accommodations make sense.

However, if we have a child with anxiety, those accommodations may become a trap. And then in hindsight, people might say to us, well, it’s your fault. You created it, you started it.

You never kicked him out of your bed. You never left them with caregivers, all of these things and that’s simply not true. It’s much more complicated than that. Because again, a child without anxiety will grow out of those accommodations. They may even push us to stop those accommodations and the child with anxiety may just become more entrenched.

Here’s an example. Many many kids are going to cry when they first get dropped off at preschool. Children without anxiety will acclimate and grow through it no matter what we do. They truly are the kids that you can leave and they’ll stop crime in a few minutes. And get right on with their playing

those are the ones. When the preschool teacher says, go ahead and leave. He’ll calm down. They really will. Children who are prone to anxiety may not calm down. They may rev up. They may cry more. They may cry so hard. They throw up and so their parents naturally will stay with them longer, or even pull them from preschool and say, you’re just not ready yet.

And for some kids that might be true, they might just not be ready yet. A child with anxiety though, may never be ready. Children with anxiety may need an extra push or extra different kinds of support. The things that we naturally do, like stay with them until they’re ready for us to leave will work for non anxious kids.

But for those kids who are anxious. Well, they might never feel ready for us to leave. And then we need to do the hard dance, the push and the pull of getting them to grow, even when they don’t want to. This does not come naturally to most of us. Especially, as I said, if we are also highly sensitive and anxious.

We may struggle to see our child’s ability to get past this anxiety sticking point. Again, no blame here. This is so complicated. And finding support that honors what is developmentally appropriate for our individual child, what is anxiety and informed and understands the patterns, and what lets us care for ourselves and our children.

Can be difficult. The thing I tell parents is that your parenting isn’t the problem. Your parenting is the solution. Just like you can model jumping when you see a spider. So you can model ways to manage and overcome anxiety when you see a spider. And so that child that is struggling to be left at preschool or that parent who is struggling to leave them.

They can be successful. Absolutely. But they will need help that honors, who they are and where they are in the moment.

This is good news, right? Dr. Ross Greene, when talking about parenting challenging kids always says kids do well when they can. Well, so do parents. We do well when we can. And sometimes we need tools to learn and practice new skills and do better. We can always level up.

If you would like help with your anxious child. Let me know

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Does an anxious parent make an anxious child? Read More »

What are some signs that a child has anxiety?

Podcast

Our first question for the Child Anxiety FAQ podcast is, “What are some signs that a child has anxiety?” I think what this questioner is asking is how we can tell if a child is having a problem with anxiety because we’re all going to suffer from anxiety.

When I first started offering trainings, I definitely suffered from anxiety before every single presentation. Shaking, sweating, lots of worrying about things that could go wrong. In that case, my anxiety was productive because it made me prepare for those trainings, you know, and inspired me to plan ahead, plan for disaster. I’d print out two copies of my notes and I’d practice and time my PowerPoint. I’d pack extra connectors for my laptop because it seemed like the hotels were I’d present never had the right one for my Mac.

By the same token, a child who is worried about doing well on an exam is more likely to study for it than a child who is not worried about doing well.

Being alive means we’re going to have anxiety and we can’t protect our children from that. Right? So the question is, how do we know if that anxiety is a problem.

So first, the most important way to know is if that worrying is trapping the child. So in my presenting if I was worried about presenting so much that I refuse to do it or canceled at the very last minute or couldn’t go on because my nausea was so bad that I was enabled to take the stage. That would be an indicator that my anxiety was no longer productive.

A child who is so worried about their exam, that their relationships or their functioning are disrupted in some way is by definition having problems with anxiety.

How does anxiety disrupt things? Well, let’s look at that. Maybe there are sematic symptoms and this is often the reason why people contact me is their child is having somatic symptoms like stomach.

Butterflies in their stomach, a pain in their stomach. Maybe they’re asking their parents to come pick them up from school because they’re getting stomach aches at school. They’re going to the nurse’s office. Maybe they have difficulty eating because their stomach is bothering them. Maybe they’re having a lot of headaches.

Uh, maybe you’ve had them to get their eyes checked and their eyes are fine. And yet they’re still having. Maybe they’re having a lot of bathroom accidents. It’s really common to need to go pee or poop when you’re very, very anxious and maybe their wedding, their pants. Maybe there are behavioral symptoms and that’s the other most common reason.

These are the two most common reasons why people contact me either their child was having somatic symptoms and the pediatrician says this might be anxiety, or the child is having behavioral symptoms. And the behavioral symptoms that we’re looking for are ones that are outside. What is developmentally appropriate and what is culturally.

So let’s dig into that little bit. So developmentally we would expect a toddler to have separation anxiety. We would expect a three-year-old to maybe struggle getting dropped off at preschool, at least at the beginning. But if that continues for longer than. Let’s say three to six months depending, or if they’re eight and having trouble separating that tells us that’s outside of what is developmentally expected for that child as for culturally appropriate?

Well, a lot of people point to, uh, my child won’t sleep alone and that might be an issue for your family, but for another family that would not be an issue in many family cultures. It is not reasonable for a child to sleep alone. And so we can’t. This behavior always means anxiety. It’s an issue if it’s an issue for your family.

So if you were needing your child to sleep alone or that’s important to you, and they’re unable to do that, it, it might make sense to look into anxiety. Now, the other behavioral issues that we see in anxious, kids are Melton. So falling apart before or after school for the child who is struggling with school refusal, a child who melts down before or after visitors or playdates, many, many, many families tell me that my kid does great at school.

They do great with other people and then they come home and they are just a mess. Those are the kinds of meltdowns that we see in anxious, kids who are holding it together for as long as they can, and then coming home and unleashing it on the family. Many anxious kids are also very rigid for some kids.

This is a personality trait, uh, a child who has a preference. They like things to be this way is different than a child. Who’s rigidity is a necessity. So the child who might whine a little bit because their shoes aren’t fitting right, or their brother or sister did something out of order or. Something out of order versus the kid who completely falls apart.

So for example, you show up to pick them up in a car they’re not accustomed to, and they can barely get in the car or they scream and cry the whole way home, that kind of rigidity. And in older kids, perfectionism is often a sign of anxiety. And of course the child may say, I feel anxious. I’m afraid I’m worried.

Or they might not have the language for it. And instead you just see a lot of reluctance or they are verbalized in a lot of reluctance. I don’t like that. I don’t want to go. They don’t always have the language to explain their feelings, but if they’re often resistant to new things or even accustomed things it’s worth considering whether or not this is anxiety.

And remember we said developmentally or culturally appropriate. So if you have a child who doesn’t want to jump on a trampoline, but you’re not a trampoline jumping family, that’s not a big deal. If on the other hand, you’re the flying Melendez and jumping on a trampoline needs to happen. Well, maybe you need.

Dig in a little bit and see why that child is resistant. It’s complicated. Right? So remember when I said that one way we know when a child or teen is having anxiety issues is if the relationships are disrupted, I want to talk about that a little bit, because that includes their relationship with you and other families.

Now it’s certain times in their development, it is normal and expected for us to be knocking heads with our children. So how do we know when it’s beyond what is developmentally appropriate? How do we know when our arguments with our 13 year old are appropriate for a child who is at the stage where they’re learning to separate and how do we know when something bigger is going on. Well, the biggest indicator is you. If you feel stuck, if you are feeling ground down by the relationship, if you feel trapped in it or start to dread spending time with them. If you are so worried that your functioning is disrupted, if you’re being interrupted at work or when you’re out, if you are getting repeated phone calls or texts, when you’re grocery shopping, if your world has started to get smaller, because you’re trying to manage your children, child’s react.

If you feel like you’re walking on eggshells, worried that you’ll set them off by bringing up the wrong topic, asking them to do the wrong thing, then that’s a sign that anxiety may be an issue for your family. So often I’m talking to parents who think that they are doing something wrong because they’re feeling unhappy in their parenting.

They feel guilty. They often feel ashamed. Let me tell you something. When you don’t feel good in your relationship with your child, that’s a symptom and symptoms are useful because in symptoms we find answers. If you are struggling, that doesn’t mean that you’re doing something wrong, but it does mean that there is something that might need to change.

Parenting is not stagnant. You grow up. Your child grows, your circumstances change and what might have worked before may no longer work. The only way we know that is when we start struggling or a child starts struggling. It’s like when your back starts to hurt, because you need a new. When your relationship is hurting, you might need a new approach.

My experience has been that parents often hold back from getting help because they think that they just need to try harder, be more patient, do more. They blame themselves a lot. When it comes to child anxiety, a new perspective makes a big difference. It really, really helps to have someone from outside.

Looking in to help you figure out what’s happening and support you in figuring out how to extricate yourself from the patterns that are making your child more anxious or keeping them and you stuck. All right. So let’s go back and look over our answer to know how do you know if your child has anxiety?

So one sematic symptoms, stomach aches, headaches, et cetera, behavioral symptoms, meltdowns, rigidity, uh, Lots of arguments. Uh, if they tell you that they’re having a hard time, you can believe them. And what I think most importantly, if you are having a hard time with them.

CHILD ANXIETY FAQ
CHILD ANXIETY FAQ
CHILD ANXIETY FAQ
CHILD ANXIETY FAQ
CHILD ANXIETY FAQ
CHILD ANXIETY FAQ
CHILD ANXIETY FAQ
CHILD ANXIETY FAQ

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What are some signs that a child has anxiety? Read More »

When should I be concerned about my anxious child?

The research shows that the family system needs to shift in order for your child's anxiety to shift.

Have a question?

How can I make my anxious child feel heard and understood?

Now the tricky part is trusting the hard work we’ve done and in the resiliency of the relationship. What I’m saying here is that we need to be prepared to disappoint and even anger our kids.

Have a question?

Can children have panic attacks?

Intervening early is always a good idea when it comes to kids. They don’t need a full blow anxiety diagnosis to benefit from the skill building that comes with recognizing their worries and helping them shift their thinking in ways that empower them to face those fears.

Have a question?

Should I homeschool my child because of their social anxiety?

Pulling a child who is socially anxious out of school or letting them stay home because they’re afraid to be away from us may make them feel better in the short term but we need to consider how that’s going to benefit them in the long term.

Have a question?

How do I help my anxious child?

If you're parenting an anxious child, I'm sure you've already been subjected to the advice that is rarely asked for rarely helpful. And often critical and leaves you feeling worse.

Have a question?

How do I calm down my anxious child?

Let me right here right now say that if your child's anxiety is out of control, this is not because you have somehow failed to calm them down.

Have a question?

Does an anxious parent make an anxious child?

I think when parents are asking this question, what they’re really asking is is it all my fault? My answer is no, it’s certainly not all your fault.

Have a question?

What are some signs that a child has anxiety?

Have a question?

94 to 99% of families are stuck in patterns that make their child's anxiety worse.

Are you?

subscribe to my Quick Sunday Newsletter for more child anxiety info

Follow Me

2022

The research shows that the family system needs to shift in order for your child's anxiety to shift.

Have a question?

Now the tricky part is trusting the hard work we’ve done and in the resiliency of the relationship. What I’m saying here is that we need to be prepared to disappoint and even anger our kids.

Have a question?

Intervening early is always a good idea when it comes to kids. They don’t need a full blow anxiety diagnosis to benefit from the skill building that comes with recognizing their worries and helping them shift their thinking in ways that empower them to face those fears.

Have a question?

Pulling a child who is socially anxious out of school or letting them stay home because they’re afraid to be away from us may make them feel better in the short term but we need to consider how that’s going to benefit them in the long term.

Have a question?

If you're parenting an anxious child, I'm sure you've already been subjected to the advice that is rarely asked for rarely helpful. And often critical and leaves you feeling worse.

Have a question?

Let me right here right now say that if your child's anxiety is out of control, this is not because you have somehow failed to calm them down.

Have a question?

I think when parents are asking this question, what they’re really asking is is it all my fault? My answer is no, it’s certainly not all your fault.

Have a question?

Have a question?

94 to 99% of families are stuck in patterns that make their child's anxiety worse.Are you?

subscribe to my Quick Sunday Newsletter for more child anxiety info

Follow Me

94 to 99% of families are stuck in patterns that make their child's anxiety worse.

Are you?