Why anxiety is increasingly common in kids, early warning signs—and the gentle fixes that help them thrive

 In Grade-schooler, Suggested Posts, Teen, Tween

Anxiety is normal—until it’s not. All kids feel nervous about something: monsters under the bed, bad storms, giving a speech. Increasingly, though, anxiety is spiraling to debilitating, even dangerous, degrees in children and teens. And often, their struggles get worse before they’re noticed and helped.

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A big reason anxiety simmers under the radar is that these kids tend to get good grades and are liked by others, says psychologist Brendan Pratt, PhD, of the Pratt Center in Los Altos, California. “An anxious kid tends to be well-behaved, meticulous, cares about school, follows rules, and wants to please people,” he says.

The problem: They put intense pressure on themselves to not only do well but be perfect. And their expectations and perceptions are often disconnected from what’s accurate or realistic, he says.

Experts aren’t sure why more kids than ever have anxiety disorders, though genetics and environment both have roles. One sure factor: Today’s kids have more to cope with (from the college chase to social media) at the same time they have fewer release valves (like downtime, nature, and practice developing coping skills). As busy school days amp up, there’s even more stress and fewer outlets for it.


WHO GETS ANXIETY DISORDERS?

  • One in eight kids
  • One in four teens
  • Slightly more girls than boys (by high school)
  • Children whose parents are anxious

What can we parents do, besides feel anxious ourselves? These 10 strategies can really make a difference:

Watch for early warning signs.

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Because anxiety has so many strengths associated with it, it’s easily overlooked. “I often hear, ‘Why is she so anxious? She’s good at tests!’” Pratt says. “But that’s why these kids often get good grades: because they’re so anxious. A child may get all ‘A’s but is cutting herself because of all the stress.”

Know what to look out for: A healthy child suddenly gets chronic stomachaches or has trouble sleeping. Or starts having bad headaches but only on school days. Or eagerly goes off to school each day but begs to stay home on what you later learn was a test day. “It’s seemingly unrelated things you wouldn’t really notice until a pattern becomes apparent,” Pratt says.

Problems tend to pick up during transition stages, like starting middle or high school. “I love it when we catch it by middle school, because kids’ grades in 6th to 8th grade don’t matter much. What matters is skill development,” he adds. “Even in high school, grades don’t matter as much as developing the skills for college.”


MORE SIGNS OF ANXIETY IN KIDS

  • Worrying often that things will go wrong
  • Ruminating
  • Avoiding group activities or meeting new people
  • Fearing minor changes in routine
  • Being rigid and perfectionistic
  • Using obsessive behaviors to manage anxiety
  • Over-sensitivity to teacher criticism
  • Mind “goes blank” when called on in class

Instead of saying, “Don’t worry,” help your child figure out when to worry.

“I tell kids the goal isn’t to eliminate all anxiety (which is impossible!); it’s to make it work for them,” Pratt says. “After all, a little anxiety motivates you to study. It’s having too much anxiety that makes you panic.” Talk through assignments: Is a worksheet worth the same amount of prep as a final paper? Can you study less for a weekly quiz than a final exam?

“Kids with anxiety like having rules that make sense; they’re very good at rules,” Pratt says. Say your child won’t ever eat leftovers because he’s afraid they’re spoiled. Break it down to put the fear in perspective: “Let’s learn about each ingredient and when they spoil. Okay, mayo is in that. Maybe we should toss it. Rice? It’s okay.”

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Instead of fixating on grades, focus on strengths.

As parents, we too often get tunnel vision about “good grades,” and kids pick up on this. Yet it’s your child’s individual strengths—persistence, love of reading, for example—not her test scores, that will make her happy and successful in life.

Better: Really think about what she’s good at, so you can truly show you value those traits and skills. Is your child great at patience or compassion? Funny? A persistent problem solver or a loyal friend? Talented at dancing or cooking or drawing? Support this fuller picture of your child by the things you say and do.

Give your child practice becoming his or her own advocate.

If you’re still doing all the talking at your 10-year-old’s checkups or ordering food for a 15-year-old at a restaurant, you’re not doing your child any favors. By 9 or 10, or sooner, your child should be getting practice talking to doctors, wait staff, store clerks, and others.

Ditto with school issues. “When my son needs help, we brainstorm solutions that start with him, like whether he should email the teacher and what he thinks he should say or ask,” Pratt says.

Start with a gentle, compassionate, supportive teacher or coach who likes your child. That way, when he eventually has to deal with someone who’s less flexible, his positive experiences with self-advocacy will make him less hard on himself. (Oh, that teacher is like that to everyone, not just me.)

Act the way you want your child to act.

If you work day and night, never take vacations, never exercise, and deal with stress in less-than-healthy ways (overeating, drinking, binge-watching TV), guess what your child will see as normal and necessary? Now picture the message your kid gets if you still work hard, yet occasionally say things like, “Okay, this thing isn’t worth my best effort” or “My family vacation is more important than this sudden deadline.”

Pratt sees parents with blind spots all the time. Take screen time: “Parents often ask me how to limit it, and I say, ‘Well, during our one-hour meeting, you’ve checked your phone five times.’ They probably do that during dinner, too. It’s easiest to start with ourselves and then extend those lessons and behaviors to our kids.”

High-achieving parents might want to make an extra show of prioritizing a balanced life, Pratt says. “Brilliant, high-performing parents can wind up with an anxious kid not because of what they’ve said or done as parents but simply because many of us feel inadequate when we compare ourselves to brilliant, high-performing people.”


TWO QUICK QUESTIONS THAT IDENTIFY EXCESS ANXIETY

  • Is it age-inappropriate? Say, a 6-year-old who still fears monsters under the bed.
  • Is it inappropriate in extent? A child might avoid all activities or become preoccupied with unlikely disasters, for example.

Find ways to help your child face (not avoid) a fear.

 A certain amount of exposure is really helpful, whether the fear is water, germs, or tests. “If you protect your child from ever having to deal with it, you can make the fear worse,” Pratt says. If your child is terrified of water, you could say, okay, we’ll never go near water. Or you could get swimming lessons that start out with just having fun and playing with toys, getting your child used to the water and gradually developing skills.

Avoid micromanaging schoolwork.

Think of what you did when your kids were learning to walk or tie shoes. You were there to support, but you backed off as much as possible so they learned how. “My son is 15 and we have a deal: If his grades are above a B-, I stay out of his way. If they go below a B-, we talk about what’s going on,” Pratt says. “That leaves me out of the every day. I just check the quarterly grades.”

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Offer time-management assistance.

Help your child divide large projects into manageable pieces with intermediate deadlines. Maybe avoid scheduling family events around high-stress periods at school.

Focus on finding the best match between your student and school at every stage, not on finding the “best school.”

Whether it’s preschool, grade school, middle school, or college, what matters most is a good fit, where the teaching style suits your child’s temperament and your child feels relaxed and happy. That might be a Montessori or a co-op in a church basement, State U or Harvard.

Pratt’s advice to anxious college-bound students: Get an undergraduate degree from a smaller school, where you can reap more supports and have great success. Then, if it’s needed, you’ll be better able to handle grad school at a bigger university.

Make sure everyone who works with your kid is on the same page.

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That means mom, dad, sitters, coaches, teachers. You don’t want one person saying “Well, he just didn’t prepare for the test” while another knows he gets worried about tests, which interferes with his memory retention and attention. If there are divorced parents and two households, Pratt says, set up consistency in the areas that relate to anxiety: bedtimes, approaches to getting homework done, access to a tutor. 

Here’s the good news…

With a little understanding and the right support, an anxious kid can learn to harness this tendency in ways that provide power, not damage. Bonus: Kids with anxiety tend to be extremely compliant and respond well to help.

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One teen was referred to Pratt for psychological support because her persistent stomachaches and diarrhea—for which doctors could find no cause—seemed to be making her anxious. Working with her, he realized it was the other way around: Her extreme anxiety and obsessions with perfection were causing the health problems. They worked things out using a combination of talk therapy, medication, yoga, and school interventions.

“She was a smart, insightful kid and took ownership of it,” Pratt says of the girl, who is now physically and mentally healthy. “I tell kids: Your anxiety is a huge gift. Let’s figure out how to harness it, so it helps you do good things like study and have friends, without letting it get out of control.”

—Content chief Paula Spencer Scott is a mom of 4 and step-mom of 2—and the author or co-author of more than a dozen books about parenting, health, and eldercare, including Bright From the Start; The Happiest Toddler on the Block; Like Mother, Like Daughter; and Surviving Alzheimer’s.

Photos from top: Sierra/Flickr, Red Flags/Flickr, Anxiety – James Arnold/Flickr, Student and Teacher/Flickr, Smile/Flickr

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