Anxiety, Worry, Fear in Children
Anxiety and fear are common experiences during childhood, and some level of worry is a natural part of growing up, such as feeling anxious when entering a new place, and feeling scared of the "monsters" in TV shows. However, when anxiety or fear becomes persistent, intense, or begins to interfere with a child's everyday life - constantly feeling scared of a imagined monster in their closet leading to sleep difficulties, social withdrawal, unwilling to go school quite often, avoiding activities they previously liked, additional counselling support may be helpful. Children may not always have the words to explain what they are worried about, parents and caregivers always end up "taking a guess" of what petrified them, so children fear and anxiety can sometimes be expressed through changes in behaviour, emotions, or physical symptoms.
How Do I Know If My Child May Have Anxiety or Excessive Fear?
Children can experience anxiety in many different ways, and the signs may vary depending on their age, personality, developmental stage, and what's happening around them. Some children may clearly express their worries, while others may communicate anxiety through avoidance, irritability, physical complaints - e.g. chest pain, headache, stiff legs and hands, or changes in behaviour. One sign alone does not necessarily mean that a child has an anxiety disorder. It is important to consider whether the symptoms are interfering with the child's daily functioning.
Possible signs may include:
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Frequent worrying about school performance, academic results, and achievements.
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Expressing concerns about how people may perceive them, that may happen with family, friendships, teachers, daycare educators, etc.
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The worries and anxiety would create impact on health, safety, or everyday situations.
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Fear of being away from parents or caregivers.
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Avoiding school, social activities, new situations, or activities they previously are fine with it.
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Difficulty falling asleep, nightmares, or frequently seeking reassurance at bed time.
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Irritability, emotional outbursts, crying, or becoming easily overwhelmed.
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Physical complaints such as stomachaches, headaches, nausea, dizziness, or feeling tense.
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Difficulty concentrating because they seemed to be preoccupied with worries.
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Repeatedly asking questions or seeking reassurance about the same concern, such as asking if the time is up, if parents and caregivers are still around, if they would be safe to return home etc.
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Becoming unusually quiet, withdrawn, or hesitant to participate.
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Strong fear of making mistakes, being judged, or disappointing others.
Why Do My Child May Have Anxiety or Excessive Fear?
Quite often parents and caregivers may immediately jump into a conclusion that they must have done something wrong that triggers their anxiety, or believe that their children must have problems and they need to be "fixed" and the anxiety should be removed.
While anxiety and fear do not work in this way. Anxiety would be considered an emotional responses from the worry thinking. Constantly avoiding situations that create anxiety can sometimes reinforce the message that those situations are unsafe - proving the worrying thoughts that they are right, although parents and caregivers are protecting children from genuine danger is important.
Parents can instead provide a calm and supportive environment where children feel understood while gradually helping them develop confidence in managing difficult feelings. Four basic skills parents can use include:
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Listen and acknowledge: Give your child opportunities to talk about their worries and let them know that their feelings are being taken seriously. If they are not able to verbally express what frightens them, you can acknowledge the feeling without confirming that the feared situation is actually dangerous.
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Stay calm and regulated: Co-regulation is the key. Children often look to the adults around them when they are uncertain or frightened. Using a calm voice and predictable responses can help your child feel safer when they are experiencing anxiety. Continuing to tell them that "that's actually safe" and "that's fine, no worries" may create a power struggles of what they are believing, that becomes contradictory regulation. Their nervious system will continue staying activiated.
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Encourage, rather than force: We may hear or experience ourselves that we just force ourselves to enter the stressful situations, we would eventually "get used to it" and "will finally learn from hard times". While we would try to avoid immediately forcing your child into situations that feel extremely overwhelming, but also be mindful of allowing anxiety to completely determine what your child can or cannot do. Support your child in taking manageable steps when appropriate. Setting your child to succeed with small-step approach is effective to help them "get used to it" easier.
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Maintain predictable routines: Consistent routines around sleep, meals, school, activities, and transitions can provide children with a greater sense of predictability and security.If anxiety is persistent, significantly affecting your child's daily functioning, or becoming increasingly difficult for your family to manage, consider seeking support from a qualified mental health professional.
How does Counselling Work for Children?
Play therapy and children counselling can provide children with a safe relationship where they can explore worries, fears, relationships, and experiences that may be difficult to communicate directly.
For younger children in particular, play therapy can provide a developmentally appropriate way to communicate and explore emotional experiences through play, rather than requiring children to explain everything using words. Through play, children may have opportunities to express fears, experiment with different ways of responding to challenges, develop a greater sense of agency, and explore experiences that may feel difficult to approach directly.
For children experiencing anxiety, play therapy can also provide opportunities to develop emotional awareness, build confidence, practise coping and problem-solving skills, and experience a sense of safety within the therapeutic relationship.
Rather than simply telling a child not to be afraid, therapy can help the child gradually develop a greater understanding of their emotions and discover ways of responding to difficult feelings.Parents can also benefit from the counselling process.
Parent involvement is crucial to help caregivers better understand what anxiety, fear, and worry are, how to recognize these signs and patterns that secretly control children's life, and develop more effective ways of responding to their child's emotional needs.
Depending on the child's age, developmental stage, concerns, and therapeutic approach, counselling may involve individual sessions with the child, parent consultation, or a combination of both.
Sam Lam has years of experiences supporting children, youth and adults who struggle to navigate anxiety, fear, and worry thinking. Our counselling office is located in Burnaby, with age-appropriate materials to support emotional regulation and expression in all ages. We are looking forward to being part of your journey when you are ready.