How to help children with anxiety

After what we went through in the past few years, many of us — especially children — may still feel uncertain or fearful about activities.

“As parents, we have the benefit of life experience to understand what is temporary. Young children haven’t lived long enough to see the bigger picture,“ says Camille Moreno, PsyD, a mental health professional at PeaceHealth.

In general, little ones find comfort in what's familiar. And that's understandable because they're getting to know the world and where they fit.

One of the main things you can do to help your child is to recognize and process your own emotions.

“Children closely watch for cues from those around them to decide whether they should be nervous,” Dr. Moreno says. Look for ways you may unintentionally signal your child to be anxious.

Signs of anxiety

Signs of anxiety may vary, depending on a child's personality and age.

Below are some possible signs to watch for.

Changes in eating and sleeping

A loss of appetite, fussiness in eating, or extra comfort eating could mean something isn't quite right. If you find no physical reason for the changes, these could point to anxiety.

Likewise, sleep patterns may shift, including disturbances, nightmares, waking in the night, and insomnia. Children may also have trouble falling or staying asleep or end up sleeping more during the day.

Eating and sleep disorders can have a significant impact on your child's overall wellbeing.  Try the tips below. If those don't work, talk to your child's provider.

Withdrawal and avoidance

Another common sign of anxiety is when a child withdraws from or avoids activities they once liked. If your child enjoyed time with friends or school, and now says he’s not interested, take note.

For example, as children get used to being with other people, try short playdates with only one friend at a time.

Follow your child's lead and adjust the activity to fit their comfort level. Let your child know you recognize their courage and progress during this process. 

Irritability, temper tantrums, and regressive behaviors

Has your child suddenly become moody? Do they get angry easily? Have you seen behaviors you thought they had outgrown, such as thumb-sucking, tantrums or bedwetting? In younger children, these might be their way of telling others that they're scared, but don't know how to express their feelings.

Offer comfort and reassurance rather than shame. Listen to what the child is telling you. Provide them with the words to better understand what they feel inside.

You can try using a feelings chart or emotions wheel with your children. This can help them identify and label specific emotions. Naming their emotions allows them to connect with their feelings. It's also a good way to let others know.

Nervousness and worry

Increased nervousness and worry also gives clues about a child's anxiety. Children face several uncertainties in life. Many worry about being behind in school, seeing old friends and making new friends. It can also be scary to be separated from their family after spending time at home.

Regularly check in with your children. What’s on their minds? Make it comfortable for them to talk about what's going on with them. Encourage your child to share their feelings. Provide a safe space for honest expression. Take a calm, nonjudgmental stance.

Fear of separation

During COVID-19 shutdowns, many families spent more time together than in the past. Some children — especially those who enjoyed staying home — find it overwhelming to go back to school or be alone with other children. This anxiety could come from being in an unfamiliar social situation, a fear of illness, or feeling unsafe outside of the home.

Parents can encourage social engagement and empower their children to practice socializing. For example, set up short, supervised play dates with other children. Over time, play dates can last longer. And, if appropriate, let the kids play in the next room so your child can gain confidence in being alone with friends.

You can ease fears by talking to your child about what to expect. If your child is fearful about school, help them remember what they have enjoyed in the past. Ask about meeting their teacher before the first day of class.

Declining grades in school

Anxiety might also show up as bad grades or difficulty in the classroom — particularly if your child used to do well in school. This could be related to lack of confidence. Or they might feel awkward in social situations. Talk to your child's teacher about possible solutions.

Ways to help your child

Besides the tips mentioned above, there are many ways parents can help their children cope.

Talk about their anxiety

Create an open and supportive environment. Let your children and teens know they can ask questions and express their worries. Acknowledge your child's anxiety while focusing their energy on things they can do.

Name the emotion. Clarify that their feelings aren't "bad" but may be uncomfortable. This exercise will help a child understand that their feelings are valid and normal.

Establish coping mechanisms

Once you have helped your child name the emotion, talk about what they can do to feel better.  Knowing how to cope with an emotion lessens the power it has over them.

Here are a few suggested coping strategies:

• Read a favorite book
• Write in a journal
• Draw pictures
• Do other art projects
• Listen to calming music
• Get physically active (high-intensity activity such as running can change hormones that affect anxiety)

Limit what your children see in the news and on social media. They might pick up on more than you realize.

Keep your promises

While it may be easy to tell your child things will get better, avoid making promises you can't keep. Give comfort and support but keep things simple and straightforward. Honestly answer questions using words and concepts that your child can understand.

Include teachers and other caregivers

Talk with your child’s teacher or other caregiver about the concerns or worries your child may have. Get their support. Let them know what you are doing to support your child at home. Ask the teacher how they want your child to approach them if your child feels worried or scared at school. Help your child identify how they will get help if they need someone to talk to while at school.

Maintain positive changes

Continue helpful habits and practices that work for your family. Keep incorporating new routines and traditions your family has enjoyed. Decide what matters the most to you and your family.

Practice patience

Be gentle with yourself and your children during this process. It is okay if your child or family do things differently. Do what’s comfortable for all involved and give each other grace.

When to seek professional help

If your child’s anxiety gets in the way of daily life, look for help from a mental health professional.  It’s better to get help sooner than later.

"The last few years taught us that conditions change and that the way we best keep ourselves and our family safe may change too," says Dr. Moreno. 

Start with your child's pediatrician or primary care provider, who can recommend other professional services, if necessary.