What to do when your child worries too much

Anxiety or excessive worrying is a common mental health problem for children and teenagers. A parent’s natural instinct is to want to help their children by eliminating this distressing feeling from their lives.

However, this is not possible because anxiety is one of those pesky emotions that we all need to help us to survive by alerting us to threats, protecting us from danger and motivating us to reach important goals. The problems arise when our anxiety is out of proportion to the actual danger of the situation, or is present when there is no danger.

The good news is that there is a lot we can do to help our children manage their anxiety and stop it from interfering in their lives, or developing into an anxiety disorder. Over the past few decades, there has been a dramatic improvement in our understanding of anxiety and how it can be treated.

Dr Aileen Murtagh, consultant psychiatrist at Willow Grove Adolescent Unit, St Patrick's Mental Health Services (SPMHS), explains: "Parents ask us to 'get rid' of their child's anxiety, but we can't do that. Anxiety is a normal human emotion and life is stressful, there will always be ups and downs. Our aim is not to eliminate anxiety, but to help children develop the ability to cope with it, particularly when it is starting to affect their normal functioning."

While SPMHS has seen an increase in referrals for anxiety disorder to both in- and out-patient child and adolescent services, Murtagh says this is a good thing as, very often, anxiety in children and teens is hidden and not talked about. When an anxiety becomes excessive or debilitating, it is considered an anxiety disorder.

“Anxiety disorder is one of the most common mental health diseases we see in children and adolescents, but it often goes undetected and untreated. This is why it’s important to have open dialogue with children at home and encourage them to talk about any problems they might have,” she says.

More services

Murtagh says that as well as an increase in awareness of anxiety disorder in children and teenagers among parents, GPs and teachers, more mental health services for young people have come on stream in the past number of years.

The Child and Adolescent Mental Health Service network has expanded, and St Patrick’s has opened new child and adolescent clinics in Cork and Galway in response to demand for services.

Jigsaw has also expanded its network of youth mental health programmes across Ireland to ensure that “every young person has somewhere to turn to and someone to talk to”.

Despite this, however, one in seven children and teenagers is waiting over a year for mental health treatment, according to the Children’s Mental Health Coalition.

“Parents can play a really important role in helping their children to develop anxiety management and coping skills by modelling good coping skills themselves, and encouraging and supporting them to face their fears, not avoid them.

“Avoidance is anxiety’s best friend; it keeps the anxiety going. Parents need to educate themselves about what they are dealing with, and there are lots of good resources and websites for young people with anxiety and their parents,” says Murtagh (see recommended resources below).

Dr John Sharry, founding director of the Parents Plus charity, author and writer for this supplement, stresses the importance of listening to and trying to understand the source of your child's worries, but in not getting too caught up in the worries or spending too much time discussing them.

One of the most important strategies he uses with parents and anxious children is to keep discussions about worries limited to specific times and durations. For younger children, this time can be a 15-minute “worry time”, or with teenagers it can simply be a chat before bed. Such an approach takes the worries seriously, but helps them be contained, he says.

Managing feelings

Parents can help their children to learn to manage their anxious feelings so that they don’t feel overwhelmed by them, explains Sharry, author of

Bringing up happy, confident children

.

There are many different strategies that can be learned to achieve this, such as becoming mindful of the anxious feelings in your body or using your breath to relax your body.

Alternatively, you can help your child learn to distract themselves from worries, for example, by focusing on the task in hand or by visualising a positive outcome or by repeating positive coping statements such as, “This is fine, I am getting through this,” before going into an anxious situation.

In addition, Sharry says certain creative rituals can also help, such as writing worries out on a page (rather than ruminating about them at night) and placing them in a worry box to be dealt with in the morning.

“Children with anxiety usually have great imaginations, though these are often fixed on negative things that might happen.

“You want to turn this around and help your child use their imagination in a more positive way to help them cope. For example, in order to overcome her shyness, one six-year-old girl I worked with as a therapist used to imagine she had a tiger with her when she walked to school.”

If the child’s anxiety continues to be a problem, Sharry advises seeking help from an adolescent mental health or counselling service.

Sharry and Murtagh both recommend a book for children and parents to read together called What to Do When You Worry Too Much, by Dr Dawn Huebner. The interactive self-help book for six to 12 year olds and their parents compares worries to tomatoes, explaining to children that they can grow worries simply by paying attention to them.

“Many children tend to their worries, even though they don’t really mean to. And pretty soon, what might have started as just a little seed of worry has become a huge pile of problems that you don’t know how to get rid of.

“The bad news, as you know, is that worries can grow pretty fast and cause a lot of trouble. The good news, which you may not know, is that you have the power to make the worries go away,” writes Huebner.

A Mental Health and Wellbeing Fair will take place at St Patrick’s University Hospital, James’s Street, Dublin on Saturday, May 21st, from 11am-4pm.

The fair will host a number of exhibitors from local and national service providers, a programme of workshops in mindfulness, yoga, laughter yoga, zumba and music, and a range of talks from mental health experts and advocates. This event is open to the public and admission is free.

Tips for parents of anxious kids

1 Know that your child's nervousness is real, as is their stomach ache. 2 Avoidance keeps fear locked in place. It makes things feel better in the moment, but worse in the long run. 3 Taking deep breaths can be helpful (only if practised in advance), but it isn't enough. 4 Help your child externalise their worry, thinking about it like a bully or pest trying to make things hard for them. 5 Teach your child to 'talk back' to their worry. 6 Teach your child to challenge, rather than obey, their worry.

7 The more we do something, the more we get used to it. Help your child get used to things that scare them, one small step at a time. 8 Worry left unchecked grows. If it is interfering with your child's ability to do things, seek out help from books or a mental health professional.

Tips from Dr Dawn Huebner, author of What To Do When You Worry Too Much

Recommended resources anxietybc.com youth.anxietybc.com reachout.com solutiontalk.ie cci.health.wa.gov.au get.gg/

Does any of this sound like your child or teen? Clinging, crying and/or tantrums when you separate.

Excessive shyness, avoiding social situations. Constant worry.

Avoiding situations or places because of fears.

Complaints of frequent stomach aches or headaches.

Experiencing sudden and frequent panic attacks.

If you answered yes to any of these statements, your child may be experiencing anxiety. See anxietybc.com/parenting/parent-child