How to help children with anxiety

Most of us feel comfortable with our routines. So when those are disrupted, we can feel a little unsteady or upset.

Children can feel especially anxious about going back to school after long breaks or missing a few days because of extended illness.

What can you do?

“As adults, 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.

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. And watch for signs of anxiety in your child.

Signs of anxiety

Signs may vary, depending on a child's personality and age. Below are a few 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, it could be due to mental or emotional fears.
  
  Likewise, sleep patterns may shift, including getting up at night, nightmares, and having a tough time falling asleep. Children may also have trouble staying asleep, which can make them sleepy during the day.
• Withdrawal and avoidance. Another common sign of anxiety is when a child pulls away from or avoids activities they used to like. If your child enjoyed time with friends or school, and now says he’s not interested, take note.
• 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.
• Nervousness and worry. Increased nervousness and worry are also strong clues. Many kids worry about being behind in school, seeing old friends and making new ones. 
• Fear of separation. Since the pandemic, some children find it overwhelming to be away from home. This anxiety could come from being in an unfamiliar social situation, a fear of illness, or feeling unsafe outside of the home.
• Declining grades in school. Anxiety can show up as bad grades or disruptive behavior in the classroom — particularly if your child used to do well in school. This might be a lack of confidence. Or it could be feeling awkward in social situations. 

Ways to help

There are many ways you can help your child feel more at ease. Here are just a few:

• Encourage good health habits. Help your child eat healthy food. Offer fruits and veggies. Limit or avoid sugar and sugary drinks.
  
  Set good sleep habits. Bedtime routines can help your child relax. And good sleep can go a long way in helping your child feel better. 
  
  Get physically active every day. Whether it’s a walk in the park, shooting hoops, playing catch or dancing around the kitchen. Being on the move can lift everyone’s spirits.

  Check out 5-2-1-0 for more tips on building key health habits.

• Practice social activities. Encourage social engagement and empower your child to practice socializing. Set up short, supervised play dates with other children. Over time, play dates can last longer. If appropriate, let the kids play in the next room so your child can gain confidence in being alone with friends.
  
  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. Meet or talk with their teacher to talk through concerns.
  Follow your child's lead and adjust the activity to fit their comfort level. Let them know you recognize their courage and progress during this process. 
• Talk about things. Regularly check in with your children. What’s on their minds? Make it comfortable for them to talk about what's going on. Encourage your child to share their feelings. Provide a safe space for honest expression. Take a calm, nonjudgmental stance.
  
  Create an open and supportive environment. Let your children and teens know they can ask questions and express their worries. Acknowledge their anxiety while focusing their energy on things they can do.
  
  Offer comfort and reassurance (not shame). Listen to what they tell you. 
  
  Provide them with words to express what they feel inside. Help them name their emotions. Clarify that their feelings aren't "bad" but may be uncomfortable. Feelings are valid and normal.
  
  Try using a feelings chart or emotions wheel. This can help them label specific emotions. Naming them lets your child share it with others. Talking about them can make feelings seem less intense.

• Foster coping skills. Help your child explore what they can do to feel better. Having ideas about how to cope can lessen the power an emotion has over them. Here are a few suggested coping strategies:

  • Read a favorite book
  • Write in a journal
  • Draw pictures
  • Do 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 pick up on more than you realize.

• Keep your promises. It may be easy to tell your child things will get better but avoid making promises you can't keep. Give comfort and support but keep things simple and straightforward. Honestly answer questions using words and concepts your child can understand.
• Include teachers or other caregivers. Talk with your child’s teacher or other caregiver about concerns your child has. Let them know what you are doing. Ask them for ideas on how they can support your child. Help your child identify how to get help from their teacher or someone else at school.
• Maintain positive changes. Continue helpful habits and practices that work for your family. Keep routines and traditions your family enjoys. 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 does things differently. Do what’s comfortable and give each other grace.

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.