Understanding the Patterns of Anxiety
How to tell if your child is just worried, or she needs help managing anxiety
We all have fears, worry and anxiety. But one out of eight children is considered to have a diagnosable anxiety disorder. As a parent, it is sometimes difficult to distinguish between typical worry and more serious symptoms. You might wonder … is this temporary, will it pass, or should we seek help? The better you understand the way anxiety works, the more knowledge you will have to base your decisions.
First, fear is an adaptive emotion that we all rely on to keep us safe. It also motivates us to work hard and get things done. However, we do need to consider when fear starts to interfere with our daily lives. For example, Sarah’s fear of getting into trouble might keep her from talking out of turn during class. However, Melissa’s fear of getting into trouble is keeping her from wanting to go to school at all. As you can see, the content of the fear is not as important as how the fear impacts our lives. While Sarah’s fear seems adaptive, Melissa’s fear has escalated to the point that she is significantly distressed on a daily basis and will also suffer from unintended consequences like missing out on academics and socializing at school. When fears become irrational, persistent and intrusive, it is likely that we are moving into anxiety territory.
Second, anxiety is maintained by a vicious cycle. Many people reflect … how did it get to this point? Well, it starts small and then it grows. Let’s use a fear of vomiting, for example. When Kelly was eight years old, she had a stomach bug. She threw up about five times spanning a 12- hour period. Now, at age 12, she remembers how awful she felt when she threw up and has been doing everything in her power to make sure that never happens again. This is very understandable; no one wants to be sick. The problem is that Kelly has created many associations related to her vomiting. She views vomiting as horrible, threatening, and even dangerous. She also follows strict rules related to washing her hands, avoids certain foods, and will not touch things others have touched with her bare hands. Vomiting has become increasingly more and more powerful in her mind. And because she hasn’t thrown up since she was eight, she really doesn’t know any differently.
Anxiety patterns are easier to see once you know the signs. There is some kind of triggering situation, such as having to get a shot or give a speech. Then there are many intrusive, worrisome thoughts connected to the situation … I can’t handle the pain. What if I mess up and everyone laughs at me? At the same time, we start to experience emotional and physical discomfort, possibly a racing heart or panic feeling. Then, we instinctively want to do something to decrease this uncomfortable feeling. We often end up using safety behaviors such as avoidance, escape, asking for reassurance, checking, or rigid rules. These behaviors are well-intentioned and often work in the short-term. For example, if I avoid getting a shot, I will definitely feel better. But, I ultimately will still be afraid of shots.
The good news is that anxiety disorders are highly treatable. The most effective treatment for anxiety is called cognitive-behavioral therapy. This type of therapy focuses on really understanding cognitive and behavioral patterns in order to create meaningful changes. Basically, we have to get out of the anxiety cycle and move more toward living life fully. Even though facing a fear is challenging, it is also very rewarding.
So consider how your child’s fear is impacting his or her life. How often are they afraid? How disruptive is the fear? How much are they suffering? How much is the rest of the household suffering? If you feel like fear is controlling your child, it might be time to find some help. A cognitive-behavioral therapist would be happy to guide your child through this journey, as well as support you in parenting a child who is struggling with anxiety.
Dr. Andrea Umbach is a licensed psychologist at Southeast Psych. She specializes in treating individuals with anxiety, OCD, phobias, panic, hoarding, and trichotillomania, using a cognitive-behavioral approach. Dr. Umbach is the author of "Conquer Your Fears and Phobias for Teens" and founder of the Charlotte Anxiety Consortium.