Talking to Your Child about Anxiety

Children and teens may not recognize that what they have been experiencing is anxiety. Some youth think the way they are feeling and acting is normal or expected. Often, overly studious or perfectionistic youth believe it is reasonable to study for hours on end, to keep their bedroom as neat as a pin, or to wash their hands excessively after every activity.

Other youth think there is something “wrong” with them. Children may focus on the physical symptoms of anxiety (e.g. stomach aches). Teens may think they’re weird, weak, out of control, or even going crazy. These thoughts might make them feel even more anxious and self-conscious. Providing accurate information about anxiety can reduce confusion or shame. Explain that anxiety is a common and normal experience, and it can be managed successfully.

You can do this in 3 clear steps. Once your child understands this information, he or she will feel more motivated to address his/her anxiety.

Step 1: Encouraging your child to open up about worries and fears.

Start by describing a recent situation where you observed some signs of anxiety in your child.

“Yesterday, when Sarah came over, you seemed very quiet and you just sat beside me. It seemed you might have been a bit nervous about having a visitor in our house. What was that like for you?” Or, “I’ve noticed you’ve been hanging home on weekends, and don’t seem to want to go out like your brother does. What’s up?”

It can sometimes help to share with your child some things you were scared of when you were the same age (especially if you shared the same types of fears), and ask if s/he has any similar worries or fears. You can also describe situations that make other kids his/her age anxious, and gently inquire if this happens to your child too.

Finally, you can try being direct by simply asking about what worries your child the most. Being specific can help your child sort through confusing fears and feelings. Support him/her by saying you believe your child, and that having these feelings is okay. Show acceptance of worry thoughts and anxious feelings. If you stay calm, it will also help your child stay calm.

Ask what worries him or her the most. You may have to prompt younger children by offering an example such as: “I know some kids are scared of ___, do you have that fear too?” When your child expresses anxiety or worry, offer reassurance by saying you believe him or her, and that having those feelings is okay. Remember, your child will take cues from you.

Tip: Does hearing “Don’t worry. Relax!" help you when you're anxious about something? It probably doesn't comfort your child much, either. It’s important to acknowledge that your child’s fears are real. Your empathy will increase the chances that your child will accept your guidance and be motivated to work on reducing anxiety through the tools/ resources you practice.

Step 2: Teaching your child about anxiety

Present the common situations that can be affected by anxiety, as well as how anxiety looks different at different ages and stages. Encourage your child to read this information or go through it with them. As you present all of this information, encourage your child or teen to share personal examples. If your teen is reluctant, use your own experiences with anxiety, or recall shared examples through movies, stories, fables, etc.

Four important points to communicate to your child:

1. Anxiety is normal. Everyone experiences anxiety at times. For example, it is normal to feel anxious when on a roller-coaster, or before a test. Some teens may appreciate some facts about how common anxiety problems are.

For example, “Did you know that one-in-seven children under 18 will suffer from a real problem with anxiety?”

2. Anxiety is not dangerous. Though anxiety may feel uncomfortable, it doesn’t last long, is temporary, and will eventually decrease! Also, most people cannot tell when you are anxious (except those close to you such as your parents).

3. Anxiety is adaptive. Anxiety helps us prepare for real danger (such as a bear confronting us in the woods) or for performing at our best (for example, it helps us get ready for a big game or speech). When we experience anxiety, it triggers our “fight-flight-freeze” response and prepares our bodies to defend themselves.

For instance, our heart beats faster to pump blood to our muscles so we have the energy to run away or fight off danger. When we freeze, we may not be noticed, allowing the danger to pass. This response is also called “anxious arousal”. Without anxiety, humans would not have survived as a species!

How you can explain the Fight-Flight-Freeze response to a child:

“Imagine you are hiking in the woods and you come across a bear. What is the first thing you would do? You may run away from the bear, or you may simply freeze. Another reaction is to yell and wave your arms to appear big and scary. There are three ways humans react to danger: fight, flee, or freeze. When we are anxious, we react in one of these ways, too. We may run away or avoid situations that make us anxious. Or we may freeze, such as when our minds go blank and we can’t think clearly. Or we may fight, get angry and lash out at people. Can you think of some ways you may fight, flee, or freeze because of anxious feelings?”

How to explain “anxious arousal”:

Sometimes when we sense something is dangerous or threatening, we automatically go into a state called “anxious arousal”. This can happen when there is a real danger, but also when something simply feels dangerous, but really isn’t, such as giving an oral presentation in class, or…(give an example of something relevant to your child). Anxious arousal makes you feel jittery, on edge, and uncomfortable. It may also make it hard to think clearly. This feeling can become overwhelming enough that anxious people stop doing things or going places that make them feel anxious. Do you think this is happening to you?

4. Anxiety can become a problem when our body reacts as if in danger in the absence of real danger. A good analogy is that it’s like the body’s smoke alarm.

“An alarm can help protect us when there is an actual fire, but sometimes a smoke alarm is too sensitive and goes off when there isn’t really a fire (e.g. burning toast in toaster). Like a smoke alarm, anxiety is helpful when it works right. But when it goes off when there is no real danger, then we may want to fix it.”

Step 3: Helping your child recognize anxiety

The third and final step in talking with your child is to help him/her understand the 3 ways that anxiety presents.

Explain to your child the three parts of anxiety: thoughts (what we say to ourselves); physical feelings (how our body responds); and behaviours (what we do or our actions).

USE AGE APPROPRIATE EXAMPLES

A good way to describe the interconnection of these parts is to draw a triangle with arrows

Physical Feelings

e.g. Tummy ache, headache, heart racing

Thoughts

e.g. “What if mom doesn’t come home?”

Behaviours

e.g. Looking for mom, staying home from school

Being a Detective: Recognizing Physical Symptoms

To help your child recognize physical symptoms, draw a sketch of a body and ask your child to identify where he or she feels anxiety in the body.

Prompt your child, if necessary, with an example: “When I feel anxious, I get butterflies in my tummy, and I get a big lump in my throat. What happens when you feel anxious?”

Teens may rather just talk about it, or identify their own symptoms from a list of “typical” physical symptoms.

If age-appropriate, ask your child to come up with a name for anxiety (e.g. Mr./ Mrs Worry). Refer to your child’s anxiety with this new name, particularly in terms of “bossing back” anxiety (e.g. “It’s just the Mrs worry talking. I don’t have to listen!”).

Older children or teens may respond better to a music analogy, such as that the volume of their anxiety is “turned up” a bit louder than other kids. They simply need to learn to turn down the volume.

These strategies help your child adopt an observer role when dealing with anxiety, giving them a greater sense of control.

LEARN ABOUT THE POWER OF VULNERABILITY

"Vulnerability is not knowing victory or defeat, it’s understanding the necessity of both; it’s engaging. It’s being all in". 

Brene Brown

 

How do we step towards vulnerability?

I think the first thing we have to do is figure out what’s keeping us out of the arena. What’s the fear?

Where and why do we want to be braver? Then we have to figure out how we’re currently protecting ourselves from vulnerability.

What is our armor? Perfectionism? Intellectualizing? Cynicism? Numbing? Control?

It’s not an easy walk into that arena, but it’s where we come alive.

LEARN ABOUT SELF-ESTEEM

What is Self-Esteem?

As human beings, we tend to place a value or a measure of worth on ourselves or aspects of ourselves. So, self-esteem usually refers to how we view and think about ourselves and the value that we place on ourselves as a person. If the value we place on ourselves is often negative, this is when we run into problems with self-esteem.

Low Self-Esteem

Have you ever been dissatisfied or unhappy with yourself on the whole? Do you ever think that you are weak, stupid, not good enough, flawed in some way, inferior to other people, useless, worthless, unattractive, ugly, unlovable, a loser, or a failure?

Everyone uses these words on themselves at times, usually when they experience a challenging or stressful situation. However, if you often think about yourself in these terms, then you might have a problem with low self-esteem.

Low self-esteem is having a generally negative overall opinion of oneself, judging or evaluating oneself negatively, and placing a general negative value on oneself as a person.

People with low self-esteem usually have deep-seated, basic, negative beliefs about themselves and the kind of person they are. These beliefs are often taken as facts or truths about their identity, rather than being recognised as opinions they hold about themselves.

The Impact of Low Self-Esteem

• Frequent Self-Criticism.

A person with low self-esteem probably says a lot of negative things about themselves. They might criticise themselves, their actions, and abilities or joke about themselves in a very negative way. They might put themselves down, doubt themselves, or blame themselves when things go wrong.

• Ignoring Positive Qualities.

When compliments are given to them, they might brush such comments aside or say that “it was all luck” or “it wasn’t that big a deal.” Instead, they might focus on what they didn’t do or the mistakes they made.

• Negative Emotions.

A person with low self-esteem might often feel sad, depressed, anxious, guilty, ashamed, frustrated, and angry.

• Impact on Work/Study.

A person with low self esteem might consistently achieve less than they are able to because they believe they are less capable than others. They might avoid challenges & opportunities for fear of not doing well. They might work extremely hard and push themselves to do more because they believe they need to make up for, or cover up, their lack of skill. They might find it hard to believe any good results they get are due to their own abilities or positive qualities.

• Relationship Problems.

In their personal relationships, people with low self-esteem might become upset or distressed by any criticism or disapproval, bend over backwards to please others, be extremely shy or self-conscious or even avoid or withdraw from intimacy or social contact. They might also be less likely to stand up for themselves or protect themselves from being bullied, criticised, or abused by partners or family.

Cause or Effect?

 It is important to know that low self-esteem is a common problem for many people in our society - so you are not alone. Low self-esteem can occur as part of a current problem (such as depression), or as a result of other problems (such as chronic illness, relationship problems) or it can be a problem in itself. Either way, the good news is that you can take steps towards developing more healthy self-esteem.

Developing Healthy Self- Esteem

If you were asked to list some positive qualities about yourself, how would you respond? If you suffer from low self-esteem, you might struggle to bring things to mind. 

In order to promote a balanced evaluation of yourself, it is ok to notice and acknowledge your positive aspects, and to behave like someone who has positive qualities and who is deserving of happiness and fun.

If most of the time all you pay attention to are your negative qualities and you feel comfortable dwelling on these negatives. Ask yourself how fair is that? By getting you to begin acknowledging your positives, you are really tipping the scales of self-evaluation back into balance.  

1. Start with a ‘Positive Qualities’ Record

When we notice something and it’s really important for us to remember it, what is it that we do to help us remember? We write things down, make a note of it, or make a list if there are many items. The same approach applies here. To start acknowledging your positives, you need to write them down. Before you start on the Positive You Journal, you need to make a Positive Qualities Record - list down all the positive qualities you can think of, no matter how small, insignificant, modest, or unimportant you think they are.

 If you get stuck, ask yourself questions like:

What do I like about who I am? What positive characteristics do I have? What are some of my achievements? What are some challenges I have overcome? What are some skills or talents that I have? What do others say they like about me? What are some attributes I like in others that I also have in common with? If someone shared my identical characteristics, what would I admire in them? How might someone who cared about me describe me? What do I think are bad qualities? What bad qualities do I not have?

 

2. The ‘Positive You’ Journal

Using the Positive You Journal, recall specific examples of how you have demonstrated each of the positive attributes you have listed in the Positive Qualities Record. For example:

Considerate I took my friend some flowers and a book when they were sick. I offered a listening ear to my colleague who was going through some difficult times. I lent my brother some money when he was down on his luck.

Once you have listed some past examples like the one above, use the journal to start noticing your positive qualities on a daily basis. Each day, set out to record three examples from your day, which illustrate certain positive qualities you have. Write exactly what you did and identify what positive attribute it shows in you. For example, on one day you may note down that you mopped the floors (house-proud), finished writing out a budget (diligent), and played with your children (fun to be with).

Doing this will take some time, but is well worth the effort. Noting down the specific incidents that illustrate your positive qualities will allow the list to have an impact on your view of yourself, making it real.

3. Healthy Self-Esteem

Self-esteem is about thinking about ourselves and our worth in a BALANCED way. It is absolutely okay and appropriate that we recognise our weaknesses. What we need to do is accept that we all have weaknesses, and make a decision about whether or not we want to improve on them. We also need to recognise, acknowledge, and celebrate our strengths and successes. Also, don’t forget any skills and abilities that might be neutral. Remember, it’s all about being balanced!

4. Coping with At-Risk Situations

Having healthy self-esteem doesn’t mean that you will never encounter an at-risk situation again, that is, a situation where you might be reminded of that old negative view of yourself. It also doesn’t mean that you will never again think of yourself in a negative light. If you have done some work on your self-esteem, then the situations that are risky for you will be less frequent than before, as the threshold for activating a negative view of yourself will now be higher. That means it will take a lot more to ‘set off’ your low self-esteem than before. Everyone might think of themselves in a negative way or get down on themselves at times. The important thing to remember is not to do it too often.

So even after improving your self-esteem, you will still encounter at-risk situations in which the rules and assumptions you have for living are broken or threatened to be broken. But you can handle them differently, cope differently, respond differently.

Remember that the effect of your past experiences on how you see yourself today can be worn down by practicing new ways of thinking & behaving day-to-day.

LEARN ABOUT SLEEP HYGIENE & SLEEP HYGIENE TIPS

Learn about Sleep Hygiene & Sleep Hygiene Tips

‘Sleep hygiene’ is the term used to describe good sleep habits. Considerable research has gone into developing a set of guidelines and tips which are designed to enhance good sleeping, and there is much evidence to suggest that these strategies can provide long-term solutions to sleep difficulties. There are many medications which are used to treat insomnia, but these tend to be only effective in the short-term. Ongoing use of sleeping pills may lead to dependence and interfere with developing good sleep habits independent of medication, thereby prolonging sleep difficulties. Talk to your health professional about what is right for you.

Sleep Hygiene Tips

1) Get regular. One of the best ways to train your body to sleep well is to go to bed and get up at more or less the same time every day, even on weekends and days off! This regular rhythm will make you feel better and will give your body something to work from.

2) Get up & try again. If you haven’t been able to get to sleep after about 30 minutes or more, get up and do something calming or boring until you feel sleepy, then return to bed and try again. Sit quietly on the couch with the lights off (bright light will tell your brain that it is time to wake up), or read something boring like the phone book. Avoid doing anything that is too stimulating or interesting, as this will wake you up even more.

3) Avoid caffeine & nicotine. It is best to avoid consuming any caffeine (in coffee, tea, fizzy drinks, chocolate, and some medications) or nicotine (cigarettes) for at least 4-6 hours before going to bed. These substances act as stimulants and interfere with the ability to fall asleep

4) Avoid alcohol. It is also best to avoid alcohol for at least 4-6 hours before going to bed. Many people believe that alcohol is relaxing and helps them to get to sleep at first, but it actually interrupts the quality of sleep.

5) Bed is for sleeping. Try not to use your bed for anything other than sleeping and sex, so that your body comes to associate bed with sleep. If you use bed as a place to watch TV, eat, read, work on your laptop, pay bills, and other things, your body will not learn this connection.

6) No naps. It is best to avoid taking naps during the day, to make sure that you are tired at bedtime. If you can’t make it through the day without a nap, make sure it is for less than an hour and before 3pm.

7) Sleep rituals. You can develop your own rituals of things to remind your body that it is time to sleep - some people find it useful to do relaxing stretches or breathing exercises for 15 minutes before bed each night, or sit calmly with a cup of caffeine-free tea.

8) Bath time. Having a hot bath 1-2 hours before bedtime can be useful, as it will raise your body temperature, causing you to feel sleepy as your body temperature drops again. Research shows that sleepiness is associated with a drop in body temperature.

9) No clock-watching. Many people who struggle with sleep tend to watch the clock too much. Frequently checking the clock during the night can wake you up (especially if you turn on the light to read the time or are using our phone) and reinforces negative thoughts such as “Oh no, look how late it is, I’ll never get to sleep” or “it’s so early, I have only slept for 5 hours, this is terrible.”

10) Use a sleep diary. This can be a useful way of making sure you have the right facts about your sleep, rather than making assumptions. It is a good idea to only use it for two weeks to get an idea of what is going on and then perhaps two months down the track to see how you are progressing.

11) Exercise. Regular exercise is a good idea to help with good sleep. Morning walks are a great way to start the day feeling refreshed!

12) Eat right. A healthy, balanced diet will help you to sleep well, but timing is important. Some people find that a very empty stomach at bedtime is distracting, so it can be useful to have a light snack, but a heavy meal soon before bed can also interrupt sleep. 

13) The right space. It is very important that your bed and bedroom are quiet and comfortable for sleeping. A cooler room with enough blankets to stay warm is best, and make sure you have curtains or an eye mask to block out early morning light and earplugs if there is noise outside your room.

14) Keep daytime routine the same. Even if you have a bad night sleep and are tired it is important that you try to keep your daytime activities the same as you had planned. That is, don’t avoid activities because you feel tired. This can reinforce the insomnia.

Stages of Sleep

Research tells us that there are two types of sleep:

1)  REM rapid-eye-movement sleep: this type of sleep occurs for about 25% of the night, and is characterised by electrical activation of the brain, very relaxed muscles and body becoming immobile, and rapid eye movements as the eyes dart back and forth under closed eyelids. REM sleep provides energy to the brain and body and supports daytime performance. Dreams often occur during REM sleep, although they can occur at any stage.

2)  NREM non-rapid-eye-movement sleep: this type of sleep occurs during the other 75% of the time, and can be further broken down into 4 stages:

• Stage 1: this stage is light sleep, between being awake and falling asleep

• Stage 2: this stage is the onset of sleep, when the person begins to become disengaged from their surroundings. Body temperature drops and breathing and heart rate become regular.

• Stages 3 & 4: These stages are the deepest and most restorative sleep, known as ‘delta sleep’ - Stage 3 is a transition into Stage 4, or ‘true delta.’ During these stages, blood pressure drops, breathing becomes slower, muscles are relaxed and receiving more blood supply, tissue growth and repair occurs, and hormones are released (including growth hormone, which is why growing teenagers need to sleep more).