From the April 2016 issue

Helping Kids Cope with Stress and Anxiety

How can you tell the difference between normal stress and an anxiety disorder? We've got answers. Plus, get tips for helping your kids cope.

Brought to you by Flinn Foundation

A little stress is just a part of everyday life for most parents. Even the thought of juggling each family member’s various activities in a given week can be a bit overwhelming.

It’s only natural that our children feel some of that weight, too, especially with their often-full schedules of academics and extracurriculars. Then there are the bigger issues, like moving or transitioning to middle school, that can also challenge a child’s peace of mind.

Research shows that stress is a real issue for many kids. In fact, a 2014 survey by the American Psychological Association found that 30 percent of teens reported feeling sad or depressed because of stress.

“We all experience both stress and anxiety,” says Kate Fitzgerald, M.D., an assistant professor at the University of Michigan Department of Psychiatry.

The good news is that some stress is not only normal, but can even be beneficial to an extent. A teen worrying about an upcoming test, for example, might feel compelled to study more.

“It shows you care and it motivates you to work hard and do well,” Fitzgerald says. “That’s normative anxiety.”

So how does a parent know the difference between normal, everyday stress and an anxiety disorder? It depends on the situation – and how your child responds to it.

“Typically we can define (stress) as being associated with a particular event,” she says, like starting a new school or trying to make a new friend. “That kind of stress causes everybody a little bit of anxiety.”

However, parents should be concerned if their child’s stress starts interfering with normal activities. The teen that’s nervous about a test, for instance, might be so overcome with worry that he can’t focus on studying at all.

“When it gets to the point that it’s a disorder is when it’s causing you problems,” Fitzgerald says. “You have a stressor and you’re so anxious that you can’t cope with it. It’s impairing your function.”

Know the signs

The signs of anxiety in children can include thinking the worst, irritability, oppositional behavior or physical symptoms like headaches and stomach aches.

“A lot of times anxious kids are irritable,” Fitzgerald says. “They snap at mom and dad because they’re feeling anxious.”

Anxiety can have a significant impact on kids, affecting their social interactions and even academics. A kindergartener who struggles with anxiety may fall behind on reading or writing and could miss out on important social skills, she says.

Another common sign is avoidance. This becomes a vicious cycle in which the child gets relief from avoiding an event instead of gaining confidence by overcoming the fear.

“Anxiety and avoidance go hand in hand,” Fitzgerald says. “Feeling better from avoiding actually reinforces the avoidance.”

Don’t over-accommodate

Parents can offer support by encouraging their child to continue with activities, even if they may seem difficult. Tell your child you have confidence in him and remind him of similar experiences that have gone well.

“Whether it’s a birthday party or a soccer game or school, it’s important just to go and be positive,” Fitzgerald recommends.

Be careful not to fall into the trap of over-accommodating a child’s anxious requests. Parents often find themselves taking their child out of a stressful situation instead of helping them confront it.

“Many of us as parents, our natural inclination is wanting to protect our child from feeling anxious or upset,” she says. “Not only are they successfully avoiding, but now the parent is sort of on board with the anxiety and reinforcing it.”

Positive language, rewards

Instead of reinforcing, encourage your child to “practice” the things that make her anxious.

“I think that’s helpful language for parents,” Fitzgerald says. “Just like you practice learning to ride a bike, you can practice doing the thing that makes you feel a little bit nervous or afraid and you get better.”

Giving names to feelings is also helpful. Therapists sometimes use terms like “the worry bully” or “worry pest” to help kids talk about their anxiety.

“Labeling it gives the kids a little bit of power over it,” she says.

Offering an immediate reward after confronting an anxiety-producing situation can also prove beneficial. Let your child choose from a prize box, have an extra book at bedtime or another age-appropriate reward, Fitzgerald suggests.

Start small

If a particular situation is causing your child stress, try breaking it down into something smaller. A 4-year-old who is stressed about starting preschool might ease into it with a twice-weekly playgroup. A middle-schooler starting a new school could practice making new friends by taking an art class during the summer.

“Take the core fear and make it more doable,” Fitzgerald recommends. “Try to design it so that you’re fairly confident your child is going to have success.”

How to get help

If you’re concerned your child may have an anxiety disorder, don’t hesitate to seek out an evaluation. Statistics show that one in three youth will have met the criteria for an anxiety disorder by adolescence, Fitzgerald says.

“It’s hugely common. What I try to underscore with patients is that it’s really treatable,” she says. “I love treating anxiety because they really get better and while it can be incredibly impairing and it does need to be recognized, the treatment works.”

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