What, Me Worry?
RECOGNIZING AND HELPING THE ANXIOUS CHILD
While many of the things that worry Andrew may be understandable – don’t we all feel a little reticence at the thought of a visit to the dentist? It’s the frequency and the level of his worry that sets Andrew, and others like him, apart. He is among the more than six percent of Canadian children between the ages of four and 17 who have an anxiety problem, making it the most common mental health issue for Canadian children, pretty much bar none, including attention and behaviour disorders. The World Health Organization describes anxiety as, ‘the most prevalent mental health problem across the globe’.
If we are complacent – and many would say that we are – it is perhaps because worry, by and large, is so familiar to us. From reports on the news of school shootings to the lead levels in toys, it’s easy to get pretty keyed up these days. A certain level of anxiety can seem like a normal response to the world around us. For many children, however, it isn’t.
WHY WORRY?
Of course, a discussion of anxiety among children can often raise more than a few eyebrows in the process. One man responded to an article in the Globe and Mail, saying, “In London, in the early 1940s, my classmates and I spent our nights in air raid shelters. We could leave for school in the morning and come back at midday to find home and family wiped out. We had no counsellors, then or later. Children had to be tough.”
To many, it raises a fair question: Why are our children such worrywarts? Why don’t they just buck up and get on with it? My grandmother, for example, left Ireland on a boat when she was 10, potentially never to see her family again, and she never complained about separation anxiety. Certainly, many of the stresses of the past weren’t remote as on TV, but right outside the door. Still, people generally did OK, didn’t they?
Well, many of them probably did, though we know now that many also struggled with ongoing anxiety issues throughout much of their lives. Studies have suggested that instances of divorce, drug and alcohol abuse and depression may stem, initially, from unrecognized – and therefore untreated – anxiety disorders.
WHEN WORRY BECOMES A DISORDER
Just because supports weren’t available in the past doesn’t mean that people wouldn’t have benefitted from them. They undoubtedly would have. Today, we know a lot more about anxiety than ever before, including the roles, both good and bad, that it can play in our children’s lives.
“A little bit of anxiety is healthy,” says Burlington, Ontario, paediatrician Dr. Laura Gerber. “It keeps us moving, it keeps us motivated, it keeps us achieving.” However, “for some children anxiety becomes impairing. They avoid social situations or avoid school, or do poorly in school as a result of their anxiety.”
When anxiety begins to affect a child’s interaction with others and alters their sense of emotional well being, it’s time to take a closer look. “My daughter at age four has already been to friends’ houses with other parents,” says Janet Freeman, a mother of four in Southern Ontario, “but Jordan never went to a play date until a year ago. He was too scared to do it.” At 12 years of age, and with high school and the teen years around the corner, Janet became concerned at how much Jordan’s fears were getting in the way of his life. He has since been diagnosed with social phobia. “We have to push him for anything. He won’t do sports because he is afraid kids will laugh at him. He worries that he’s not as good as other children. He refuses to partake in organized sports or anything involving being with others.”
RECOGNIZING AN ANXIOUS CHILD
In retrospect, Janet can see that Jordan displayed symptoms of an anxiety disorder for years, but it isn’t surprising that he wasn’t diagnosed until recently. In her practice, Dr. Gerber finds that, more often than not, the signs can easily be misinterpreted or misunderstood. “Parents may not be aware of the child’s anxiety until later,” says Dr. Gerber. “Because children don’t have the words to express their emotions and they don’t recognize what it is that is making them feel upset or out of control.”
Unlike adults, who are able to articulate and discuss whatever anxieties they may be feeling, children’s physical symptoms often tell a more complete tale. “Children will get stomach aches at night on school nights,” says Dr. Gerber, “they won’t occur during activities they enjoy over the summer holidays.” Headaches can also be an indication. Again, it is the timing and the onset that can be most telling. “A proper headache history can usually sort out which headaches are medically concerning and which are associated with an underlying anxiety issue.”
“Most children don’t suddenly develop anxiety,” she says, “but at some point it may be worsened by a particular stressor.” Karyn says. For example, one of Andrew’s recurrent fears – that a criminal will enter his classroom – is the result of the experience of the school drills. “He will say ‘Mom I have a stomach ache and then he will say something about the lockdown,” says Karyn. “I have to tell him to do what they tell you and you are going to be fine. I do a lot of convincing.”
WHAT YOU CAN DO ABOUT IT
For many parents of anxious children, just being able to put a name to a range of seemingly unrelated concerns and symptoms provides a great leap forward. Help is now available, including a peer support group. “He now knows that there are other children like him. He’s not alone in this.”
There
is a lot that parents can be doing such as formal therapy, programs
within the school and learning how to provide support in the home, but
the vast majority of parents don’t do anything at all. If our kids were
to break out in purple spots, we’d be first in line at the emergency
room. But when it comes to mental health, we are typically slow to act.
In the vast majority of cases, it is the physical symptoms of anxiety –
the stomach aches, the headaches – even though social issues, or school
avoidance, may have been present for years. This was true in both
Andrew’s and Jordan’s cases. Without the physical symptoms, their
anxiety disorders would remain undiagnosed.
Ultimately, children
are tough, but it’s also a big world out there with a lot going on in
it. For children who struggle with anxiety, often just being tough isn’t
enough. Given that we know what anxiety is, and that we know how to
help, why wouldn’t we?
