How to support a child with anxiety

Even at a young age, it’s normal for children to feel anxious about the unknown or some sort of change. Anxiety, which is a fear response, can even be helpful, as it allows the child to act cautiously in certain situations. However, if your little one overreacts to new or unfamiliar situations, it’s important to find ways to reassure them.

What is anxiety?

Anxiety is a fear reaction, albeit an exaggerated one. In fact, fear is a normal reaction in the face of a real danger (e.g., a fire). In this case, it’s how the body prepares to face a concrete threat. Anxiety, on the other hand, is a response to feeling in danger (e.g., thinking there is a risk of fire). Even if the threat is not actually present, the body reacts as if the danger were real.

For example, it’s normal for young children to be afraid of things like loud noises, monsters, falling into the toilet, and Santa Claus. These fears disappear as they get older.

However, with anxiety, the fear of a situation is often imagined or exaggerated in relation to the actual situation. Anxiety can become a problem if it interferes with a child’s daily functioning or takes up too much space in their life. For this reason, it’s important to find ways to reassure them.

The main causes of anxiety in children

There are many reasons why a child may be anxious. Here are a few examples.

• Genetics. Having an anxious parent increases the chances that a child will be anxious. Some toddlers inherit an anxious temperament. Accordingly, their anxiety might be higher than average and it might be harder for them to calm down. An anxious parent can also transmit their anxiety to their child through their attitudes (e.g., being more worried and nervous in certain situations, having a tendency to overprotect their child, etc.).
• Separation from their parents. A baby may become anxious when they’re separated from their parents or when someone they don’t know approaches them. Separation anxiety begins at around 8 months of age and can last until the child is 18 months.

• Irrational fears (e.g., monsters and wolves) and the fear of getting lost when you’re out in public together.
• New situations or a significant change. For example, the birth of a little brother or sister, going to a new daycare, being in a new group, moving, conflicts at home, a separation, or a death can all cause temporary anxiety.
• A lack of routine and rules. Poor nutrition and lack of sleep can put a child at greater risk of anxiety. The absence of clear and concrete rules can also be a source of anxiety. Children need rules to feel safe.
• Overprotection. Overprotecting a toddler can make them feel insecure and anxious about the future and things they can’t control.
• An event that has occurred in the child’s environment. For example, a toddler who has had a bad experience may fear it will happen again whenever they’re in a similar situation. For example, they slipped in the bath and are now afraid of water, or they were bitten by a dog and now they’re afraid of dogs.
• Excessive demands or expectations placed on the child. This causes the child to feel inadequate and fear making mistakes or disappointing others—all of which can increase their anxiety.
• Neglect and abuse. Failing to meet a child’s basic needs and exposing them to aggression are both situations that make a child anxious.

Signs of anxiety

The following signs of anxiety are common in young children:

• Overreacting (e.g., crying, refusing to listen or throwing a tantrum) to certain events or changes in routine. They try to avoid certain situations, such as visiting someone, going to daycare, participating in activities, or being babysat. A sudden change in behaviour can also be a sign of anxiety. For example, a child who becomes agitated, irritable, sad, or worried.
• Physical discomfort such as headaches, stomachaches, nausea, or rapid breathing.
• Sleeping problems. They have a hard time falling or staying asleep. They refuse to go to bed or won’t sleep alone. They often have nightmares.
• A constant need for reassurance. They seek to be near their parents constantly.
• Difficulties in relationships with others.
• Isolation. Some toddlers are more anxious than others and withdraw into themselves, don’t play with other children, and try to avoid new situations.

Helping an anxious child

Here’s how you can help your toddler deal with bouts of anxiety and cope with temporary fears.

• Play peek-a-boo. This game will make your little one realize that you’re always there, even when they can’t see you. It can be particularly helpful for a child who is experiencing separation anxiety.
• Give your child a comfort object to hold onto during times of transition or separation. This can be a stuffed toy, a blankie, or any other object that reassures them. Later, as your child gets older and gains confidence, you can encourage them to leave it at home. Tell them they can carry it around with them in their heart. Gradually, they’ll learn to soothe themself without your help.
• Establish routines for key times of the day, including a morning routine and a bedtime routine. This will give your child a sense of security. You should also make sure that your toddler is eating and sleeping well. If they’re having nightmares, try to figure out why.
• Calmly listen to your child. Watch how they react and ask them questions to identify what’s causing their anxiety. Answer their questions in simple terms that are appropriate for their age. If they can’t speak yet, talk to them in a soft, reassuring voice. Help them verbalize their emotions. For example, you can say: “You’re scared. I can feel your heart beating very fast.” This will reassure your child and reduce their anxiety.
• Don’t minimize your toddler’s fear, even if it seems exaggerated, because it’s very real to them. Let them know that you take them seriously and don’t make fun of their fear.
• Give your child as much time as they need to get over their fear of something. However, you shouldn’t let them avoid all scary situations. It’s a good idea to gradually expose them to what they’re afraid of. This way, they’ll see that there’s no danger and they’ll overcome their fear.

• Explain to your child what will happen if a change is coming. For example, if you’re moving, take them on a tour of the new neighbourhood and show them pictures of the new house. If they’re anxious about starting kindergarten, take them to activities that the school organizes for future students. You can also go play in the school playground with them a few months before school starts.
• Invite your child to use their imagination when it comes to dealing with their fears. You can tell them to use their superhero cape or invisible sword to build courage and chase their fears away. This will help them develop confidence. Little by little, they’ll tame their fears and learn to reassure themself.
• Play pretend with your toddler and read them stories to prepare them for new situations that they might find frightening or difficult to adjust to. It could be a book about starting kindergarten, moving to a new home, or going to the dentist for the first time.
• Show your child how to take a deep breath to calm down. Ask them to put their hands on their stomach and imagine a balloon that inflates when they breathe in and deflates when they breathe out.
• Make sure your child has a chance to move every day. Running, jumping, and dancing are activities that release tension and stimulate the production of hormones responsible for well-being and relaxation. This can help lower anxiety.
• Remind them of their successes. Mention the fears they used to have but don’t have anymore. This way, they’ll gradually learn that they’re able to overcome their fears.
• Offer them “trial periods” for new activities. This will encourage them to try something new.
• Praise them when they make an effort to overcome their anxiety.

How can you avoid passing on your anxiety to your child?

Your child can easily sense your emotions and fears. Since they learn by imitation, they might feel worried if they sense that you’re worried yourself. Because of this, try to stay as calm as possible when a situation makes you anxious but doesn’t present any real danger.

For example, avoid using catastrophic words such as “this is terrible” or “this will never work.” These words are likely to make your child anxious about the situation as well. If your anxiety is affecting your child, seek support from someone close to you or a professional (e.g., a psychologist or social worker).

When should you consult a professional?

If your child’s anxiety is having a major impact on their daily life, or is causing them significant distress that’s hard to alleviate, consult a professional (e.g., a doctor, pediatrician, psychologist, or social worker). If a child’s anxiety is left untreated, the problem can get worse over time.

Here are some signs that your child might benefit from outside help:

• You’ve noticed a sudden change in the way they respond to events.
• Anxiety interferes with their daily functioning: they aren’t sleeping as well, they refuse to eat, they isolate themself, or they lose interest in the games they usually like to play.
• When your toddler’s anxiety after a major change doesn’t get better, even after a month.
• Their anxiety causes them to have extreme fears or phobias.
• You avoid certain situations because of their anxiety.

Things to keep in mind

• A certain level of anxiety is normal in children.
• Adopting a calm and reassuring attitude will go a long way in helping your toddler overcome their anxiety.
• Don’t hesitate to seek professional help if your child’s anxiety becomes significant and prevents them from functioning normally.

Scientific review: Dr. Sophie Leroux, psychologist, Centre hospitalier universitaire Sainte-Justine Research and copywriting: The Naître et grandir team Updated: March 2019

Photos: iStock.com/Birkholz and GettyImages/photoguns