Anxiety Support
Generalised Anxiety Disorder (GAD) is a mood disorder characterised by excessive worry, panic, fatigue, impaired focus, muscle tension, sleep difficulties and restlessness. Anxiety disorders can cause individuals to become stuck in thinking patterns which negatively impact their sense of self and productivity. To understand how to help your child manage their anxiety, it is important to understand the ‘why’ of anxiety.
Strap in, it isn’t as simple as just ‘worrying all the time’.
Fear is a survival instinct, which occurs in the brains limbic system (hippocampus, amygdala, hypothalamus and thalamus) the area of the brain which is responsible for emotional processing. The limbic system is the part of our brain which allows the processing of memory, stress and emotional responses required for survival. This helps us do things like eat, reproduce and care for others. The limbic system controls appropriate responses to stimuli; the information gathered by our senses. This area is responsible for our fight, fright or flight response - which are all fear responses to perceived danger.
Fight = using our muscles to hit, kick, bite or otherwise attack the danger we face.
Fright/Freeze = staying completely still to avoid being spotted by the danger.
Flight = using our muscles to run away or escape from the danger.
In a typically functioning brain, we experience fear when we are faced with an immediate or unavoidable threat. Anxiety is very similar to the experience of fear except, the difference is - fear is based on real danger whereas anxiety is often based on imagined danger. In some cases, instead of experiencing fear about unsafe situations it can simply be unwanted or unfavourable situations. Anxiety can be based on previous experiences which cause the individual to preconceive there will soon be a threat, even if in reality, the chances that the threat will occur are low. Because our thoughts have so much power over our emotions and behaviours, even the thought of being in danger can cause an entire physiological response in our body.
The psychosomatic symptoms of anxiety are actually all survival adaptations which help us survive. Below are symptoms of anxiety which all have a very important role in surviving in the wild. As we are no longer living in primal times where we are faced with obvious danger such as being confronted by lions or bears, we instead experience these responses based on what we perceive as dangerous. Still, our brain is wired in this way and this comes to the surface when we experience fear responses in our body.
fast breathing:
By engaging in shallow breathing, our bodies are creating an imbalance of oxygen in our body so that we are able to utilise this oxygen in our muscles for running or fighting e.g. the dangerous animal we are faced with in the wild.
sweating
By creating sweat, our bodies are trying to cool our body down to prevent it from overheating. Sweat on the body is also a survival adaptation, our bodies become slippery - making it harder for a predator in the animal kingdom to grab us.
muscle tension & hands shaking
When adrenaline and cortisol flood the body in stressful situations, our bodies become tense as we are ready to run or fight. As we calm down, our muscles tend to shake as an after effect of the tension.
heart racing
When we are faced with danger, our heart beats faster to ensure there is an adequate amount of blood and oxygen in our muscles so that we are able to engage in a fight or flight response.
widening of pupils
One effect of stress on our bodies, which people may not notice, is our pupils dilating. This is a way that our eyes let in more light, so that we are able to spot danger and be more hyper vigilant of our visual surroundings.
sore stomach
When we are faced with danger, our bodies naturally decrease the energy being used on our digestive system, and redirects it to our muscles, heart and lungs for fight or flight. This can result in an uncomfortable feeling in the stomach, aches or pains.
When understanding anxiety, it is important to understand that the above symptoms can be experienced in the absence of danger. It can take something as small as a thought or trigger, to cause the person to have a full anxiety response including one of the fight, fright or flight responses.
To assist with calming, it is important to know which symptoms your child experiences so that you are able to target the specific body system. Breathing interventions are evidence-based and have been proven to reduce stress in individuals with anxiety. This is because by changing the rate of breathing, we are tricking the brain into thinking the danger is gone. When the brain notices the body’s breathing has returned to normal, it is able to regulate and starts to return to what we call the ‘rest and digest’ state. The ‘rest and digest’ state describes the body returning to baseline, in a relaxed state where oxygen and blood is flowing throughout the body systems normally again.
Anxiety can be caused by the worry that something bad might happen, or that an unfavourable experience will occur or re-occur. As we do not live in primal times anymore, this danger has become more related to what the person finds important. in their life. Children often worry about things like:
academic achievement
social success
pleasing their parents
things that impact getting their basic needs - sleep, eating, hygiene
Within the categories above, children can experience worries which impact their ability to attend, participate and be successful in these tasks. As parents, it can be difficult to understand how to help our children particularly when they are unable to articulate their specific worries.
What you want to avoid as parents or caregivers is being dismissive or invalidating, as their anxiety response is completely real, uncomfortable and overwhelming for them. Try to avoid statements like:
“it’s not a big deal”
“calm down”
“stop overthinking it”
“it’s all in your head”
“you’re overreacting”
These statements can imply that their feelings are not valid or understood by those around them. The above statements do not address the underlying problems and can come across as dismissive. This can lead to the child not feeling heard and cause them to think their feelings do not matter or are unimportant to the adults around them.
The overarching goal is not to get your child to do the thing that scares them, but instead, to strengthen your relationship with your child so that they are able to feel prepared to manage the situation - with help and eventually independently. You can do this by stopping, listening and reassuring. Let your child know that no matter how they feel, you are there to listen, support and problem solve with them. Replace the statements above with things like:
“I’m here to help you”
“Can you tell me about it?”
“We will work it out together”
“How can I help you feel better?”
“We don’t have to do that right now, we can wait until you are feeling a little bit better”
Give them room to talk about their feelings without interruptions, this is not the time to offer solutions but instead to listen and make sure they feel that when they speak - they are heard. Children are always doing the best they can and they are not being silly - they listen to their body clues and act accordingly, this is their survival instinct.
Most children will exhibit difficult behaviour or avoidance when faced with an anxiety provoking situation. Some children can even engage in difficult behaviour when they are not sure what they should be doing, as difficult behaviour always results in an adult coming over to them to address it.
Children can avoid environments where they feel overwhelmed, this can be school, the bathroom, the car or even some areas of the community. When children try to avoid environments, parents typically see large emotional escalations prior. This can be explored with an occupational therapist, to understand the child’s sensory processing and how to improve engagement in activities. Otherwise, this can be addressed by offering as much information to the child about the environment as possible. When things are predictable, they are much less scary. Try to describe to your child what the place will look like, who will be there, will it be noisy, will it have a certain smell? By providing predictability, there is also the opportunity to put in place problem solving strategies. Too loud? Offer headphones before entering the environment. Too busy? Allow a quiet space for your child to regulate with you before returning to the environment.
Again, the goal is not to force your child to engage in the anxiety provoking situation regardless of how they feel. The goal is to work with them to up-skill so they are able to manage the environment at a pace they feel comfortable with.
Tracey-Leigh Edwards
Occupational Therapist
