Helping Children & Adolescents Cope with Anxiety

Helping Children & Adolescents Cope with Anxiety

By on Oct 11, 2017

New York Times Magazine ran an article today looking at why more American teens appear to be suffering from severe anxiety. As the article suggests, this increase in anxiety is likely due to a manifold of reasons. We can't just blame it on smartphones or peers.

We also can't blame it on parents. As the article points out, clinicians are finding adolescents are no longer complaining about anxious pressure from their parents. Polly Young-Eisendrath (a clinician who is not mentioned in the article) found this in her own practice. Rather than saying "I just need to get my parents off my back," Young-Eisendrath found her adolescent clients talking about their parents being their best friends and champions. Yet, as she states in her book The Self-Esteem Trap, these teens were experiencing

"obsessive self-focus, restless dissatisfaction, pressures to be exceptional, unreadiness to take on adult responsibilities, feelings or superiority (or inferiority), and excessive fears of being humiliated" (p. 21).

As I said, there are multiple variables that likely contribute to these symptoms (and Young-Eisendrath has her own theory involving America's cultural obsession with individualism and exceptionalism), so it's not about blame. It's about what we as parents and educators can do to help.

Here are some suggestions (and I use the term "children" here as we can start this early in development):

  1. Recognize how our children's/students' anxiety raises our own anxiety. First things first: we can't effectively help them if we're freaking out ourselves!
  2. Recognize what sparks anxiety in our children/students and help them to see it -- particularly with teens and social media. When we help them to notice how choices, behaviors, certain friends, or activities generate certain emotions and behaviors (such as being angry or withdrawn), we empower them to do something about it. Sometimes one needs to reframe how they're looking at a particular situation, other times one may need to stop engaging in that situation. Our job as adults is to help our children see themselves so they can make choices that are best for them (e.g.: "I notice you get anxious and more self-critical after spending time on social media;" don't judge, reflect.)
  3. Use cognitive tools to help ourselves regulate our own anxiety, and teach these tools to our children/students so they can regulate theirs. One very helpful tool is to think of one's life as a long road trip. And on this trip you are taking a busload of emotions. Anxiety is one of those emotions, and anxiety will often try to drive the bus. The key is to recognize anxiety and notice when she's walking towards the front of the bus to take control of the wheel (my anxiety is a she; yours may be a he). That's when you tell her that you know she's there, she just needs to take her seat in the back. This helps to create some emotional distance between ourselves and our emotions without denying we have those emotions. Anxiety is there, but she doesn't get to rule our lives by driving the bus. Another tool to use is the "How do you eat an elephant?" question. Answer: one bite at a time! (Children love this one.) Anxiety can emerge because we're overwhelmed. Breaking things down into small bites helps our children (and us!) remember that everything is a process.
  4. Encourage our children/students to face their fears. The Times article talks about the effectiveness of exposure therapy. We can encourage or even create situations in which our children/students can face their fears. Afraid to speak in the front of the class? A presentation is just what they might need. Remind them to use their cognitive tools. Send anxiety to the back of the bus! And focus your attention on the content of what you're saying rather than yourself or even your audience's reactions. Fearful of speaking to adults you don't know? Have your tween check in with the restaurant hostess while you park the car. Prepare your tween ahead of time for such situations, letting them know that these situations are not intended to torture, but to help them overcome their anxiety.
  5. Remind our children/students of their own data. "You were anxious about going to camp last year, too. How did you feel when you actually got to camp?" Oh! Right! I actually had a good time! Remembering previous experiences and really looking at that data reminds them of their ability to overcome anxiety and moves them out of catastrophic thinking.
  6. Bring them into the present moment. Anxiety often occurs because we're thinking about the future. We're thinking, "What if?" It's helpful to just take a moment, look around, and have them ask themselves, "Is everything ok right now? Am I in any danger right now?" Life is about uncertainty, not certainty. And we need to help our children cope with life and accept that there is no certainty. There is only what is in any given moment and deciding and acting from there. If we're too anxious, we won't be able to determine the best course of action.
  7. Have them do something for others. Excessive anxiety can mean excessive self-consciousness. Doing something for someone else is a great way to turn their attention away from themselves. In fact, depending upon the situation and age, you may want to tell them that each of us is the center of our own universe, which means people are generally thinking about themselves, not others. So all that anxiety about what others are thinking of you means you're assuming that you are the center of other people's universes...which is rather self-absorbed if you think about it.
  8. Get them back in their bodies. Go hiking. Seriously. Take your children hiking on a challenging trail so they'll have to concentrate on where to put their feet and how best to move their bodies. Or play soccer with them. Or enroll them in martial arts. Physical activity will get them out of their heads and put them back in their bodies, relieving them from self-conscious, anxious thoughts. The brain circuits involved in movement are also involved in thinking and emotions. What those circuits do for movement, they also do for thinking and emotions. This is why moving our bodies in purposeful ways helps with our thinking and emotion regulation (of course, this is an oversimplification; for more detailed information on the link between movement and cognition see a white paper I cowrote with Dr. Deborah BuddingBorn to Move, Part 1: Movement and Cognition, which includes all scientific references; note it is paywalled).
  9. At a very early age, have children/students start practicing making decisions and doing things for themselves, and let them experience the result of their decisions and actions -- whether the result is good or bad (Montessori schools do this!). Of course, don't let them make major life decisions like whether or not they should change schools (because children don't know what they don't know). But give them time to practice making decisions for themselves. Sure, they might choose to go to school without their lunch because don't want to make it, but don't make it for them. Their hunger may be just what they need to motivate them to practice planning ahead. Our children don't need to be, nor can they be, happy and content all the time. After all, they're human. But what they do need is to know that they can do things for themselves -- that they can care for themselves physically, emotionally, psychologically, etc. In her book, Young-Eisendrath quotes psychologist Erik Thompsom as he describes a story from primatologist Jane Goodall: "When a mother is not strong enough to resist the self-attacks that a young chimp may make in protest over being weaned, and take him back to her breast, this weakens him, and he may never be able to thrive among his peers" (p. 74). Assume our children can handle their discomfort, remind them they can, and know that opportunities to practice making decisions and doing for oneself prepares them for life.

Of course, keep in mind that this advice is for neurotypical children and adolescents. Atypically developing children or teens may need medication or other therapies to feel relief from anxiety. They may also need more accommodations, like not being forced to sit with other children during group at school because it's simply too flooding and anxiety provoking. If adult support as provided above isn't helping, then a neuropsychological assessment can help parents (and the child!) better understand their child's neurology as well as help healthcare providers identify other therapies and proper medication if necessary. There is no one-size-fits all solution for every child.

Ultimately, articles such as the one in the Times need not makeparents and educators more anxious. Rather, they can stimulate our thinking about how we can help our children self-reflect and provide them with tools and experiences that allow them to practice how to effectively manage the uncertainty that is life.

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