Anxiety In Children, Part 1 of 2

In this first episode of a two-part series, clinical social workers Kristina and Heather dive deep into the rising concern of anxiety in children. They explore how the symptoms of anxiety often mirror other conditions like ADHD or depression, making it crucial for parents and caregivers to recognize the signs early. From physical symptoms to avoidance behaviors and explosive outbursts, the impact of untreated anxiety can be significant. Kristina and Heather stress the importance of early intervention to prevent anxiety from evolving into depression and offer effective strategies such as cognitive behavioral therapy, medication, and teaching children essential coping skills. They also discuss the critical role parents play in modeling healthy coping mechanisms, like deep breathing and outdoor activities, and knowing when to seek professional help. Tune in for invaluable insights on how to help our children navigate anxiety and build resilience for a healthier emotional future.

Gear Up! Adventures In Parenthood is recorded and edited by Dave Purnell and produced by Jen Plante Johnson for the ODC Network in Holland, Michigan.

The ODC Network is a non-profit organization that strives to advance outdoor education and conservation in West Michigan. 

Since 2000, The ODC Network has served over a million people through hands-on, outdoor learning experiences and conserved thousands of acres of native habitat through restoration and preservation projects.

The ODC Network’s vision is building a better community by connecting people, land and nature. To learn more and get involved go to: www.odcnetwork.org.

Transcript

Heather  00:00

Today, we're starting a two part series on something that's affecting more and more children: Anxiety. Statistics show that by age 18, about 30% of children will experience an anxiety disorder, but shockingly, 80% of them won't get the treatment they need. So it's more critical than ever for parents and caregivers to recognize the signs and know how to help, especially since it might not look like what we'd expect and sometimes can be confused with other conditions like ADHD or depression.

Kristina  00:33

So today we'll talk more about what anxiety does look like and how it often shows up internally through things like trouble, sleeping stomach aches or avoiding certain situations. These signs can be hard to notice, especially since children are still learning how to express their feelings.

Heather  00:52

The good news is there are ways to manage anxiety effectively, and we'll talk about some of them today - things like cognitive behavioral therapy, medications when needed, and some simple yet powerful strategies that parents can use, like sensory play, outdoor activities and connecting with nature. These simple tools can really make a difference in helping kids feel calm and build their resilience.

Kristina  01:18

We're so glad you're joining us for this important conversation about how we can better support children who are dealing with anxiety and learn some tangible steps we can take to navigate anxiety in our kids.

Heather  

Welcome to Gear Up! Adventures In Parenthood.

Kristina

A podcast where we explore the struggles and challenges we all face as parents. We'll share ideas and offer tips and strategies for raising happy, healthy children. My name's Kristina Boersma

Heather

And I'm Heather Bouwman. Kristina and I are clinical social workers who've been working with families and children for a good long minute. We're Support Service Directors for the Early Childhood Network of ODC Network in Holland, Michigan. And we get to support parents and children as they navigate the tricky terrain of raising children and growing up in today's world.

Kristina

We're here to help unpack the hard stuff and connect with the joy of parenting. 

Heather

Are you ready? 

Kristina and Heather

Let's hit the trails.

Heather  

This project is made possible by the ODC Network, an amazing nonprofit organization based in Holland, Michigan, where we get to work supporting preschool aged students, their teachers and their parents.

Kristina  

The ODC Network is all about nurturing the community and the next generation through a wide variety of innovative nature-based initiatives.

Heather  

Please visit www. ODCNetwork.org to learn more about the ODC Network's mission and impact.

Kristina  02:54

I am really looking forward to the conversation that we get to have today, because it is about anxiety in children. And you know that that's been very much my world. 

Heather  03:07

It's a lot of people's world. 

Kristina  03:09

It is, and in fact, it's becoming more and more and more prevalent-

Heather  03:13

Absolutely-

Kristina  03:14

As the years go by- 

Heather  03:15

In children younger and younger. 

Kristina  03:17

So Grace, sweet, sweet Grace, has struggled with anxiety since she was really, really young. She comes by it very naturally. I also am an anxious person, and so nature, nurture kind of a lot to try to tease out. But today we're going to talk about what anxiety looks like in children, and what we can do to help our children who are anxious,

Heather  03:43

I'm ready. That is such powerful information. Absolutely. I'm ready, let's do it.

Kristina  03:48

So one of the things that I will talk to parents about that has been helpful for me too, is that in young children, many different things look like the same thing. For example, a child who is anxious can look like a child who has ADHD.

Heather  04:06

Because of the hyperactivity...

Kristina  04:07

Yes, and for how, for how it manifests. Depression in children, looks a lot like anxiety in children. And I'll say to parents, it's like you're seeing this constellation and you're trying to make sense of the stars that you're seeing. And in young children, the constellations overlap, so they have some of the similar symptoms you may see, but they may not have enough of the constellation to actually say your child has clinical anxiety. 

Heather  04:37

Yes. And it's really hard to tease out the individual stars in the constellations. 

Kristina  04:43

Yes, absolutely. So we can tend to jump. It's kind of like way back when I was in the 70s and 80s, everybody was hypoglycemic. Everybody was. And so if you didn't know what was causing something, you'd say, "Oh, it's hypoglycemia." 

Heather  04:59

Must be that blood sugar. 

Kristina  05:01

We went through a wave where children's behavior was just identified as, "Oh well, they have ADHD." And not every child has ADHD, obviously. Childhood is messy. It can look chaotic. Children can look like they're all 

Heather  05:21

Disorganized.

Kristina  05:22

Yeah, or hyper, and could be because they're over tired. 

Heather  05:25

And I don't mean disorganized with stuff. I mean disorganized kind of spatially and mentally. Yeah, it just can look like chaos, right? Times, right? Because that's how development is at times.

Kristina  05:36

And some temperaments, like Artisans, for example, can look super hyperactive because they love to be on the go, and they're so good with their bodies, and they like to jump off things-

Heather  05:48

And they can look like they run on a motor.  But that's who they are wired to be.

Kristina  05:54

So it's important that we figure out how to identify symptoms of anxiety in children, as it's important to figure out depression and those other things too, because then we're able to better support our children.

Heather  06:09

I'm so glad you said that, that it is so important to be able to identify that, because if we don't, we know that the prevalence becomes much more intense as they age, right? Untreated anxiety gets bigger. And then can turn into depression. I think even when you and I were in grad school, they would kind of speak of it as an either or, like you were either ran anxious or you ran depressed. And that was kind of a thing for a bit, and now we know they can very much coexist.

Kristina  06:42

Oh, and most often do. And it's important for us to recognize that, especially in childhood, anxiety is internal. So it may be that anxiety is occurring for quite some time before we see the outward manifestations. So, in children, those outward manifestations vary widely, and they can range from children who experience trouble sleeping or complain about stomach aches or other kinds of physical symptoms that internal feeling is manifest externally, right? They may become particularly clingy or avoidant.

Heather  07:25

Right. We see this at the preschool. Separation anxiety.

Kristina  07:29

And that's primarily what it is in young children, is separation anxiety. Children who are anxious may have difficultyfocusing. They can get fidgety. And that's where we say, you know, everything that moves is not necessarily ADHD.

Heather  07:44

Correct.

Kristina  07:45

It can be anxiety that's showing up in that being fidgety or being inattentive, having a difficult time focusing. Kids who are anxious can have these really explosive outbursts. Now, that has been true for Grace, where it's like,"Where in the world did that come from?"

Heather  08:05

Right. It's like she had a capacity to take things in and to manage and to cope. And then all of a sudden, there's notmuch warning sometimes, that that capacity is not just diminished, gone. Completely gone. And then the volcanic explosion happens.

Kristina  08:22

Yeah. And I still see it with her, even at 15, explosiveness is not as much, but being avoidant and having difficulty focusing. Now she also has ADHD. But those two things you cannot completely separate for a person that has, you know, kind of both of those conditions, and that would be Grace. So growing up for her, it took us a while to figure out kind of that's what was happening. And once we did, then we were able to move in with some other things that we could do to help her, and we're going to talk about that a little bit later. Another thing that can make anxiety kind of difficult to pinpoint is that we use lots of words to describe children's behavior, and any of these things could also be caused by anxiety - things like being self conscious or shy, maybe a child feeling kind of apprehensiveor worried or being particularly fearful. They don't do a good job of capturing what the child's actually struggling with. And if you don't identify what they're actually struggling with and just try to kind of treat what you're seeing the shyness or being avoidant or being worried, it doesn't help that underlying anxiety. 

Heather  09:41

Don't you think that we've learned as therapists to de personalize so much of that,  like, rather than saying, "Oh, she's really anxious," to be like, "Oh, the anxiety got hold of her." That kind of depersonalization - we want to be so careful that we're not creating an inner voice within children, when we talk about, "Oh, there's just so shy. It takes them a really long time," because so often we say those things to people in front of the child.

Kristina  10:14

And then they take on that persona: "I'm shy." 

Heather  10:17

They live into it.

Kristina  10:18

Yeha. So we need to be careful about kind of just looking at the outward manifestations and thinking, "Aha, that's it. My child is shy, and so I need to..."

Heather  10:32

Give them more opportunities to not be shy. 

Kristina  10:35

Right. And really push them out of that comfort zone. And if they're being avoidant, because they're anxious, pushing them will only make them more anxious. So it's really important that we learn to identify it. It's also important that we understand the consequences when we don't. 

Heather  10:55

Kristina, you said something really important there about avoidance. Talk to us more about what you mean by avoiding, right?

Kristina  11:03

So avoiding can look like a lot of different things. It can look like being very resistant to participating in something that peaks that child's anxiety. So it could be going to the grocery store because the grocery store for whatever reason, for that child really triggers that anxiety to go up. So they're not going to want to go to the grocery store, even if they liked to go to the grocery store before, something has happened there. They lost sight of you. Something has happened. Oh, you know how we're all just legs right to the little ones. And sometimes they find the wrong pair of legs and they follow them, or they, you know, are going to them for comfort, and they're not the right person. That can really challenge a child, especially if they have anxiety that now the store is not a safe place. So they want to avoid those things as they get older. My daughter avoids her schoolwork like the plague, and that has a whole lot to do with her anxiety. Because once she begins it, she already in her brain knows it's going to be completely overwhelming. It's going to take way too much time. I'm not going to understand it. It's going to be too hard, right? She has this whole tape going in her head of those anxious thoughts that then, in order to avoid the anxious thoughts, she avoids the activity. So that's what being avoidant is about. And it can be really fun stuff. And you think, "I don't know why you want to avoid this. This is super fun. You're gonna have a great time." And yet, they avoid it. So children in general like to have the same stories read to them over and over and over again. Part of that is because it's predictable. They know what's going to happen, and they can settle into really enjoying the book.

Kristina  11:32

There's a comfort and security there, because it's known.

Kristina  12:52

Right. So children who run more anxious have a harder time starting books that are unknown, because they don't know what's going to happen, and all of a sudden, that anxiety gets tapped.

Heather  13:04

Because there are so many possibilities. What could be. And we don't know where we're going.

Kristina  13:10

Right. So they may avoid having new books read to them, or experiencing those kinds of new things. We all avoid some things, because that's a way that we cope with life. The trouble is, when avoiding those things really interfereswith a person's well being, interferes with their relationships, right? Interferes with their ability to get through the day. So we see that in children. Many times we just force them into it again, because we're treating the symptom asopposed to what's actually happening.

Heather  13:42

What's underneath, what's the cause. Right.

Kristina  13:45

And this is not some kind of personal failure. It's not like you're a terrible parent if your child is anxious, at all. First of all, we all have anxiety. We have to have some anxiety. It's what helps us prepare and get ready for things that may be tricky or difficult or unknown. It allows us to react the way that we need to react.

Heather  14:09

Hey, hey, listeners, Kristina and I are so grateful to be a part of your village. If these conversations and episodes areimpactful to you, we deeply appreciate your support to continue doing the work we love so much for such an amazing nonprofit organization, please visit www.gearup-podcast.com to make a tax deductible contribution. Thank you.

Kristina  14:38

Anxiety, in and of itself, isn't a bad thing having too much anxiety is.

Heather  14:43

Yes. There's a tipping point. Let's talk about some of the current statistics. So if we look at the prevalence rates of anxiety disorders, we'll see that the numbers rise as children get older. And we, because of our world, our kids are dealing with so much more than we ever were.  It's the social media. It's the school pressures. It's that there are so many just societal pressures in general. We just talked about parental perfectionism. And that, within that, there are two component: there's parent perfection, and then there's child expectations. Kristina, you alluded to this already, that anxiety disorders are internal, like that anxiety is internal. It's cognitive. And so that also is why we seeit as kids develop and become older. That's why the rates go up, because their cognition is developing. And so those rates increase as they gain that cognition. Separation anxiety is what you had said we see in our preschool world. And we see even within that varying extreme, varying levels, right? And it's interesting too, there's this parent, child component to it. And we'll talk about when us as parents are carrying an anxiety. And how our kids can pick up on that. And it kind of feeds them in ways. But even in just that separation anxiety spectrum, there's huge differences in how intensely children feel that. So anxiety is a very real thing. It can be a very debilitating thing when not treated. And we don't want to leave it untreated. A study of more than 10,000 kids interviewed by trained professionals found that 30% had developed an anxiety disorder before they were 18. That's a lot. Three out of 10 kids is a lot. 

Kristina  16:46

It's extremely prevalent. And it's getting more prevalent as the years go by. 

Heather  16:50

It is, absolutely. And that's not just because we're getting better at diagnosing it. There are a lot of factors that go into that. We are getting better at diagnosing it. Also it's just happening more frequently. Another really important factor for us to be aware of, and probably a huge part of why we're talking about this: 80% of kids with anxiety don't get treatment. That's way - That's eight out of 10. 

Kristina  17:16

Yes, which has devastating consequences, right? 

Heather  17:20

It absolutely does. It leads to lifelong, perhaps mental well being issues. 

Kristina  17:26

It doesn't have to be that way.

Heather  17:28

No, because we can teach them early on how to cope and how to manage and how to vocalize and verbalize their feelings. 

Kristina  17:36

It took me a long time to get therapy for Grace. And part of that had to do with being in the business we're in. We know a lot of the therapists of the area, so that sets up this whole dual relationship thing. 

Heather  17:48

Well, and we always have to factor in I know you and I have talked about this several times. Our children live with therapists. So do our husbands. Poor souls. Lucky people. Doesn't always make me feel so lucky.

Kristina  18:01

Right. But there is this hurdle that parents need to kind of overcome, at least I did, even as an anxious person. I'm an anxious person. I love being in therapy. Think everybody should have a therapist, because we all got stuff to work out. So I'm not anti therapy at all. I'm a therapist, and I understand how helpful it is. But there is something about admitting as a parent, especially as a therapist parent, that your child needs help beyond what you're able to offer. So that took me a while. And it can take parents a while. We want to be able to help our kids on our own. But it's important to recognize when it's time to get them help, because if we don't, things can happen. So talk to us about some of the things that can happen when we don't treat anxiety.

Heather  18:46

 Yeah, if we leave our anxiety untreated for too long, it will very likely turn into depression. And then those things will be co occurring. And they will feed one another. And that's a really important thing to know. And like I said, people used to say those didn't coexist. And now we just know that they very much do. So there are things like cognitive behavioral therapy that are very powerful and impactful. There are also medications that can offer great assistance. But getting help is such a huge part, and that might be talking to a friend initially, that feels like a safe space, right? I think we all have our starting place of what that looks like for us. We want to call the friend that we know can give it to us straight, and be able to say, "I think that might be a really good idea. You can start with yourpediatrician and ask them." And then it just becomes figuring out who's a good fit. So often people start with maybe one therapist and they think, "It isn't that great. Find another one. Go find another one that's going to work well for your child, for your family. If your child's in therapy, you're also going to have a big piece of that. We both worked with kids. And you work with the parents as much as you do with the child. So find someone that you want in your life for a bit to teach those things. Treatment doesn't have to be a lifelong thing. I think that's a piece of it. For some people, they think "I'm gonna embark on this and this is gonna be the rest of my life." Maybe. And maybe that's okay. And also maybe not. Maybe we just need some coping skills. Maybe there are things we can tweak and adjust that will have huge impact. It doesn't really matter. We just need to get relief, right? 

Kristina  20:42

Yeah, for sure. And there are things that we're discovering every day that can help individuals who struggle with anxiety: yoga and practicing that very controlled presence with your body can be super helpful. So can things like singing together...

Heather  21:02

Being in nature. And we'll talk about all of those things. Talk to us first. What can we do as parents when we suspect - we hear this from parents a lot - "I think my child might have some anxiety." We will hear about separation anxiety, but also they see these behavioral shifts. Maybe it's the explosive fits that come seemingly out of nowhere. Maybe it's that their child is refusing to participate in something or doesn't want to go somewhere. Talk to us about how we can identify and then help our kids in those moments.

Kristina  21:41

Right. So, first of all, we need to not panic, okay? Us panicking will not help our children. And many times, when children are like chronically anxious, even the most well meaning parent can do things that actually make it worse, because we don't want our children to suffer, right? And so we try to protect our children from the thing that might be causing them anxiety. If my child is anxious going to the grocery store, I don't make her go to the grocery store anymore. That doesn't necessarily help. So it's important to kind of get in our minds what we're trying to do with anxiety and what we're not trying to do. So one of the things to just make peace with is the understanding that we are not trying to eliminate the anxiety. What we're trying to do is help children and others learn to cope with the anxiety- 

Heather  22:40

And manage it. 

Kristina  22:41

To manage the anxiety. It's like the anxiety is not going away, so how are we going to cope with it? None of us want to see a child that's unhappy. But it's important that we don't remove the things that are stressing them, right? What those stressors are?

Heather  22:57

Because there will always be stress. Stress will come.

Kristina  23:01

And we can't bubble wrap our children, right? So if we help them learn how to tolerate that anxiety and function as best they can, that's what's going to help them. 

Heather  23:13

Yes, that's what builds the resilience.

Kristina  23:15

Even when they're feeling anxious, right? That's going to help them learn to tolerate it. And in fact, the anxiety will decrease over time. So I have in my office, and I've had this for years, this stuffed bright orange... I call it my "worry monster." It has a humongous mouth that you can put things inside of it. Okay? It's actually, it's not a terrifying looking monster. I think it's kind of hilarious. And kids do too. They really, really like it. But I'll talk about how that's my "anxiety monster," and it's always with me. Sometimes it's really little. Sometimes it's pretty big. And one of the things that I can do to help my anxiety get bigger or smaller is to decide if I'm going to feed it. And I'll talk about how that anxiety monster can be kind of a bully, right? It'll be like, "You're too scared to go in that store. I'm too big." And if you don't go in the store, you're actually feeding it. Because that big old bully, worry monster got to make the decision for you. And sometimes we let it because it's just what we have to do in the moment. And we recognize that that is going to make the worry monster bigger. But if the worry monster is telling you to do or not do something, and you're able to do the opposite, that worry monster gets smaller and smaller, and his voice gets weaker and weaker. And he's not nearly as powerful over us. So being able to remember that our job as parents is not to eliminate anxiety. But help our child learn to manage that anxiety, even as it's present.

Heather  25:05

We use in our preschool world Diane Alber's SPOT emotions. And I think they're brilliant. They're so simple, but so effective, especially for our age group. And she has the gray one, which is worry, and she also has a green spot emotion. They have faces on them. They're plushies. It's what we use. I have the big plushies and the little ones. Andit is literally the visual. I use them together. And it's so gray, as we're "Anxiety" is really its name, but we call it "Worry," just to make it more developmentally appropriate for three and four year olds. And then there's the peaceful spot, which is green and just looks calm. And of course, we tell them the story about it. But we do talk about when that worry gets too big, what does it feel like in our body? Like when we get worried and talk about how we can tighten up our jaw, our bellies might hurt, and maybe our shoulders are real tight and our neck is tense,and how we hold that worry in our body. And we'll have the kids do that. And then we'll talk about, you know, that's when our worry spots really big. And then we'll show the little plushie and be like and really, we want our worry spot to be little. And our peaceful spot to be nice and big. Because how does our body feel? How does our body feel when our peaceful spot is big and our worry spot is nice and small? And it's so smart, what you said about feeding the worry monster, because he is a bully, and to be able to say to kids bigger than preschool, like "he gets cocky." And he kind of can taunt you. And even for adults, that makes a lot of sense. And it depersonalizes, right? That whole anxiety experience. It's like, "Ooh, that worry monster. He's got hold of you right now, and he's getting cocky". 

Kristina  26:59

And I'll say to children and anyone really that when worry shows up and we feel it in our body, it's important to be able to say like, "Hey, I know you. You're the worry monster, and you think you're tough stuff, but really you're not. I know what to do with you. I'm strong." So to not be afraid of the feelings, because we know the things that we can do to help grow our peaceful spot.

Heather  27:23

And that we do that work alongside our kids, right? To be able to say to them, "There will always be worry spots. There will be things that grow our worry spot. But what are the things we can do to shrink that and grow our peaceful spot? And avoidance we just don't want to avoid so much. We want to help them cope. We want to help them grow the skill. That's the essence of coping. And avoidance ultimately does reinforce anxiety. And it impacts their ability to cope. It impacts their inner voice. And when we can say to them, "I'm here, I've got you. I see that anxiety being cocky. You know what? You've got strong shoulders. Let's take our deep breaths. I believe in you. I'm right here with you. Yep. Let's do this." All of a sudden, that worry monster shrinks. And then your child, they feel empowered.

Kristina  27:48

That's when that confidence spot really grows.

Heather  28:24

Yes and the bravery, right? And we can talk about what it means to be brave-

Kristina  28:29

In the face of that anxiety...

Heather  28:32

And how we all need to work on being brave. 

Kristina  28:34

Yep.

Kristina 

Thank you so much for joining us for Gear Up! Adventures In Parenthood. I'm Kristina.

Heather  

And I'm Heather. And we're so grateful to join you on your parenting journey, until next time…

Heather and Kristina

See you on the trails!

Kristina  

The Gear Up! Adventures In Parenthood podcast is brought to you by the ODC Network in Holland, Michigan. It is produced by Jen Plante Johnson, recorded and edited by Dave Purnell, with original theme music by Dave Purnell,

Heather  

The ODC Network is a nonprofit organization that strives to advance outdoor education and conservation in West Michigan.

Kristina  

Since 2000 the ODC network has served over a million people through hands on outdoor learning experiences and conserved thousands of acres of native habitat through restoration and preservation projects.

Heather 

The ODC Network’s vision is building a better community by connecting people, land and nature. To learn more and get involved, go to www.ODCNetwork.org.

Thank you so much for joining us for Gear Up! Adventures In Parenthood. I'm Kristina.

Heather  

And I'm Heather. And we're so grateful to join you on your parenting journey, until next time…

Heather and Kristina

See you on the trails!

Kristina  

The Gear Up! Adventures In Parenthood podcast is brought to you by the ODC Network in Holland, Michigan. It is produced by Jen Plante Johnson, recorded and edited by Dave Purnell, with original theme music by Dave Purnell,

Heather  

The ODC Network is a nonprofit organization that strives to advance outdoor education and conservation in West Michigan.

Kristina  

Since 2000 the ODC network has served over a million people through hands on outdoor learning experiences and conserved thousands of acres of native habitat through restoration and preservation projects.

Heather 

The ODC Network’s vision is building a better community by connecting people, land and nature. To learn more and get involved, go to www.ODCNetwork.org.