Anxiety often goes unnoticed in children because it’s more difficult to recognise than anxiety in adults. We asked the experts how to determine if your child is at risk.
What is anxiety?
There are a number of anxiety disorders, the most common of which are separation anxiety, social phobia, generalised anxiety disorder, obsessive-compulsive disorder (OCD) and specific phobias. While each disorder has its own unique symptoms, it is important to note that anxiety may also present as a symptom in other disorders, such as autism spectrum disorders and adjustment disorders, or quite often as a stand-alone symptom that requires some level of intervention.
Put simply, your child may present (fortunately, very treatable) symptoms of anxiety that may not necessarily develop into a diagnosable disorder.
What causes it?
According to Kirsten Friis, a counselling psychologist based in Cape Town, it can be difficult to pinpoint the causes of anxiety. The way a child experiences a situation for the first time may impact their future response to similar situations. In this way, traumatic incidents, or even information about such incidents, can cause anxiety. Friis explains that children will often look to a trusted adult to make sense of new situations. “For example, if a child cries on the first day of school making the caregiver anxious and flustered, the child may experience the caregiver’s anxiety as confirmation that school is a dangerous place and develop anxiety around going to school.”
Anxiety can also be a learned behaviour – children typically pick up information through observation and imitation of adults and peers, and may “learn” anxiety in this way.
What are the signs?
“It is important to remember that fear and anxiety are normal and adaptive responses to perceived threats,” explains Friis. What this means is that all children may exhibit some signs of anxiety at being separated from their caregivers, or trying something new, for example, and that, unless this anxiety is causing marked distress and impairment in functioning, it may be contextually appropriate. However, says Friis, “children may not recognise that their fears are unreasonable or excessive, and may under-report their level of distress. Adults are better able to evaluate the level of perceived threat to mediate this for the child.”
Noticeable signs a child may be suffering from anxiety (as a symptom that may be diagnosed) include clinging to caregivers, refusal to participate, limited range of play and attempts to avoid feared situations such as classrooms, age-appropriate or group activities.
How can you help?
“It is common for children with anxiety to not talk about how they are feeling,” says Meryl Da Costa of the South African Depression and Anxiety Group (SADAG), Africa’s largest mental health support and advocacy group. “It is important to talk to your child. Let them know you are there for them.”
She urges parents to seek professional help when anxiety impairs a child’s social activities, development or schoolwork. “It is important that a child goes to see a specialist. We recommend that parents take their child to a psychologist to help the entire family cope.” Friis adds that significant changes in eating or sleeping patterns, or simply that the child is no longer thriving are also signs it may be time to speak to a professional.
Clinical psychologist Thembelihle Dube stresses that it is vital that family members commit to supporting the child’s treatment by creating a safe space. “When a child lives in a chaotic household where they feel threatened, they have cause to worry. Families need to understand that an unsafe home doesn’t augur well for the healthy development of a child.”
Her advice to parents is to treat children with love, respect and care. “Children thrive in an environment where there are healthy boundaries, consistency and open communication. Being seen (given time and attention) and heard (knowing that there is someone who will listen to them and won’t dismiss them if they are in distress) will go a long way in facilitating healthy development.”
Friis agrees that children benefit from gentle encouragement. She suggests acknowledging the child’s fears, rather than trying to show the child that her fear is unreasonable.
SADAG offers support to those suffering from depression and anxiety. For more information visit www.sadag.org or call 0800 212 223 to speak to a counsellor.