The Drama of the Anxious Child

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September 30th, 2013

Childhood anxiety is on the rise at every level, from fear of monsters under the bed to severe anxiety disorders

When I was first studying psychology, thirty years ago, I learned that about 10-20% of children are born with a temperament that is highly reactive to anything new and unfamiliar. Some of these children go on in life to be anxious, timid, or shy (or, as we shy people like to say, “slow to warm up.”) A much smaller number of children, about 1-5%, were diagnosed at that time with a full-fledged anxiety disorder.

Nowadays, there are still 10-20% with that reactive temperament, but the number of children with a diagnosable anxiety disorder has skyrocketed, up to 25% according to the National Institute of Mental Health. A report from the National Institutes of Health adds, “There is persuasive evidence from a range of studies that anxiety disorders are the most frequent mental disorders in children and adolescents….” These new numbers must be viewed skeptically, of course, because of the trend towards looser and broader definitions of mental illness. Many commentators have linked this trend to the influence of pharmaceutical companies on diagnosis and prescription patterns.

Despite these caveats, however, I believe that childhood anxiety is indeed on the rise at every level, from fears of monsters under the bed to phobias and panic attacks to severe anxiety disorders.

Last year I gave a lecture on childhood anxiety to parents at a public elementary school. I heard about children who couldn’t be in a different room from their parents, even to use the bathroom, children who were too afraid of the water to swim or even take a shower, and children who were too afraid of making a mistake to function well in the classroom.

Of course, these were parents who chose to attend a lecture on childhood anxiety, but many teachers have told me that they now have a number of highly anxious children in every class. What struck me most in this group was that none of these children was in therapy, and none had received an “official” diagnosis of an anxiety disorder (though I did give out a few business cards).

In my practice I have seen more and more children who have too much social anxiety to go to school, too much stress about grades to enjoy life, and too much separation anxiety to achieve independence as they grow older. My colleagues report the same rise in fears, worries, and anxieties.

What’s going on?

Anxiety is an alarm system—we need a little jolt of it so we will look both ways before crossing the street, but we also need an all-clear signal when the danger has passed. I think our constantly wired world has drowned out the all-clear signal. We hear instantly about every disaster, and we are bombarded with graphic images that repeat on a loop—first onscreen and then in our minds.

Another way to think of anxiety is as a simple formula: Add up all the things that cause us stress, and then subtract all of our abilities to cope. The net result is our anxiety level. This formula makes it clear why childhood anxiety is on the rise. Schools are more competitive and stressful, children are more overscheduled, parents are worried about finances and safety, and our society is based on a win-lose model, where only a few children will be able to succeed. Meanwhile, coping mechanisms are disappearing: Children don’t get enough time outside, either experiencing nature or running around in their neighborhoods. Children don’t spend nearly enough time doing “nothing,” enjoying the downtime necessary to process all their new experiences. Instead, they are desperately engaged in a drive to never be bored. I think many parents have put themselves—and their children—into an anxiety-producing corner. They want their children to be academically successful and always happy and creative and socially/emotionally intelligent. It’s an impossible demand, and the inevitable result is anxiety and burnout.

In order to change this, we first need to look to ourselves. What are we doing to manage our own anxiety? I have lost count of the number of parents who tell me they don’t pressure their high-strung children. Let’s get real. I’ve been observing a strange mix of avoidance and pressure in today’s parents. They say things like, “You don’t have to swim (or go to birthday parties, or play soccer) if you don’t want to,” but at the same time they are distraught about their child not having a best friend or the right playdates in kindergarten.

As parents, we need to focus on the opposite of worry, anxiety, and fear. In terms of the body, that means relaxation, physical activity, roughhousing, and outdoor time. In terms of overprotectiveness, that means letting children have adventures that are scary, fun, and safe. In terms of specific phobias, the opposite is a gentle nudge towards facing the feelings and overcoming the fears. And for us parents, the opposite of worry is trust: trust in the power of development, trust in the resilience of children, and trust that the world is a good and safe place for our children to grow up.

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