Thursday
Sep032009
Childhood Anxiety
Thursday, September 3, 2009
Does your child seem anxious or worried? A recent study found that more and more young children are depressed and anxious. It also found that children with depression were most likely to have mothers with a history of depression. (I cringe a bit writing that...I wonder if the study looked at the impact of depression in fathers too? Or if this just another attempt to use science to blame the mother.)
Putting blame aside, if your child does seem anxious what should you know and what can you do?
Family Anatomy, one of my favourite blogs (and podcasts) written by Ottawa psychologists, just wrote a five part series on childhood anxiety. If you are anxious about your child's anxiety, give these posts a read:
Give them a read and share your thoughts on my blog or on theirs. Do you have tips for reducing anxiety in your kids?
Updated to add: The study, "Depression and anxiety symptoms: onset, developmental course and risk factors during early childhood" by Sylvana Côté et al (which two readers sent me via e-mail) looked at maternal depression, but not paternal depression. While there is certainly evidence to show that babies are happier if their primary caregiver is happy, I think it is important in this day and age, especially in Quebec, where the study was done where 1 in 2 fathers take parental leave, to also assess the impact of paternal depression and anxiety on kids.
Putting blame aside, if your child does seem anxious what should you know and what can you do?
Family Anatomy, one of my favourite blogs (and podcasts) written by Ottawa psychologists, just wrote a five part series on childhood anxiety. If you are anxious about your child's anxiety, give these posts a read:
Childhood Anxiety
- Part 1: Definitions and parent concerns
- Part 2: What can parents do?
- Part 3: How beliefs affect behaviour
- Part 4: Controlling reactions to stress
- Part 5: Taking action to control fear
Give them a read and share your thoughts on my blog or on theirs. Do you have tips for reducing anxiety in your kids?
Reader Comments (17)
My friend Melissa is going to e-mail me the full study. I'll take a look in the morning and report back.
My son has an underlying condition that lends itself to anxiety issues. One thing that both we (as parents) found helpful but also that my son liked was play therapy. It made a huge difference in his anxiety levels. He's been getting a bit anxious again lately and he's actually asked to go see Ms. Natasha again (he's older so he's able to make such a request).
Dunno, Annie. Those blog posts seem like an advertisement for cognitive behavioral therapy. Let me guess, the blog owners/authors are cognitive behaviorists? How about anxiety that is the result of PTSD, which does not respond well to CBT or desensitization therapies? How about anxiety that has a physiological cause like sensory integration or processing issues? A child with auditory processing issues needs auditory therapy before his fight/flight response stops being triggered. I think finding out why a child is anxious is far more complicated and critical to determining treatment than those blog posts would have one believe.
Jake:
Thank you for the comment. I'm interested in all points of view and options in terms of dealing with anxiety. I presented Family Anatomy's ideas as one approach, but was asking readers for others too. I don't know enough about it to pretend to be an expert. I'll ask Brian to respond to your comment.
Personally, I do have one anxious child and some of the things that have worked here to calm his nerves a bit include:
- re-establishing a routine
- focusing on nutritious diet, especially Omega-3 (I also take Omega-3 supplements, especially when I am feeling anxious/down and I know that it helps me)
- focusing on him, spending more one-on-one time, talking, etc.
I'm interested to hear others' ideas too.
Melissa: Is that the type of thing that Larry Cohen talks about in Playful Parenting?
:) I am sure that CBT is very helpful for many children. And I know many parents for whom the things you are trying are very helpful. So often we can help our children regulate anxiety by slowing down how the world is coming at them. We have gotten used to "go, go go," while children are stressed by it (well, we probably are as well).
I have a child whose anxiety was debilitating and who needed to be hospitalized five times for uncontrollable vomiting we did not recognize as connected. After years of specialists, including a neurologist who wanted to put him on anti-psychotics (um, no thank you), I tripped over the world of sensory integration. Initial testing revealed that his processing disorder made sounds too loud, a tap feel like a knife, lights to bright. The world came at him too loud, too bright, too fast. Little wonder he was in a constant state of anxiety and often terror. Totally non-invasive (though time consuming and intense) auditory processing therapy with an occupational therapist retrained his ear so he could filter the world properly. The little boy cowering behind this sensory onslaught could now feel safe in the world. He could accurately sense where sounds and movement were coming from so he wasn't constantly being startled.
Occupational therapy is still a part of our weekly lives but he is a much happier, more confident boy. He is still working on his balance and upper body strength. The tantrums (formerly several a day) are rare. He can engage strangers. He is reading, which his very low frustration tolerance made impossible.
I admit I have a knee jerk reaction to single approaches. Every specialist we brought him to saw only one aspect of his issues but only an occupational therapist was able to consider all of his senses and work with other specialists to meet all of his needs. Every child is different and, I think, may not respond to only one model of treatment. Letting children know in advance what the schedule is going to be, one-on-one attention, and a healthy diet is going to be helpful for anyone, child or adult. And there is no down side. :) But for some children it may not be enough. I regret not having had my son evaluated by an occupational therapist sooner.
Both of my children have benefited greatly from occupational therapy. OT actually helped my daughter with her speech delay almost as much as speech therapy did. By addressing her sensory processing concerns, her language was allowed to develop.
It has been years since I've read Plaful Parenting but I believe that yes it is the same thing. Here's a link to the Association for Play Therapy website - http://www.a4pt.org/ps.playtherapy.cfm . My son's therapist was a LCSW and she had the coolest office. The first few therapy sessions were conducted with her sitting in her comfy chair and Alex sitting in a little tent. That is where he chose to go and so they chatted through the tent.
Eventually he came out and they "played" - most of what they did was with characters in a sand box because that is what he felt comfortable with. If he had gravitated towards another method of play, she would have used that.
It was really great to see how she worked with his comfort level and with his interests but she still achieved noticeable results.
Congratulations on finding a treatment that worked for your son!
CBT has been shown in research to be helpful in the treatment of anxiety and depression, and the anxiety articles on Family Anatomy were meant to provide information about that approach. As a psychologist, I use cognitive-behavioural therapy in my work, but no one method can address every problem, in my opinion. And the therapeutic approach isn't the only factor in the equation - the therapist-client relationship is important, too - so not every therapist will be equally effective with all of the people who come through the door.
The key, I think, is not to give up. If your child is having trouble, and they don't respond to the recommended treatment, further investigation could be required. A thorough assessment might provide essential information, but it's also important to find a professional whom you can trust. Not only that, if you're looking into potential treatments, you need to find sources of information that you can trust as well - the internet is a blessing and a curse in this respect, because it can be difficult to determine what's accurate! On our website, we present information based in research and the clinical experience of psychologists, but every situation is different, so we end each post with the suggestion that readers look into obtaining individualized, professional help if necessary.
Incidentally, we're lucky enough where I live to have a community agency that provides Occupational Therapy services to children; therapy can even be done while the kids are at school!
I worry that my daughter will become a highly anxious child. She is a perfectionist and doesn't like to try new things if she thinks she won't get it right. She refuses to print the letter "O" because although it's one of the easiest letters to do out there, she doesn't think she makes good circles so there is no way anyone will know her "O" is an "O" and not a funny looking circle. She has difficulty with language processing too so that certainly doesn't help things. She has been to see an OT and SLP and we will likely continnue with what is available to us thorugh the school system. But because it has been determined that whatever she has is not "diagnosable" the OTs are starting to throw up their hands with us, telling us there is nothing much more that they can do. So now it's in our hands...
Like you mentioned, Annie, I find that spending more 1:1 time with her helps alot. That and lots of hugs, giving her space rather than arguing with her when she is "stuck" on a fallacy and then coming back to her and giving her positive reinforcement for what she has done or can do. Thanks for this post. :)
As a pediatrician in the US with an alternative medicine style of practice, I have come to rely on the basic priniciples of the ancient Chinese medicine system to help decipher the nuances and causative factors likely to be playing a role in childhood worry. I recently wrote a piece called Childhood Worry: Uncovering the Cause which is on my blog. I believe we must look to several systems for answers if we hope to answer the individualized questions that come up for specific kids and families. There is never a one-answer-fits-all scenario, and in my experience, the broader the reach of our inquiry, the more likely we will land upon the needs of the child in question who might be experiencing worry or anxiety as a symptom.
On another note, while I think studies have value and can give us information, as you state we must broaden our approach and look at not just a mother's influence, but the father's impact as well whether or not he is physically present, the extended family members, the school, the environment, the community, etc. I find in my practice an approach based on energy medicine principles seems to work well and parents readily understand the concepts.
Thanks for your dedication to exploring the art and science of parenting.
Still very confused about what to do for my anxious, depressed, melodramatic 8 year old. And sadly financial issues currently affect what help we can get him.
Its a cruel disorder (fear) especially if not understood properly
Great post! I will surely bookmark and share this to my readers!
I recently attended a talk by Dr. Gabor Maté, the co-author of "Hold on to your Kids: Why Parents Need to Matter More Than Peers." He believes that all anxiety is rooted in relationships. The book talks about establishing and maintaining a secure attachment with your kids and its importance in helping them to learn to regulate their emotions.
Family Anatomy:
I have read that book. I'm curious about your thoughts on that. Do you agree that all anxiety is rooted in relationships?
I'm not sure that I'm totally in agreement with the notion that all anxiety is relationship-based, but relationships are often a major factor. Why do people get nervous about giving a presentation? Because they worry about how the audience will perceive them.
But is a fear of flying based on a relationship? I think what Maté meant is that having had a secure bond with a responsive adult allows you to manage your emotional reactions more effectively, so you wouldn't have developed the phobia in the first place.
The most important message that Maté gives is that it's never too late, that new experiences can affect brain function. It's not about blaming parents for their kids' problems, but it's a wake-up call that parents are in the best position to make a difference in their kids' lives!
I met Dr. Maté after his talk, and he's got some fascinating ideas. He's also extremely perceptive. And he agreed to appear on the Family Anatomy podcast in the new year (http://familyanatomy.com/show).