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The Worried Child - Introduction

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Of all the problems parents are likely to encounter with their children, worries or some form of anxiety is likely to be very common.

 
All children experience fears and worries from time to time, and there is nothing unusual about that.
 
No matter how bright they are, children have had less experience with the real world than adults, and hence don’t really know what they should be afraid of and what is either impossible to harm them or highly unlikely. 
 
Children learn how to categorize things from one extreme of completely safe to the other, which is something to stay away from. As children grow older and their minds mature, they also learn to categorize what is real from what is completely imaginary. They learn from experience and also from relying on information they get from adults they trust. 
 
There are some general ways to know when anxious or worried behaviour is something that needs to be watched and responded to. For example, when your child often feels extremely frightened or distressed about situations that would not bother most other children of the same age, and this is not just an isolated incident but persists over many days or weeks, it may be sign of a more serious mental health problem that needs attention. 
 
It is important to be alert to behaviours that may signal actual disorders and catch them early, but it is just as important not to jump to conclusions or impose unnecessary ‘problem’ labels.

We will provide more details about how to tell the difference further on in this chapter and, in general terms in the Course to Follow section.

 
Most children respond with anxiety when encountering something for the first time, such as an unruly crowd, an unfamiliar bathroom, and a host of other possible experiences that are brand new. This is a healthy response to something strange and uncertain, and alerts the child that this new thing should be checked out first to make sure it is safe. 
 
 Many of the things that young children are anxious about, such as a closet, a basement, the dark, clowns, etc., are no longer an issuefor them by the time the child is in elementary school. 
 
Fears and anxieties should be seen in terms of a child’s development—normal at a very young age and then more unusual as the child gets older.
 
If, however, someone moves from a different country, they may encounter things that they had never seen before. Someone coming from a climate where the rivers never froze may show extreme fear when someone suggests they walk on a frozen river. Even though they may be older, the fact that they have never experienced this would suggest that the fear falls in the category of what is normal. 
 
Children have more fears than adults. They have many of the realistic fears that adults have, such as predators, natural disasters, etc., but also many imaginary fears as well, such as ghosts and bogeymen. 
 
What is the difference between “fear” and “anxiety”? Fear is an agitated feeling caused by actual or threatening danger, pain or harm. When someone skilfully avoids a real danger, it shows good judgement. If we didn’t have fear to protect us, it would be almost impossible to avoid hazards and injury. Life would be one catastrophe after another! 
 
The fear response is called anxiety when a person is having the same kinds of physical responses that people have when they are afraid, but these responses are to events or things that are either not dangerous, or are much less harmful than the person imagines.   Being afraid of a dark basement is a good example. Even if the person is shown with the light on that there’s nothing harmful there, as soon as the light is turned off, the person imagines all kinds of scary things and the anxiety response sets in.
 
Children and adolescents show excessive anxiety through signs such as :
 
  • Agitation, in a high degree of distress, or even angry when others seem incapable of creating a safe space
  • Physical symptoms, such as stomach aches and headaches on a regular basis
  • Sleep problems, such as trouble falling asleep and problematic nightmares
  • Worry about events days, even weeks, before the event is to occur.
  • Overly responsible or overly perfectionist—wanting everything to be “just right.” 
  • Constantly asking “What if….?”questions, and challenging the adult’s knowledge with “How do you know…..?”
  • Creating stress for other family members, and having to modify activities
 
Signs that there is a child or adolescent with excessive anxiety in the family are:
 
  • Family functioning is disrupted and many events are missed
  • A lot of time is spent by family members consoling and reassuring the child or adolescent about relatively safe and normal activities.
 
 

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Many of the worried or anxious behaviours of this age group do not indicate a mental health problem.
 
It is important to remember, however, that your child may not be developmentally ready for a formal school program or even day care, and his or her worried or anxious behaviours may be telling you that.   This may not fit with your schedule or need for your child to be more independent. 


All of the fears and anxieties described in this resource can be normal and expected when a child is very young. They may occur even more in children who are highly sensitive or highly aware of their surroundings to begin with.
 
Fears and worries change as children grow older; a normal and understandable fear or worry at one stage, such as fear of separating from a parent, may not be appropriate at another stage. 
 
In general, girls seem to display more fears than boys, but boys may hide their fears better than girls. For some particular fears or worries, such as anxiety about social situations, there appears to be little difference in rates between boys and girls.
 
Many children, especially those with highly developed verbal skills, ask a lot of questions at this stage, and many of those questions begin with “What if…….?” Even if your child asks lots of questions, if you are able to calm their fears with reassurance and information, then there is no cause for concern.

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It is sometimes not clear whether or not a behaviour needs to be considered a significant problem that needs to be remedied.
 
Your child may show:
  1. sad mood
  2. tantrums, negativity, aggression, non-compliance, crying
  3. separation fears, clingy behaviour
  4. preoccupation and inattentiveness
  5. change in eating patterns
  6. loss of previous control of bowel or bladder
  7. change in sleeping pattern
  8. delay in reaching developmental milestones, or regression to a previous level
  9. social isolation, withdrawal
  10. nose picking
  11. thumb sucking
  12. nail biting
  13. stuttering
  14. pulling on clothes
  15. picking at skin
If the behaviour sometimes seems to improve and then sometimes seems worse, continue to monitor it.
      
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Some kinds of behaviours strongly indicate a more serious problem, especially when they interfere with normal functioning and, in spite of all your efforts, they appear to be persistent or even getting worse.
 
Watch for:
  • worried behaviours that last for an unusually long period, over weeks or months
  • significant change from previous mood or behaviour patternwithout being able to regroup
  • combination of behaviours such as uncharacteristic sad mood, accompanied by angry and aggressive outbursts
  • inability to contain worries at school, learn and socialize with others as expected
  • worries so extreme that he or she does not accept your reassurance
  • persistent talking about the same fear, and refusing to stop.   Even though talking about it at the time is inappropriate, they can’t put it aside, even for a few minutes; they express an urgent need for others to be involved in their fear. Your child’s speech is pressured and conveys a great deal of intensity and urgency.   This is occurring even though the child has encountered the object of fear many times before and each time nothing terrible has happened and you continue to reassure your child that he or she is safe.
  • behaviours listed above may be accompanied by a significant change in the family environment.

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Children in the middle range of childhood will show a range of fear and anxiety responses. These children might be responding to actual events that have occurred in their lives, such as a car accident or a dog bite. Or it might be to something they have seen on television, such as a tornado, or war scene. As well, they may be responding to images created by their own vivid imaginations.

Children in this age group are experiencing new things almost every week, if not every day of their lives. In this respect, they must evaluate everything that comes into their lives with respect to its safety or potential for harm. Children will exhibit a fear or anxiety response in order to alert others whose job it is to keep them safe, and often, also, to avoid the threat, which gives them some time to do a more thorough job of evaluating the level of potential harm. 
 
If they show a fear response, even if it is very strong, and then they find a way to overcome the fear and deal with it in a way that works not only for them but for others in the situation, then there is no cause for concern. 



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Children can exhibit worries and fears in many different ways at this stage of their lives.  These behaviours can come and go, and if this is so, continue to monitor them.
 
Your child may show:
  • fretting, tension, anxiety
  • changes in mood
  • preoccupation with stressful situations—role-playing it over and over or talking it through
  • self-destructive behaviours
  • fear of specific situations
  • decreased self-esteem
  • changes in eating habits
  • occasional wetting or soiling themselves
  • changes in sleep patterns
  • a decrease in academic performance or focus
  • preoccupation with sexual behaviours or talk
  • changes in social interactions’
  • separation fears
  • fear of being alone
  • refusing to try new recreational activities
  • nail biting
  • stuttering
  • grinding of teeth
  • aggression or anti-social behaviour
  • a strong need to be protective of others
  • diminished interest in school activities
  • excessive school absences
  • jealousy
  • reacting out of proportion to the event
  • regression to behaviour that is characteristic of him or herself at a younger age
  • self-destructive behaviour
  • suspicious/untrusting
  • talking about a lot of worries
  • tantrums/negativity/aggression/noncompliance/behaviour that is unresponsive to correction/anti-social behaviour
  • school refusal    
  • inability to eat, change in appetite


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Watch for:
  • Worried behaviours that last for an unusually long period of time, over weeks, or months.
  • Significant change from previous mood or behaviour pattern.
  • A combination of behaviours such as uncharacteristic sad mood accompanied by angry and aggressive outbursts.
  • Worries so extreme that no matter what you or others do your child is unable to be reassured.
  • Inability to concentrate on school work
  • Persistent talking about the same fear, and refusing to stop. They can’t seem to put the worry aside, even for a few moments; your child is expressing an urgent need for others to help him or her avoid the feared object or situation; your child’s speech is pressured and conveys a great deal of intensity and urgency.
  • Physical symptoms associated with the anxiety, such as vomiting or even fever
  • Behaviours listed above are accompanied by significant change in family environment

Many children can exhibit extreme fear responses to new or unusual events, but then by using their own internal resources and/or relying on those who are there to help them, they find a way to manage the fear so that is doesn’t interfere with their normal activities. 
 
If, however, the fear is persistent and your child, even with your help and the help of others, can’t overcome it so they can resume normal activities, then it is probably time to get some help.
 
If, in spite of all your efforts, the behaviours persist or are even getting worse, then get some professional help.
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In early adolescence, your child’s world has just gotten a whole lot bigger. For the first time, you are probably allowing them to have some increased independence, to walk to the store, take the dog for a walk, or even go to the movies with friends, without an adult accompanying them. This can be a time of increased anxiety, but it is usually managed successfully by most adolescents. 
 
This is not usually a time when fears first emerge, but with new experiences of being on one’s own, some of the fears that were present at an earlier stage of development might reappearwith increased intensity and or frequency. It would not be unusual, for example, if an adolescent taking public transportation on their own or with a friend, all of a sudden becomes extremely afraid of insects, if one happens to be on the bus.  Or they may hear on the news about a child getting lost, and think it will happen to them.

Adolescents are experiencing many new things during this stage. They are experimenting with making their own decisions and doing things on their own.   In this respect, they must evaluate everything that comes into their lives with respect to its safety or potential for harm, and now they need to use their own judgement. 
 
If they show a fear response, even if it is very strong, and then they find a way to overcome the dread and deal with it in a way that works not only for them but for others in the situation, then there is no cause for concern. 


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The young adolescent may show:
  • sadness
  • self-destructive behaviour
  • talking about a lot of worries
  • reaction way out of proportion to the event
  • changes in socialization patterns, such as withdrawal from others
  • preoccupation with stress
  • changes in mood and attention
  • aggression or anti-social behaviour
  • need to protect others
  • insufficient sleep/ oversleeping
  • decrease in academic achievement
  • preoccupation with sexual behaviour or talk
  • diminished interest in school activities
  • excessive school refusal
  • substance abuse
  • nervous habits, like picking at skin
  • performance anxiety before tests or sporting events
  • anxiety around particular subjects or assignments
  • upset when routines are changed
  • change in appetite or inability to eat


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Watch for :
  • Worried behaviours that last for an unusually long period of time, over weeks, or months.
  • Significant change from previous mood or behaviour pattern.
  • A combination of behaviours such as uncharacteristic sad mood accompanied by angry and aggressive outbursts.
  • Worries so extreme that no matter what you or others do your child is unable to be reassured.
  • Persistent talking about the same fear, and refusing to stop. They can’t seem to put the worry aside, even for a few moments; your adolescent is expressing an urgent need for others to help him or her avoid the feared object or situation; your adolescent’s speech is pressured and conveys a great deal of intensity and urgency.
  • Physical symptoms associated with the anxiety, such as vomiting or even fever.
  • Behaviours listed above are accompanied by significant change in family environment.
  • Decisions about family events are continually being made in order to avoid your adolescent’s anxiety reaction.
The behaviours may come and go. It may be difficult to monitor it because your child may not always be sharing with you what’s going on, or even hiding it from you, but continue to try to monitor the situation, as best you can.

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Moving from dependency to independence can be a big step for many young people. They may develop some anxiety reactions that, in effect, slow the process down. If, however, they are ultimately able to overcome them and continue to move towards more independence, given a bit of time, then there is no cause for concern. 
 
On the other hand, if they and the family seem to be making many decisions around the anxiety, which has the effect of severely limiting your adolescent’s choices and the choices of the family, then seek professional advice. A professional can help reduce stress, and to help your adolescent cope in more suitable ways .
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Later adolescence is the last step before becoming an adult. One of the main challenges of this stage is that it becomes necessary to make one’s own decisions. You want your mature adolescent to make their own decisions and learn from their mistakes, but at the same time, you hope they will be open to advice, so they can benefit somewhat from your experience. This can be a time filled with anxiety for many young people. They may be dealing with difficult learning experiences where some of their choices may have turned out differently than they expected. Their friendship patterns may be changing. 
 
All of the changes introduce much uncertainty, which turns into anxiety, just at the time of life when they are receiving feedback from others that they have to “grow up” and demonstrate it in their choices and behaviour.   It can, however, all be managed with some rational thinking. Many older adolescents don’t want to accept help from their parents or other adults. They rely more on their peers for support. They want to prove their competence and are reluctant to show any behaviour that might make them seem dependent. This is a normal response. However, it doesn’t hurt to continue to offer advice, even if it is outwardly rejected. You never know what someone might be thinking, and much of your advice might be secretly absorbed and incorporated into their decision making process.
Adolescents may exhibit many fears of the unknown, such as leaving high school, their first job, or first year living alone at university or college. Some adolescents do not anticipate difficulties, and don’t show signs of anxiety until they are actually in the situation. Others may have a lot of anticipatory anxiety, thinking about how difficult the new situation might be. Your young adult needs guidance, reassurance and information so they can manage their feelings effectively. They need to know that their feelings are entirely normal giving the enormity of the steps they are taking.   Most people feel anxious when they are just beginning something big, such as a job or university career. If older adolescents show signs of anxiety, but continue to pursue their chosen course of action, then there is no cause for concern. In fact, applaud their success in managing their feelings effectively. Let them know how proud you are.


If your older adolescent has experienced a trauma or loss or is in a turbulent environment, these experiences may develop into specific fears. The object of fear may seem unrelated to the trauma, event or situation. For example, after being in a traffic accident, an adolescent might develop a fear of the dark or even being alone, which seems unrelated to the accident.
 
Focusing on a specific fear may be the adolescent’s way of having some control over fear itself and avoiding the more upsetting fear of cars or driving. If this lasts for only a few weeks, it is not a cause for concern. If it persists for more than a few months, then professional intervention might be necessary.
 
Adolescents with permanent or temporary disabilities, such as those caused by athletic activities, may develop specific fears in response to a sense of insecurity related to the disability. Having a fear may provide a way for adolescents to feel some control over their environment. They may feel unable to control events or circumstances. But if they reason, “I can’t go outside because there might be a dog there”, this seems a more acceptable reason for staying indoors than their disability or injury. 
 
It is important not to give in and reinforce irrational fears in adolescents. These fears can turn into bigger problems than the original problem, and be even more persistent. 
 
Adolescents sometimes develop fears related to what is happening to someone else, in the neighbourhood, or in the news. Sometimes rumours spread like wildfire and are highly exaggerated. If someone sees a single man perhaps dressed a bit shabbily, before you know it, everyone is talking or texting about the “rapist” in the area. Adults need to model calmness and rational problem solving.

Adolescents sometimes take on a protective role towards others as a way to deal with their own fears, but in a way that looks to others as if they themselves are not afraid. If this is helpful to someone else, it is a fine way to cope, but if it becomes intrusive you may need to step in and set some limits.



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The length of time a youth exhibits extremely anxious behaviour can be a cause for concern. Excessive anxiety can interfere with your adolescent’s ability to face normal challenges. If the fear becomes a reason to restrict activities, such as refusing to show up for work or attend classes because it can’t be done perfectly the first time, then this is cause for concern.
 
 
Young people will sometimes avoid whatever they view as the cause of their anxiety.  This is a normal human response. However, if avoidance is not possible and the anxiety is great, the young person might resort to skipping classes or being truant in order to avoid the feared object or experience. They also may try to appear to have a physical illness in order to control the situation.
 
 
Irrational fears that persist for a long time can occur with other problems, such as sadness, low energy or lack of interest in usual activities, as well as other kinds of anxiety, such as about social situations or performing in front of others. 
 
 
Youth who have suffered a loss or trauma or live in a turbulent environment can develop specific fears, which can persist for several months. A youth who has been in a car accident might be fearful of trying something new. You need to be reassuring but firm, and encourage your child to resume the level of independent behaviour that existed before the trauma. A temporary setback of a few days or even a week is considered normal, but if your child is unable to resume his or her normal activities soon after the trauma or loss, then it is cause for concern. 
 
 
Youth who have become disabled, either permanently or temporarily, may also develop fear reactions. Be gentle but firm and support your child to face their fears and not give in to them. 
 
 
Your adolescent may exhibit the following behaviours: 
  1. sadness
  2. self-destructive behaviour
  3. talking about a lot of worries
  4. reaction way out of proportion to the event
  5. changes in socialization patterns, such as withdrawal from others
  6. preoccupation with stress
  7. changes in mood and ability to concentrate
  8. aggression or anti-social behaviour
  9. need to protect others
  10. insufficient sleep/ oversleeping
  11. decrease in academic achievement
  12. preoccupation with sexual behaviour or talk
  13. diminished interest in school activities
  14. excessive school refusal
  15. substance abuse
  16. nervous habits, like picking at skin
  17. performance anxiety before tests or sporting events
  18. anxiety around particular subjects or assignments
  19. upset when routines are changed
  20. change in appetite or inability to eat
  21. extreme avoidance of something everyone agrees is important, such as applying for a summer job.
 
Concerning behaviours may come and go. They may be difficult to monitor, because young adolescents may not always share with you what’s going on and may even be making a concerted effort to hide it from you because of their need for independence and privacy. Nevertheless, continue to monitor the situation as best you can.  Young adolescents are likely to be experiencing physical changes in their bodies associated with puberty, and also possible sexual feelings towards others. They may have confusing feelings regarding these events that they may be too embarrassed to talk openly about. Be respectful, but try to be observant and available for questions. Let your adolescent know you are there if they need help sorting things out.


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If the persistent fear(s) is severely restricting your child’s ability to participate fully in everyday activities, then this is a serious problem. If your adolescent is unable to distinguish between those situations that are truly dangerous and those that are not, then professional intervention is warranted. For example, if your older adolescent refuses to attend work because the boss might be there, or school because there might be a pop quiz, or refuses to leave the house because there might be a dog or an insect nearby, then you and your adolescent should seek professional help.
 
If you have made repeated efforts to be supportive while encouraging your adolescent to participate in activities, but your adolescent continues to be fearful and avoid things, then professional intervention is warranted. Avoidant behaviour can become a strong habit and should not be allowed to persist for more than a few weeks.
 
A youth may have suffered a trauma or significant loss, or be living in a turbulent environment. If a sufficient period of time, such as several months has passed, and the fear response is persisting or getting worse, this is cause for concern and suggests the need for professional involvement. Sometimes the response changes. Whereas initially there was an emotional reaction to every little thing, now there might be a flatness and almost lack of reaction to anything. If this is the case, seek professional help.
  
Watch for :
  1. Worried behaviours that last for an unusually long period of time, over weeks, or months.
  2. Significant change from previous mood or behaviour pattern.
  3. A combination of behaviours such as uncharacteristic sad mood accompanied by angry and aggressive outbursts.
  4. Worries so extreme that no matter what you or others do your child is unable to be reassured.
  5. Persistent talking about the same fear, and refusing to stop. They can’t seem to put the worry aside, even for a few moments; your adolescent is expressing an urgent need for others to help him or her avoid the feared object or situation; your adolescent’s speech is pressured and conveys a great deal of intensity and urgency.  
    • Sometimes these behaviours become even more persistent and become what may be called “obsessions”: repeating the same thing over in one’s mind. These can be thoughts of scary or embarrassing things, such as germs, getting sick, other dangers or being rude. 
    • Sometimes these thoughts relate to what is often called a “compulsion”. A compulsion is a very strong urge to repeatedly act out rituals or behaviours in a very definite manner, such as a certain order, or to make sure things are done symmetrically. The person often has the very strong feeling if it’s not done in exactly the right way, or exactly the right number of times, something terrible will happen, although this can be somewhat vague as to exactly what might happen.
 
In addition, watch to see if:
  1. Your adolescent has developed physical symptoms associated with the anxiety, such as vomiting or even fever.
  2. Behaviours listed above are accompanied by significant change in family environment.
  3. Decisions about family events are continually being made in order to avoid your adolescent’s anxiety reaction.
  4. Important decisions or events seem to be permanently on hold because of the fear or anxiety, such as applying to school, or securing a summer job. 
If it is clear that the problematic behaviour is persisting or even getting worse, then encourage your older adolescent to seek professional help.
 


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This stage of life can be particularly challenging for the adolescent and for a parent or guardian. It is often difficult to know how much to help and step in and how much just to allow your older adolescent to make their own decisions, make some mistakes and hopefully learn from them. “The only thing wrong with a mistake is if we don’t learn from it.”

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There are many challenges facing older adolescents as they prepare to take their place as adults in society.  Even the best plans often fail for reasons one could hardly predict, such as changing economic circumstances, and there is a need to adapt and make a new plan.   But if specific fears are emerging or re-emerging and are preventing your adolescent from engaging in the normal struggle to find their place in the world, then help them to remove this obstacle.

What factors may influence fearful, worried or anxious behaviours in general?

  • Genetics, biology, infection or other physical illness
  • Brain chemistry
  • Temperament
  • Home environment
  • Risk factors in the community
  • Family changes such as new siblings, divorce, death or illness
  • Experience or witness of a traumatic or very stressful event such as abuse, war, serious accident, natural disaster or violent event affecting the community
  • Overactive imagination—some children vividly visualize whatever they are frightened of and experience it as if it is really happening
 
 
Understanding children’s fears
Children have many more fears and anxieties than adults. They share many of their parents’ fears but also have many fears of their own. A child has had less experience with the world than adults have and so has had fewer opportunities to discover what is truly harmful and what is simply new and unfamiliar. As a result, they can come to wrong conclusions about the extent to which they are in danger. They need adults to explain the world to them, reassure them and help them feel safe.
 
 Many experiences are happening for the first time for your child, so he or she has the added burden of never having done it before, “the unknown,” making it all the more frightening.
 
Your child may not always know the difference between fantasy and reality and can become very frightened by things he or she imagines or sees in movies an on TV. Since “seeing is believing,” he or she believes what is seen and imagines to be “real.” 
 
Your child may reject your attempts to convince him or her that something is safe. This may be because in your child’s mind, the experience of the fearful object is very real and vivid. The body reacts to events in the mind as if they were real. Think about having a bad dream and how your body might react to it. 
 
Sometimes older children and adolescents have the belief that, in fact, their worries are what keeps them safe. They believe that if they stop worrying, whatever they are worried about will come to pass. This is a remnant of superstition and should be challenged. Worries never kept anyone safe and in fact, too much worrying can take a physical toll on a person.

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  1. Girls tend to show more worries than boys.
  2. Children with chronic or life threatening illness may show more fears and worries than other children.
  3. Some children have temperaments that tend toward worry in general. This may include highly verbal children or children with highly developed imaginations.   
  4. Some children are born with a more sensitive nervous system, so they are more reactive to stressful situations. Such a child might also be born with a better than average ability to learn from experience, and thus may be able to improve his or her resilience over time. 
  5. Anxiety does seem to be associated with heredity. 30-40% of children who have at least one parent with extreme anxiety, seem to show the same characteristics. This is considered a very strong genetic link. But it also means that 60-70% of children whose parents have severe anxiety, do not exhibit this behaviour.
 
Children with permanent or temporary disabilities may develop a lot of worries or anxieties in response to a sense of insecurity related to the disability.  Having a fear reaction is often a way of bringing others closer to you, which may make your child feel they have some control over their environment or the disability itself. Your child may feel unable to control events or circumstances. But they may reason: “If I’m upset, you’ll stay close to me.”         
 
It is important not to give in and reinforce irrational feelings in children. These feelings can turn into problems that are worse than the original problem, and be even more persistent.   Initially the worry may be a way for the child to adjust to the illness or disability, but if it persists for several months, or seems to be worsening, then you might want to consider seeking professional help.

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Any of the following family issues may cause your child concern. Many children are unable to talk about their worries, but may express them through actions or behaviours instead. 
 
Evaluate your current living situation and how it might be affecting your child:
  1. Have there been any significant changes in your child’s life?
  2. Is there a family member who is sick and requires care?   Has anyone recently died?
  3. Has there been a recent separation between the parents, or increased talk about separating?   Is there an increased level of conflict, verbal or physical between the parents?
  4. Has a parent recently lost their job? Is a parent talking about having to work far away from home to support the family?
  5. Has a family member left the home, or has your child been separated from the parents for a lengthy period of time?
  6. Has there been a recent move or change of schools?
  7. Is there a new baby in the family?
  8. Has your child recently lost a pet or a friend?
 
It is important to pay attention to how parents show their worries and fears to their growing child. Can they adapt to the needs of a teenager and reflect their confidence in the child’s newfound maturity with less protectiveness and more collaboration? 
         

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Having a disability may also create a sense of “difference” in your child, or about your child from others in the family or from outside of the family. 
 
As a parent of a child with a disability, you may feel an addedresponsibility or burden of protection, sometimes based on the belief that the world is not safe for your vulnerable child. Your child may pick up on your feelings and share your belief bout the dangers the world holds for them. You need to evaluate the merits of these beliefs.
 
Children can experience a loss of independence when they are disabled, creating a possible loss of confidence about their ability to go places alone and manage their worries.

Children with newly-acquired disabilities, such as broken arms or legs, with loss of mobility, may experience emotional difficulty re-entering the world outside, with casts, crutches, or wheelchairs.
 
Children with degenerative disorders, who are experiencing progressive loss of physical capability, sight, vision, or hearing, may feel self-conscious about others seeing their decline. 
 
Children who have a serious illness or a serious chronic health condition may experience a lack of confidence or sense of shame about their illness, and may choose to avoid school in order to hide their embarrassment.


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Children who are teased or bullied because of their differences may avoid going to school in order to escape harassment.
 
When teasing or bullying starts to occur, a child who had previously been well adjusted with respect to their worries or fears, may suddenly become more anxious and want to avoid the situation. Bullying can begin in day care. 

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  • If you are a newly arrived immigrant or refugee, your desire to succeed in your new country and your desire for your child’s success in the new country may be viewed by your child as a very strong expectation and one they may worry they will not be able to meet. In addition to your own stress in a new country, and changes in work, habits, languages, and support systems, your child may feel pressured to assume new family responsibilities, yet expected to comply with family customs and social roles.
  • If your family has had a traumatic experience in your country of origin, you and your child may be carrying persistent fears related to the previous trauma. For instance, heights or loud noises may remind your child of the past (see section on Trauma).

  • If you and your child are new to a country, you may be faced with aspects of your new country that seem strange and incomprehensible to you. There may be a lot of fear and anxiety with all members of the family, in respect to how everyone will fare in the new country.
  • Children and families who have had traumatic experiences in their countries of origin may have particular difficulty with transition.   It is normal to want to keep your children close to you in times of stress.   The stress however needs to be handled so that normal activity can resume as soon as possible.

  • Anxiety may come from the loss of traditional supports, such as grandparents and other extended family members no longer being close by and available.
  • Added tensions related to new peer experiences and wishes to exercise more choices tend to increase worries. 

     

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  • If children have had a traumatic experience, they might avoid certain situations, people or places that remind them in some way of the trauma. They might carry a general sense of fearfulness and worry, that the world is an unsafe place as a result of the trauma.
 
  • If children have had traumatic experiences in their past, events in the present might remind them in some way of the traumatic event, and they might get trauma symptoms again.   These are called “triggers.” 
 
  • Your child might or might not speak openly about this.
 
  • Your child might over-respond to an event, or might especially avoid something for reasons that may be inexplicable to you in the current situation. For example, your child might avoid swimming in the school pool, which might be connected to a traumatic event in the past related to either swimming or water. Your child might avoid swimming class or want to stay home on swimming day, if these events “trigger” feelings of fear. 
 
  • It is possible that you, as the parent, may feel a situation is dangerous because of your own traumatic past and might not want your child to participate in activities at school that are reminders of your own past experience, even though others see them as reasonably safe. 
 
  • When a parent has fears and is reluctant to engage in certain activities, the child might exhibit the same fears and reluctance.  Keep in mind that parents are strong role modelsYou might need to seek help to overcome your own anxieties. 



Other Belief Factors


With young children there is something called the contagion effect. If one child begins to scream with fear, then others immediately join in and assume there must be something real to be frightened of.   For example if one child in the family is afraid of monsters, the other children might respond as if the monster were real and that they are afraid as well. 



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Children are often afraid of things because they “believe” they are harmful. For very young children, many of their beliefs are false beliefs or beliefs that are exaggerated with respect to the degree of danger or the probability that the feared outcome will occur. It is helpful to evaluate what the child’s beliefs are so that you can help them to feel safe.



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Fear is an important human emotion. Some of the important things to learn are:
  1. What to be afraid of, so that you can keep yourself and others safe, and
  2. Which fears are to be ignored or managed because they are a response to imaginary things or to things of very low probability. 
As a parent, your responses to your child’s expression of fear are extremely important in this learning process. You want your child to grow up knowing what to be afraid of and how to respond in a reasonable way to those things that are truly harmful, and how to manage irrational fears.
 
Do not dismiss or make fun of your child’s anxieties.   Instead, look at each expression of fear as a potential learning situation—an opportunity to teach coping strategies, positive images and self-talk.
 
Most importantly, model for your child how you want him or her to behave. Children pay much more attention to what we do than what we say. Show bravery when that is what is called for. Demonstrate good problem-solving skills when that is necessary. Demonstrate that your decisions do not focus on avoiding the feared object or situation, unless avoidance is truly called for. 
 
Be understanding and reassuring, but also firm, so that fear does not become the prime reason for the behaviourand communication style at home. Avoiding something that you are fearful of is a normal response, but when the object is actually not potentially harmful or not very harmful, the avoidance response itself can become a bigger problem than the actual threat. Once your child gets away from whatever it is that is frightening to him or her, the anxiety settles down. The next time the situation arises, your child wants to use the avoidance strategy again. It seemed to work the last time. This is where parental guidance is important: to help your child learn a different response to fear that will keep doors open for a richer experience of life.
 
Demonstrate good coping skills. We all need to learn how to assess the risks in any situation, prepare for them, and decide how and when to act. Helping children learn how to approach life safely but with courage is helping them to live life to the fullest.


Children have a multitude of new experiences during this stage of life. Literally every day is filled with an encounter of something they have never seen, felt, heard, eaten or experienced before.   If your child is showing a fearful response, provide information and reassurance. Use a calm voice and be careful not to over respond with your body language and tone of voice. Your child will pick up a lot of cues from your non-verbal behaviour about whether this is something that should truly be avoided. Many children will show a fearful response and may persist in it for awhile, but then successfully work through it.
 
It is often helpful to have several other people besides yourself demonstrating that whatever is happening, it may not be as frightening as your child is imagining it to be.  If for example, there are a few adults around, or older siblings, and everyone can sit still while a bee looks around the picnic table, then your child will learn not to panic and run away from bees.
 
Your child may be showing one or more fears or worries that you consider to be unrealistic. Help him or her to get on top of the fear and not let it be in charge of your child’s life. Take the time to teach your child how you manage such a fear. Involve others in the child’s life. Ask them to share how they manage such a fear. Being brave is not being without the feeling of fear, but acting in spite of one’s fear.
 
“Courage is being scared to death but saddling up anyway”—John Wayne
 
The more time children spend thinking and talking about fears, the more they grow.
When the fear response kicks in, certain physiological responses occur which need to be managed. Usually one’s heart speeds up, breathing becomes a bit more shallow, and there might be a strong tightening feeling in the pit of one’s stomach. Your child will benefit from some guidance from you regarding how to slow the heart rate and get breathing back to normal. Techniques such as focusing on the breath, “belly breathing” which is the way babies breathe, can bring the body back to normal fairly quickly. 
 
 
If possible, make sure that your child is getting a consistent message about the feared object or situation. If a sibling or other adult in the family is giving an opposite message, this will be confusing to your child in his or her efforts to evaluate what’s real. 


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1)     As a general rule for very young children, give lots of spoken reassurance and support that is tangible, which means things the child can hear, see and touch.

2)     Allow your child to express his or her feelings through drawings and activities.

3)     Give a clear message that fear is not a good reason to avoid doing an activity that everyone else is expected to do and that you expect your child to do.

4)     Do not make exceptions for your child because of an irrational fear.  This gives the mistaken message that the fear is rational and is a good reason to avoid the object or activity.

5)     Accentuate the positive. 

a)     Where possible, point to times when your child has shown courage and ability to conquer fear.  Help your child remember previous successes.

b)     Recognize your child’s progress when he or she does confront a fear, even if it’s not 100% successful.

c)     Show how proud you are when your child exhibits bravery.

d)     Demonstrate with your tone of voice and body language that you have confidence in your child’s ability to conquer fear.

 

6)     Talk things over with other adults in your child’s life, parents, grandparents, aunts and uncles as well as close friends to share ideas and strategies. Also discuss the situation with your child’s teacher, especially if the situation is one that is affecting your child’s school life.  You may find out that your child doesn’t even exhibit the fearfulness in another setting, and if this is the case, it would be interesting to find out what are the differences between the two situations.

 

7)     If your child persists in avoiding planned activities because of a specific fear, monitor the situation to see if it is improving or getting worse.

 

8)     Don’t jump to conclusions about the seriousness of the problem.  Having fears is a normal part of childhood, and most children find a way to overcome them or simply outgrow them. 


Steps to Take
 
  1. Talk with your child to find out whether anything might be affecting him or her and causing fearfulness. If your child is willing to talk openly with you, this is a good sign and may lead to the two of you being able to solve the problem.
  2. Working with your child, make a plan of action that focuses on how your child can feel more comfortable participating in whatever activity is in question.
  3. Talk to your child about fears in general and how people tend to get a handle on them. The objective is not to let fear control one’s behaviour. Everyone lives with a certain amount of fear. Help your child realize how normal fear is.
  4. Help your child understand that people who exercise bravery on a regular basis, such as firefighters and police officers, talk about being afraid, but taking action in spite of their fear, or acting “with their fear.” “Courage is never to let your actions be influenced by your fears”—Arthur Koestler.
  5. Help your child refocus on something else besides the fear in order to get past it. Young children often win through some form of distraction. If you are not there they are going to have to distract themselves.

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  1. Avoid blaming the child or becoming angry at the fearful behaviour.
  2. Focus on reinforcing children when they are acting brave.  Try to catch their attempts at bravery in order to reinforce it.
  3. Try to evaluate how much of normal life is being sacrificed because of the fearful behaviour.  This may also be affecting the lives of other people in the family, if for example, it’s not possible to spend time outdoors because of a fear of insects.  If  your child’s behaviour is causing serious disruption to the family functioning, then seek professional help.  This is a problem that can be solved.

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To help decide if your child has a serious problem, try answering the following questions:
  • Have most children outgrown this problem by now?
  • Is your child missing out on many potentially enriching and fun-filled events because of a persistent but irrational fear?
  • Do other members of the family miss out on many events because of a persistent fear of one of your children?
  • Do you feel that fear is determining too many of your young child’s choices?
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Children during this stage of life have many fears. This is a normal part of development.   Here is only a partial list of normal fears of childhood:
  1. animals, dogs
  2. bugs/insects
  3. thunderstorms/lightning,
  4. disasters such as hurricanes, tornados, earthquakes, volcanoes
  5. heights
  6. escalators
  7. water, swimming pools/lakes, ocean
  8. performance- speaking in front of a group
  9. the dark
  10. scary TV or movies
  11. staying alone
  12. supernatural beings such as ghosts/ goblins, witches, monsters
  13. tests, school performance
  14. washroom/toilets
  15. bodily injury- choking, heart stopping, vomiting, death
  16. bad guys—robbers/kidnappers/intruders
  17. dirt/germs, getting sick/serious illness/toxic substances
  18. flying
  19. clowns
  20. ladders
  21. fire alarms
  22. being kidnapped
  23. getting lost
  24. being expelled from school
  25. family coming to harm
  26. being bullied
 
Fears of potentially harmful things help people to survive. When children express a fear, it should be seen as an opportunity to learn about realistic dangers and risks, and how to protect themselves and remain safe. You wouldn’t want your child to be completely fearless in a world where potential danger does exist.
 
When your child exhibits a fear, it is an opportunity to learn the difference between what is real and potentially harmful or dangerous, and what is purely imaginary and fanciful, as well as what is likely to happen from what has a very low probability of occurring. It is very unlikely if you live thousands of miles away from a volcano that a volcanic eruption will harm you.
 
Bruno Bettelheim, a famous psychologist said that many children enjoy going to scary movies during childhood in order to “practice being brave in the face of something scary, knowing that it’s just pretend and therefore relatively safe.”  Your child can say: “Even though it’s scary, it’s just a movie; it’s not really happening to me.” 


If your child is exhibiting anxious behaviour, remain calm and speak in normal tone of voice. Try not to mirror your child’s panicky emotional response. Evaluate the situation in a calm and problem solving mode, showing your child how you’d like him or her to respond. 
 
A tool that is useful to help children gain some control over a feeling is a feeling scale or thermometer. Ask your child to rate on a 10 point scale how upset or afraid they are about the object or situation. Then figure out together how to get the feeling down a few notches. This will introduce an element that change happens in small steps and that one can gain control over feelings.
 
 
(A Little) 1…..2…..3…..4….5…..6…..7…..8…..9…..10 (A lot )
 
Try to demonstrate and show more than you say. Use gestures, not just words. Act things out rather than just explaining them. When you do use words, it often helps to use very concrete language with children during this stage of development. Use words that describe pictures, things that can be seen, touched or heard.  
 
Be understanding and reassuring, but also firm, so that fear does not become the prime reason for the behaviour. Avoiding something that you are fearful of is a normal response, but when the object is actually not potentially harmful or not very harmful, the avoidance response itself can become a bigger problem than the threat itself. Once your child gets away from whatever it is that is frightening to him or her, the anxiety settles down. The next time the situation arises, your child wants to use the avoidance strategy again. It seemed to work the last time. This is where parental guidance is important, so that your child learns a different response to fear that keeps doors open to a richer experience of life.
 
Teaching children to calm themselves is very helpful. Learning to breathe through your belly can reverse the body’s mechanism getting too excited.  Belly breathing is how a baby breathes and when one breathes deeply and into the belly it is very difficult to feel anxious. Many children try to hard with this exercise. It’s important to let the breath do the work and no your child.
 
Reward coping behaviour. If children are able to calm themselves down when feeling anxious, cheer them on. Tell them how proud you are of them. This way they are more likely to do this again. You are giving them positive attention for the behaviour you want to see. 


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Getting some control over one’s negative feelings, such as anxiety and excessive worry, is a major contributor to a child’s self-esteem. You are right to be concerned if your child is holding on to anxiety or excessive worry a considerable length of time, many months, and it is interfering with normal development or activity. For example, if your child is refusing to go outside because something bad might happen, or refusing to try something new because you can’t do it perfectly the first time, then your child needs some focused help.
 
Children will naturally avoid whatever they fear. If avoidance is not possible and the anxiety is great, your child might resort to crying or tantrums, or repeated statements of physical illness in order to control the situation, and avoid the feared object. 
 
Sometimes when children exhibit anxious behaviour, they receive the kind of response from adults that they want but may be lacking the rest of the time. For example, if a child is hungry for hugs and affection, but you may be too busy or stressed by other things to offer it at this time, being fearful is one way that children often receive physical comfort and reassurance. In this way, however, they learn that being fearful is a good way to get my needs for affection met. 
 
Children will often talk excessively when they are anxious. They will persist in asking questions such as “What if…..?” and “How do you know…..?”, challenging your authority to interpret reality and keep them safe. This phenomenon is occurring in a large part because your child’s ability to think about possibilities is expanding, and with that expansion is the inclusion of a lot of scary thoughts. You can applaud your child for exercising his thinking, but also help him or her to problem solve and think rationally about situations.
 
If your child has suffered a trauma or loss or has been living in a turbulent or violent environment, he or she may have developed a specific fear in order to avoid a re-enactment of the trauma. Sometimes, for example, after a traffic accident, or having witnessed a violent incident, a child might develop a fear of the dark or a fear of the outdoors, which seems unrelated to the original incident, but the function of the fear is to keep the child in the light or away from the potentially threatening outdoors. Your child may be trying to gain some control over fear in this manner. If this kind of behaviour persists for many weeks, seek professional help. It is important not to give in and reinforce irrational fears in children. These fears can turn into problems themselves that only add and worsen the original problem. 
 
One approach that often helps is to ask children if they can manage the anxiety or if they want your help. This conveys a sense of respect and the notion that even though they are expressing a strong emotion, there is the possibility that they may have a sense of their own ability to manage. You may not always need to swoop in and be the rescuer.
 
We may try to make the world as safe as possible for our children, but that is not always possible. Often what helps is to simply sit with your child and be there as an emotional support.   If there are two of us together in this, it often feels safer. 
 
It is possible that your child simply wants more of your time and attention. Children learn fairly early that when they are anxious, adults typically make time for them. Try to make time to be with and play with your child when they are not anxious, so that they are getting positive attention for positive behaviour, not only when they are experiencing negative feelings.
 
It is often helpful to enlist the support of others, both from your child’s peer group as well as from the family, and demonstrate how they handle their own fear of the object or situation.
 
Try to manage your own anxiety. This may be a challenge when your child is displaying negative feelings such as excessive anxiety at times when it is very inconvenient for you, such as when in a public place. Try not to react to your child’s emotional displays. Model emotional control and good problem-solving behaviour.
 


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If the persistent anxiety or excessive worries severely restrict your child’s ability to participate fully in normal activities, then this is a problem that needs your attention.
 
If your child is not able to divert his or her attention to something positive and persists in the negative emotions, such as anxiety or worry, then professional help should be sought. For example, if a child refuses to go outside because there’s a cloud in the sky that might turn into a hurricane or tornado, or refuses to go outside because there might be a dog or an insect nearby, then you and your child should seek professional help. 
 
If your child has suffered a loss or trauma, or is in a turbulent or violent environment, and the fear response, even though it seems unrelated to the original trauma, is continuing for several months, or may even be getting worse, then seek professional help. 
 
If your child has recently become either temporarily or permanently disabled, a judgement needs to be made regarding the need for professional involvement. 
 
The time needed for your child to adjust to the disability will depend on its severity. Most people need to take some time to adjust to major changes. Usually there is a reaction and then a period of adjustment.
 
If children have developed excessive anxiety as a means of managing the adjustment, perhaps trying to keep an adult close to their side, and the anxiety response is persisting or perhaps even getting worse, then professional help is warranted. 

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Middle childhood is a time when many children express a lot of anxiety and worry. They are experiencing many things for the first time and also can experience a great deal of failure because of all the new challenges.  Erik Erickson said “children learn more during this stage than any other time in their entire lives”.  This is an important part of the developmental process and often leads to enhanced competence and self-esteem. There are many things that can happen to derail this normal developmental process: family disruption, trauma, loss, personal injury, or simply an individual temperament that allows one’s imagination to go into overdrive and exaggerate normal childhood anxiety.  With the right types of responses from adults, however, children can learn how to comfort themselves, what works and what doesn’t; and that they can be in charge of their feelings.  This is a great gift to give them.
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Adolescence is a time when many individuals experience a lot of anxiety and worry. Many are moving into a school system that is fraught with changes and uncertainty. There are many different subjects and different teachers for each one, a school with many more studentsyet less social familiarity, opportunities to make many more choices, but each one also contains the possibility of failure, and peer pressures become more intense—the pressure to fit in and be included, to be “cool.”  Alcohol and drugs are often more on the scene, and your adolescent is going to have to decide whether to participate or not and if so, how much. This decision alone can cause a lot of anxiety and worry. These are not easy decisions and each one comes with its own specific rewards and consequences.



Many young people respond well to encouragement and support. It may be helpful to share your own experiences of this stage of your life, especially if you had some highly anxious moments that you eventually recovered from. Let your young adolescent know how normal this experience is.
 
Adolescents may benefit from tangible support such as sitting with them as they confront their anxiety, allowing them to practice a speech in front of you many times until they reach a comfort zone, or accompanying them to the doctor.
 
Adolescents may not be expressing their anxieties directly, but may become a bit more shy or withdrawn. If you notice this, don’t be afraid to gently pursue it and try to find out what’s behind the change in their behaviour.  They are naturally protective of their self-image, which may be even a bit more fragile during this stage, and don’t want you to see their internal struggles.
 
If your adolescent appears to be over-reacting to some event in the news or the neighbourhood, this is a good opportunity to have a discussion about safety and
procedures.  Everyone in the family should, for example, know what the plan is in case there’s an electricityblack-out, fire or emergency event.
 
If young adolescents are able to overcome their anxieties and worries, to carry on with the activities that make up their lives, then applaud them, tell them how proud you are, celebrate their successes and even if their efforts if not totally successful. 


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Children in early adolescence can be anxious about many things, with all the changes that are occurring in their lives. This is a time when many young people show strong displays of emotion. 
  1. Ask them if they are managing their worries on their own or if they need some help with it.
  2. These apprehensions do not normally become a major focus of an adolescent’s life.   In fact overcoming anxiety and gaining control of one’s negative emotions is a major contributor to a young adolescent’s self-esteem. If your adolescent’s anxiety reaction is interfering with normal development or activity, it is a reason to be concerned. For example, if your adolescent is refusing to attend normal activities, or refusing to try something new because it can’t be done perfectly the first time, then your adolescent needs some focused help
  3. Adolescents will naturally avoid whatever they fear.  If avoidance is not possible and the fear is great, your child might resort to crying, or repeated statements of physical illness in order to control the situation, and avoid the feared object. 
  4. Sometimes, when adolescents exhibit a lot of anxiety, they receive the kind of response they want from others, such as attention and reassurance.   A lot of teenage “texting” and “messaging” is an expression of their anxiety and a reaching out for support and reassurance. 
 
Persistent fears can occur with other problems. Talk to your adolescent about whether other problems are present, such as sadness or difficulties with peers. Problems can be solved, but only when they are identified.
 
Adolescents sometimes talk excessively when they are fearful. They will persist in asking questions such as “What if…..?” and “How do you know…..?” challenging your authority to interpret reality and keep them safe. 
 
Adolescents sometimes become very quiet when they are anxious. If you notice this, tactfully find the right time to ask if anything is wrong and do they want some help.
 
Encourage your adolescent to use calming techniques when he or she is having a fear reaction. You may have some favourite ones of your own to pass on. These can be a variation of focusing on the breath, belly breathing the way babies breathe, or a visualization exercise where you imagine yourself in a calm relaxed place or even as a piece of limp spaghetti. Another one is to put whatever you’re afraid of in a balloon and watch it disappear over the horizon or into outer space. Be creative and come up with your own.
 
If your adolescent has suffered a trauma or loss or has been living in a turbulent or violent environment, he or she may have developed a specific fear in order to avoid a re-enactment of the trauma. Sometimes, for example, after a traffic accident, or having witnessed a violent incident, an adolescent might develop a fear of the dark or a fear of the outdoors, which seems unrelated to the original incident, but the function of the fear is to keep the child in the light or away from the potentially threatening outdoors. Your adolescent may be trying to gain some control over the fear in this manner. If this kind of behaviour persists for many weeks, seek professional help. It is important not to give in and reinforce irrational fears in children. These fears can turn into problems themselves that only add and worsen the original problem. 
 
One approach that often helps is to ask adolescents if they can manage the fear, or if they want your help. This conveys a sense of respect and the notion that even though they are expressing a strong emotion, there is the possibility that they may be have a sense in their own ability to manage. You may not always need to swoop  in and be the rescuer.
 
Often what helps is to simply sit with your adolescent and be there with emotional support.   We may try to make the world as safe as possible for our children, but that is not always possible. It is often helpful to sit side by side and face a challenge together.   If there are two of us together in this, it often feels safer. 
 
It is often helpful to enlist the support of others, both from your child’s peer group as well as from the family and demonstrate how they handle their own fear of the object or situation.
 
 
Anxieties can come and go. If this is the case, continue to monitor it and do what you can to help. If your efforts are not enough, then it might be time to get some professional help (see below under Red Light).
 


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If the anxiety state is severely restricting your adolescent’s ability to participate fully in activities, then this is a problem that needs your attention.
 
If you have made repeated kind but firm efforts, encouraging your adolescent to participate in the activity they fear, and your child continues to avoid what they fear, then seek professional help. 
 
If your adolescent has suffered a loss or trauma, or is in a turbulent or violent environment, and the fear response, even though it seems unrelated to the original trauma, is continuing for several months, or may even be getting worse, then seek professional help. 
 
If your adolescent has recently become either temporarily or permanently disabled, a judgement needs to be made regarding the need for professional involvement.
The time needed for your adolescent to adjust to the disability will depend on its severity. Most people need to take some time to adjust to major changes. Usually there is a reaction and then a period of adjustment.
If your adolescent is showing excessive anxiety as a means of managing the adjustment, and the anxiety response is persisting or perhaps even getting worse, then professional help is warranted. 
 
If your adolescent is having persistent physical problems, such as sleeplessness, vomiting, headaches, stomach aches, or ever fevers, and physical causes have been ruled out, then seek professional help.
 


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Early adolescence is a time when one is typically eager to practice being independent, both in feeling, thought and deed. In their efforts to be independent, many young adolescents can make some serious mistakes which increase their anxiety about themselves. Sometimes fears that they may have conquered as children re-emerge and come back to haunt them. Because of their aversion to being “helped,” it can be a challenge to be “helpful. But with the right approach, it can be done.
 
Early adolescence is a sensitive time for many youth.   Many young people are just beginning to move into a sphere of more independence and are “spreading their wings.” Things don’t always go as planned and your young adolescent has many new and challenging experiences which can cause anxiety reactions. 
 
Peer relations take on a new sense of importance and many young people turn to their peers more than their parents at this time. This is fine, as long as they are able to get the right kind of help and advice. If it is apparent to you that persistent and widespread anxiety reactions are interfering substantially with your young adolescent’s life, then be supportive, offer your help and guidance, but also continue to expect that they should participate fully in their lives.
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There are many firsts during this stage of development—first job, first extended time living away from home, first relationship, first break up, etc. Many adolescents at this stage seem unprepared for these events, and seem to get blindsided by circumstances when they don’t turn out as expected. Let them know their apprehensions and feelings of frustration and discouragement are normal. 


If adolescents express some anxiety but then find a way to cope with it and continue with their plans, there is no cause for concern. Applaud their efforts and let them know you are proud of and impressed by them.
 
Many people benefit from acknowledgement by those they revere that you have confidence in their ability to manage the challenges ahead, daunting as they may be. 
 
Remind them of their previous accomplishments and successes in the face of challenge. You are the best person to be able to do this because you recall their history probably at least as well as they do.
 
If they are open about their feelings with you then consider yourself fortunate, because they are allowing you to engage with them around their feelings. 
 
If, however, they are more typical, and may be hiding their feelings, then you may have to pay more attention to their behaviour. If they have become more sullen and subdued, it may be because they are covering up high levels of anxiety and fear that they don’t want others to see.   While mindful of their need to protect themselves, you might ask in a respectful manner if they are feeling afraid of what’s coming or not coming and let them know you’re there if they want to talk about it. Share your own stories of how you felt at this stage of your life and how you handled it, especially the mistakes you made.
 
Ask yourself whether your child continues to be engaged in normal life that is proceeding as it should, or if they are they hiding at home, spending hours watching TV, on the computer or with electronic games.  This is the litmus test of whether this behaviour is in the “green light zone” or if it is something that bears watching.
 
If they are able to overcome their anxiety, then applaud them and celebrate their successes with them!

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If adolescents are skipping many classes, or spending a lot of time alone in their room, then this is cause for concern. If the reason they give for this behaviour is an irrational fear, then this needs to be identified as a problem because it is not a good enough reason to avoid significant aspects of life. If they don’t want your help about the problem, make other offers. Perhaps there’s a coach or a school counsellor who is available. If not, seek professional intervention.
 
A general rule of thumb is: Face What you Fear!  You can do this abruptly or in small steps, but if you run away from what you fear, the fear will certainly intensify.  It can be helpful to have someone by your side as you face your fears. 
 
If your adolescent is afraid of rejection and is not looking for a job, you might go with him or her and provide moral support.
 
Anxieties have a tendency to come and go. Try to monitor the situation as best you can, which may be difficult, as young people of this age often keep these kinds of things to themselves, not wanting others, especially those close to them, to see their internal struggles.   Pay attention to what they are doing, rather than what they are saying. Are they attending school? Are they attending social gatherings? Are they doing their work? These will likely be better clues to their overall level of functioning.
 
Ask yourself: 
  1. Are you able to communicate with your adolescent about the problem, or are your efforts met with strong denial and avoidance?
  2. Does your adolescent have a plan as to how to manage the problem?
  3. Is the situation getting a bit better, staying the same or getting worse?

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If the persistent anxiety state is severely restricting your adolescent’s ability to participate fully in everyday activities, then this is a serious problem. If your older adolescent is unable to distinguish between those situations that are truly worrisome and those that are not, then professional intervention is warranted. For example, if your older adolescent refuses to attend work because the boss might be present, or school because there might be a pop quiz, or refuses to leave the house because there might be a dog or an insect nearby, then you and your adolescent should seek professional help.
 
If you have made repeated efforts to be supportive, while encouraging your adolescent to participate in activities, but his or her avoidant and fearful behaviour still persists, then professional intervention is warranted. Avoidant behaviour can become a strong habit and should not be allowed to persist for more than a few weeks.
 
A youth may have suffered a trauma or significant loss, or be living in a turbulent environment.  If a sufficient period of time such as several months has passed, and the fear response is persisting or getting worse, this is cause for concern and suggests the need for professional involvement. Sometimes the response changes. Whereas initially there was an emotional reaction to every little thing, now there might be a flatness and almost lack of reaction to anything. If this is the case, seek professional help.
 
If, in spite of your help and the help of other family members and/or friends, your older adolescents’ fears continue to interfere with their lives, persist, or may even be getting worse, then seek professional help. If your adolescents don’t seem to recognize the problem, or if they acknowledge the problem but don’t have a reasonable plan or approach to dealing with it, then seek professional help.


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There are many challenges facing older adolescents as they prepare to take their place as adults in society. Even the best plans often fail, for reasons one could hardly predict, such as changing economic circumstances, and there is a need to adapt and make a new plan.   But if anxiety reactions are emerging or re-emerging and are preventing your adolescent from engaging in the normal struggle to find their place in the world, then help them to remove this obstacle.
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Since many of children’s worries and fears are related to their school life, either academic or social, it is usually helpful to discuss the problem of children’s worries and fears with their teacher, to get the teacher’s perspective. Sometimes teachers can be very helpful in coming up with a useful plan and putting it into practice. The more adults who get involved in supporting the child, the more often the result comes that much more quickly.
 
As a rule of thumb, if children and adolescents of any age are able to overcome their worries and anxieties, it is a reason to be proud of them and they of themselves—celebrate in the most appropriate manner. If the anxiety comes and goes, then monitor it for a while. If, however, it persists for a few months, or may even be getting worse, and is interfering with normal functioning and reaching their important life goals, then seek professional help.