We talk to our children about their fears: going to sleep in the dark. About their anxieties: meeting new people. About their frights: looking behind doors when they are alone. And about their stress: feeling overwhelmed by all of their homework. Fear, anxiety, fright, and stress.
Are they all four words for the same thing? In this book, The Worried Child: Recognizing Anxiety in Children and Helping Them Heal, Dr. Paul Foxman explains that fear, anxiety, fright, and stress while related, all have slightly different meanings. And, once we understand their definitions, we can figure out which feelings are unavoidable and which are controllable.
Let’s start with some definitions:
- Fear: an instinctive reaction to clear and present danger or threat
- Anxiety: a state of apprehension or worry about a danger or threat that may occur
- Fright: state of fear when danger or threat catches us by surprise
- Stress: any situation (positive or negative) that requires adjustment or change
Fear is part of our survival instincts. When we are faced with danger, our body goes into what scientists call “fight or flight” mode. This happens without our thinking about it, instead or body takes over and prepares by tensing muscles, increasing the heart rate, sharpening the vision and hearing, and intensifying breathing. All of these changes allow our body to fight the threat or run quickly from it. These physical changes, once triggered by danger, cannot be easily stopped.
So, how do children (and adults) go from fear to anxiety? When children have repeated reactions to fear, due to frequent threats or stresses, this recurring “fight or flight” reaction can lead to symptoms such as difficulty concentrating, memory impairment, and anxiety. In other words, anxiety is the fear of fear. Anxiety tends to develop after a child experiences a traumatic situation. At first, they have the fear reaction (fight or flight), but the lasting repercussions may include persistent worry, concern or dread. In other words, multiple fear reactions, when not discussed and untreated, can lead to anxiety.
Below, I have shared a partial list of the potential “external” causes for anxiety that Dr. Foxman mentions in his book. An external cause is something that happens in the child’s environment, rather than within the child himself. Many of these external causes for anxiety make sense to us as parents, but some of them might be surprising:
- If the child sees a gun or weapon
- If the child experiences violence, even if not directed at him
- If a piece of personal property is stolen from the child
- If the child is ill or violently vomiting
- If the child experiences a serious or painful injury
- If a parent is ill and therefore incapacitated in some way
- If the child suffers sexual or physical abuse
- If the child is a victim of bullying, or witness someone being bullied
- If the child lives through a natural disaster
- If the child survives a terrorist attack or war
- If an immediate family member dies or is suddenly absent
In addition to these external triggers for anxiety, there can also be internal triggers. Internal triggers are situations that occur within the child himself. Two types of internal triggers are strong emotions and cognitive patterns. How can strong emotions trigger anxiety? If a child experiences extreme anger or extreme excitement, these emotions within the body can feel like a fear reaction (rapid heart rate, tense muscles, etc.). As a young child, it is hard to distinguish between external danger and strong internal emotions. Therefore, children who go from “low to high” and back again can also develop anxiety. Another internal trigger can be negative cognitive patterns such as perfectionism, pessimistic thinking, and all-or-nothing thinking. These repeated thoughts can lead children to develop high levels of anxiety about the future or their self-worth.
Dr. Foxman believes that there are three ingredients that explain how, why, and when anxiety develops in children.
First, he believes that children have biological sensitivity or inherited characteristics that predispose them to anxiety.
Second, he believes that you develop an anxious temperament based on your early life experience. Those with an “anxiety personality profile” have some of these characteristics:
- Strong sense of responsibility
- High standards of achievement
- Difficulty relaxing
- Tendency to please others
- Difficulty with assertiveness
- Over-sensitivity to criticism and rejection
- Tendency to worry
Third, he believes that stress induces this anxiety to come out. Stress is the “when” piece of the puzzle, inducing anxiety when changes need to take place.
Foxman created the following chart based on his ideas:
Biological sensitivity + Family and Childhood Experience à Anxiety Personality + Stress à Strong Reactions à Anxiety
There are multiple different anxiety disorders in children including separation anxiety disorder, avoidant disorder, overanxious disorder, social phobia, post-traumatic stress disorder, obsessive compulsive disorder, and panic disorder. While some worry and anxiety is normal, it is a problem if it interferes with the child’s daily functioning. If you find your child is struggling with anxiety on a frequent and intense basis, getting him evaluated will help him and you live happier lives.
Whether your child is suffering from an anxiety disorder or just plain old anxiety, there are still many things you can do in order to help control the anxiety. As a general rule, distinguish between what is in our control and what is out of our control. We can control ourselves, but not those around us. Unpredictability and uncertainty are associated with anxiety. So you choose how to spend your time, how to maintain your relationships, how to care for your children, and live according to your core values.
Some other tips:
- Rest. When you sleep, your body relaxes. Therefore, help your child get as much sleep as his body needs.
- Exercise. Exercise is great for your body and brain! Exercise relieves stress and fights anxiety. Get your child kicking a ball or running around the track.
- Proper nutrition. Highly processed or sugary foods can feed anxiety. Eat foods that are high in vitamin B and low-fat proteins.
- Daily routines. Routines help calm anxious children because they allow them to feel in control. Establish daily routines and do your best to stick to them (without stressing out!).
- Replace worry with positive and rational thinking. Help your child change his thinking. When he wants to think an anxious thought, help him transform it to a positive or rational one. With practice, this can become a way of life.
- Model calm. If you are anxious, there is no way that you are going to help your child overcome his anxiety. Therefore, work on your own anxiety. In the end, it will benefit your child as well.
