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Worried about your child's worrying

Neha Sharma, MD is a top Boston doctor at Tufts Medical Center.Anxiety is a normal part of childhood. In fact, every child goes through phases of worry at one point or another.  But sometimes it can lead to more serious repercussions down the line. 

According to a 2016, report by the Child Mind Institute, mental health disorders are the most common health issues faced by our nation’s school-aged children, affecting one in five kids. 

These numbers come as no surprise to Neha Sharma, DO, a child psychiatrist at Tufts Children's Hospital and Director of the Pediatric Mood and Anxiety Clinic, and General Child and Adolescent Psychiatry Clinic at Tufts Medical Center. She receives multiple calls each week concerning different children suffering from moderate to severe anxiety.  

“Anxiety can be a normal reaction and evolutionarily necessity to protect us from dangerous situations,” she says. “But, when this anxiety becomes debilitating and consuming, it can impact a child academically, socially and in family relations.” 

Worry warning signs

For school-age children who have difficulty verbalizing worries, anxiety often manifests through complaints like a stomach aches or headaches, which can often be worry masked as physical pain. This leads to multiple visits to the pediatrician in search of a diagnosis. 

“Once the pediatrician has determined that the child is physically and medically well, it is important to ask the child about issues about school, friends, and bullying,” says Dr. Sharma. “Think about the big picture, and look for any environmental, social, or behavioral changes to narrow down the focus further. It is really an investigation process.” 

In addition to physical symptoms, other signs to look out for include excessive tantrums and meltdowns, panic attacks, severe shyness or holding back and not participating in activities they once enjoyed. 

“Anxiety can become so overwhelming that children can shut down,” notes Dr. Sharma. “So a child may avoid activities and tasks that provoke anxiety, and this worsens anxiety because it prevents a child from getting comfortable with a scary situation.”

Getting help 

When children’s symptoms become problematic and they are unable to perform day-to-day activities and/or the anxiety is affecting the entire family, it may be time to seek further help.  

A good place to start is with a trip to your child’s pediatrician or their school counselor to discuss their symptoms. It’s also important for parents to realize they may play a role in their child’s anxiety.  

“Parents can really help their children by providing age appropriate information, and knowing what is coming up goes a long way,” explains Dr. Sharma. “Then, backing that up with reassurance and relaxation techniques like deep breathing and position self-talk.”

The good news is that there is a very high success rate in treating children with anxiety disorders.  Today’s standard of care starts with most children entering into cognitive behavioral therapy, which can help them to challenge what is irrational about their worrying and anxiety.  This type of treatment can be adapted to a child’s age.  

For more severe cases, medications may be a more effective treatment and can help lessen the symptoms.  

“The medications used to treat anxiety in children have been effectively and safely used for more than 20 years in both adults and children,” says Dr. Sharma. “They are very well tolerated in children and the goal would be to keep them on a medication for six to 12 months in collaboration with CBT therapy; then slowly wean them off the medication.” 

In addition to getting their child professional help, parents should also be supportive, nonjudgmental and loving. The goal is not to avoid anxiety or to get rid of it, notes Dr. Sharma. Instead, the goal is to help kids manage their worries and tolerate physical and emotional discomfort.  Learning how to cope will set children to manage many growing pains of life.