- Parents should never,
never tell their child that it's not okay to
have a negative emotion. And, you know what that leads to? That leads to avoidance strategies. Feelings are temporary, no
matter how discomforting it is, it's like a wave in the
ocean, it comes and goes. - Why does anxiety and phobias
need a separate conversation when it comes to kids than adults? - Because developmentally, it
looks different in children. And oftentimes, children are misdiagnosed. A lot of times because
children are growing, they have these very short periods of time in which they appear to be
struggling with something. And that's actually
developmentally normal. So, we also don't want to pathologize these children needlessly. We don't want to make it look
like everybody has a disorder because they're just going
through some growing pains. And so, I think that's why the separate conversation is needed because there is a lot more sensitivity to how long they have to be suffering with something before
it really does warrant some professional intervention. - So, let's start with
what life looks like for a child who has anxiety. - Particularly as a child, you need somebody to take
care of all of your business. You can't support yourself. That's the way that mammals work. And as children, their attachment develops based on whether or not they feel secure when they're with their
primary caregivers, when they're in their environment, do they feel safe? And anxiety can develop when there's a very chaotic environment, when your primary caregivers aren't always consistently there to support
you, especially when you fall, or have a fear, or have
something bad happen to you. So, sometimes it's environmental
and if there is structure and if there's an
establishment for safety, then the child can come back
from anxiety pretty easily too. - Or is it more just a predisposition that they have from birth? - Anxiety does show some predispositions. So, we know that even from birth, that there are differences in temperament. So for example, some babies
are just harder to sooth, they're a little bit more
sensitive to noises and lights and other types of sensory information. Usually that's a precursor for having a little bit more
of an anxious temperament. Doesn't that mean that you'll develop a full-fledged anxiety disorder, but just means that under
pressure or under stress, you are more likely to
develop some anxiety symptoms. Anxiety manifests in
a type of a difficulty with going to school, with
pretending that they're sick so that they don't have to go to school. Oftentimes, there's issues with separation so part of their not
wanting to go to school isn't necessarily that
they don't like school or that they are being, for
example, bullied in school, but that they don't want to be apart from their primary caregivers. And so oftentimes for children, anxiety manifests in bodily symptoms. They'll say that they have headaches, they'll say that they have stomach aches and they can't go to school. And oftentimes, they also
complain of other types of things like being easily distracted. And so, sometimes you can see how that could lead to misdiagnoses. Is it time to take them to
the primary care doctor? Is it time to see if they have ADHD? But all of the time, you have to make sure that you're considering that anxiety might really be the explanation for it. - So when I was young, probably between the
ages of three and eight, specifically my mother, when
she would leave for the night and I had a babysitter, oh my gosh, you would have thought that I
had been stabbed in the back. I could not believe that my
mother was gonna leave me. And then, it was just
something I grew out of. I didn't seek treatment. My mom would just go, "Well, I'm leaving." You know, you're going to
eventually get over it. And I did. For a parent, how would they know if it's something they're gonna get over or something that could actually
be detrimental long-term? - I think oftentimes for children, we look about the span
of three to six months. If it doesn't go away in
about that period of time, then it's time to kind of look at that a little bit more in detail and to see if there's something
that needs to be done. Also, some children from a very young age do show a proclivity towards
being extra conscientious. So, they want things to be in their place, they want things to be organized, they're a little bit of a control freak, even as a little child. And when you see that, that
also tends to correlate with anxiety symptoms as they grow. - You mentioned earlier
about somebody, or a child, exhibiting anxious traits,
but not having the disorder. - [Judy] Right. - What is the definition of
a child under the age of 10 having anxiety disorder, or compared to just having anxious traits? - I think there's two very
major things to look for. One is, is it clinically impairing them on a variety of tasks in their daily life? Is it impairing them at school? Is it stopping them from being able to develop good friendships? Is it hard for them to
function in the home? Is it hard for them to
do self care activities? Like get up, get dressed, shower, put your backpack
together, get on the bus. That's one area. The other area is that
the individual perceives a huge amount of distress. So, if they themselves say,
I'm very upset about this, I'm upset by my own anxiety, I'm upset that my stomach hurts so much, I'm upset that I can't go to school, that's the other criteria for
knowing that it's a disorder. - How does a four year old do that? - And that's part of the problem. With children, they don't necessarily say this is bothering me this much. So, as a parent, or a teacher, or an adult that is in this child's life, it's kind of your
responsibility to check in, to see how they're doing, to
ask very specific questions. And I think with children,
especially because they're not usually mature
enough to spell it out with their own words,
it's important to ask them very, very pointed questions about it. Because when you ask,
you do get an answer. - So, for a child who goes
through your six months, and a child being, we're
calling a child, what? Anyone under the age of 10? 18? - Yeah, well, I guess, you know, if we're talking about a minor, yeah, anybody under the age of 18, I guess we've been
focusing a little bit more on the younger children, so. - Let's start there. I like that.
- Yeah, let's do that. - So, with the younger
children, let's say under 10, they are getting out of school, talking about how anxious
they are going to school, faking being sick so they can avoid it, it's been going on three to six months, what's happening on a neurological level? - So, oftentimes with children, what they notice is just that they have a difficult time handling and managing their environment. So, if they feel like
there's too much stimuli, or that there's too much of
a focus on them individually, individuals who have
anxiety, sometimes don't like when other people are looking at them, paying attention to them. And so, if they feel like
there's too much going on in that direction, they'll
oftentimes start to feel not only the bodily
symptoms, but just worries, fears about what's gonna happen next. And in fact, anxiety wouldn't even exist if we didn't have the
ability as human beings to think into the future. Because if we're being mindful and we're just staying
in the present moment, nothing's happening except
that we're sitting here and having a conversation on the couch. It's when your mind races to, what do I have to still do
for the rest of the day? What's gonna happen when I have to give that school presentation? When I go and play on the school yard, am I gonna get bullied again? It's when you think in the
future that anxiety happens. And so, children who sort of have that future forecasting ability and tend to attribute negative
outcomes to the future are more likely to have anxiety. - This is really good, I like that. This is so good because
it's, anxiety only can occur because we have the ability
to think about the future. - [Judy] Yes. - Which immediately tells
me a way to combat anxiety, and this is higher level,
not just with kids, but for anybody, being in the moment, being mindful, being present, however you get there,
meditation, whatever. - [Judy] Right. - Could be a way to treat, is
a way to treat the anxiety. - Absolutely and I think
it's interesting because most children have a hard
time thinking into the future because they're so
present minded, you know, the minute they don't get a toy, they're like, my world is over. They don't think that in five minutes, they won't even want that toy anymore. But I think sometimes children who are a little bit more
beyond their years that way, their brains are sort of accelerated in terms of thinking into the future and projecting sometimes that
actually leads to anxiety. And there's been a number of studies actually looking at people
who are more conscientious, more ambitious, and whether
or not more anxiety occurs. And we're not talking necessarily about one that's diagnosed with the disorder, but just anxiety symptoms in general. Also anxiety can have a very physical manifestation for people. So, when people say that they're
having an anxiety attack, they mean that they are
having a panic attack. It means that they're having all these physiological
reactions, quickened heartbeat, heart pounding, maybe sweating, maybe just feeling like you're
crawling out of your skin. So, that would be just
some of the examples of how anxiety can manifest in the body. - And for a child, is that the same thing? - For children, I think they don't have as many emotion words to
capture how they're feeling, but they oftentimes will
talk a little bit more about things hurting. So, headaches and stomach aches. They sometimes will just say
that they don't feel right because their vocabulary is
a little bit more limited sometimes it's hard to know exactly what it is that's going on. But I have found that with children, oftentimes they'll talk
about pains in their body. - Is a temper tantrum a
panic attack for a child? - Not necessarily, yeah. So, I think sometimes with children who have temper tantrums, it is because they're overstimulated and they
need to kind of gain control of their environment again. Other children are just
having temper tantrums maybe because they need
to have limits setting, maybe because they have
another type of issue, like an externalizing behavioral problem, such as ADHD, or oppositional
defiant disorder. So, it can really vary. - Are there red flags
that would tell a parent, all right, stop asking questions, get this kid into a psychologist, or therapist, or psychiatrist ASAP. - Well, there's a couple of
things that we would look for. I mean, oftentimes children
who are anxious, they cry. And so, if you see that they're
crying multiple times a day, sometimes being set up by things that are just really at the drop of a pin, it's time to see if they need some professional intervention, especially if the teachers
are already pointing it out. If they're having difficulties, even just maintaining eye contact, I mean, just things
that feel kind of basic, but are important for
our social functioning. That's another reason to go and
consult with a professional. I think oftentimes when
children are really anxious because they can't really speak about it, there's so much agitation. So, every once in a while you
will see a child acting out and this goes back to
your earlier question about temper tantrums, that
sometimes you will see that. And if it happens all the time, especially around stressful events, like going to school, finishing
a homework assignment, being around too many people at one time, that's another clue that
perhaps it's actually anxiety and you need some professional support. - Phobias. - [Judy] Phobias. - We've talked about anxiety. - [Judy] Yes. - What's a phobia? - A phobia is an irrational
fear against something that probably doesn't have
the proclivity to harm you as much as you think it does. So, it's not a phobia to be
afraid of a saber-toothed tiger if you're in a cage with them. That's not a phobia, that's
a very realistic fear and you should be afraid for your life. A phobia would be being
afraid of a tiny spider that is not poisonous, but
you just don't like spiders. And then it makes you not
even want to be in the room with them, run away, cry, right? It's irrational because they're actually not
gonna do anything to you. - So, phobias are irrational fears. With children around the age of 10, what are their common phobias? - Common phobias are
monsters underneath the bed, lots of monster types of phobias. They oftentimes also have
phobias, interestingly, younger children have phobias of germs. And so, it almost looks like OCD, it almost looks like
obsessive compulsive disorder, but again, children can grow out of that. So, don't be afraid if all of a sudden your child's afraid of
germs and they're young, maybe in a few months, it's gonna go away. So, objects, monsters, and I think cleanliness are
three of the biggest ones. - And do you see common
phobias in teenagers? - Common phobias in teenagers are sort of run the gamut a lot more. I think at that point, they've had a little
bit more life experience and they actually sometimes
start to develop phobias from watching other people. If they see other people
be afraid of something, like their own parents, their friends, then they all of a sudden start to be afraid of the same thing. - Yeah, I see so many parents who are afraid of dogs
and then their kids, who are five, are afraid of dogs. Because they just go, mom
and dad are scared of this, so I need to be scared of this. - Absolutely, and yet again, you know, you look to your caregivers for how you should be navigating your life and your social world, so that doesn't surprise me at all. - So that covers the 10 and under. I would imagine it's maybe a little easier to have these conversations, maybe, with a child who's 10 to 18? - Yes. - How does anxiety manifest
differently in that demographic? - I think oftentimes with the
preteens and the teenagers, it manifests more sort of in
like a decreased zest for life because they are so anxious, it actually limits their ability to go out and do new activities and meet new people and put themselves up to just
the kind of new opportunities that sometimes can actually
make you feel really happy and really confident about yourself. So I think with preteens and teens, you see them kind of isolating themselves. - I'm not a parent, but don't all preteens and
teens isolate themselves? I feel like they all go home,
lock themselves in their room, listen to music, like, leave me alone. Like, that's just what they do. - I think mostly, that's
a really good point, I think mostly it's about friendships. If they're isolating
themselves from their peers who they're supposed to want the love and support of the most at that age, that's when you know something's going on. - That's important to note. - Yeah.
- Yes. - Definitely, as a parent, yes. I mean, if they want to
go and lock themselves in their rooms and talk
to their girlfriends, that's not really as much of an issue, but if they're locking
themselves in their room, not talking to anybody, and at school they're isolating, that's a big issue. We oftentimes also see that
their grades start to drop. Again, they lose motivation for what they used to like doing so they stop participating
in extracurricular activities and they stop working in school. And that's another thing to look for in those preteen to teenage ranges. - Why is it so important
to watch this series? - I think it's important because anxiety is such a big problem and it's a big problem that a lot of times people don't talk about or they throw it around
very flippantly, like, oh, I'm just anxious. Well, are you serious about that? Is it actually impairing your life? And if it is, we need to
do something about it. And with children, because they don't have that developed vocabulary, it can impact their life
in so many significant ways and yet they can't talk about it. And that's why it's so
important as parents, as caring adults, to
know the signs of anxiety and to know that it's not something else. Sometimes people think it's ADHD, sometimes people will think that there's a medical condition. It's not, it might be anxiety so make sure you know the signs and be able to delineate
that for yourself. - Thanks for watching. Check out the links below
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health videos every week. Did you like what you heard in this video? If you want to ask a MedCircle doctor a question directly, you can. Learn how by visiting the
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