Kids Mental Health
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Is it worry or anxiety? What every parent needs to know.


Guest post on kids mental health by Dr. Caroline Buzanko, Licensed Psychologist & Clinical Director of Koru Family Psychology.


Young girl sitting and hugging her knees with her head down looking sadAll kids worry at times. However, when they grow too big, worries can become overwhelming, exhausting, and debilitating. Anxiety is one of the most common mental health concerns for kids but often either goes unnoticed or misdiagnosed. When not addressed effectively, many kids go into adulthood struggling with anxiety for a long time. When left untreated, kids with anxiety disorders tend to miss out on important social experiences and are at higher risk for poor school performance, substance abuse, and other disorders such as depression. It is therefore critical that parents understand what anxiety is and how to help their kids. Here are the most important things every parent needs to know to get you started. 


Worries are normal!


Like adults, kids have a lot going on in their lives – and a lot more than ever before. And like adults, kids experience anxious feelings. Anxiety is a normal, protective feeling that is important to keep us safe, to perform our best, and to even motivate us. Worries are to be expected. Especially when kids experience a stressful situation, such as going to a birthday part where they don’t know everyone, or a big transition such as going to a new school.

Although occasional feelings of anxiety are normal, it is critical to understand what is normal and what is problematic. 


When does anxiety become a problem?


Normal worries become a problem when a small thing, or everyday experiences, turn into a big reaction. And, when: 


Kids start to worry about/expect bad things to happen regularly. 

★ When the worry starts to cause more frequent and extreme distress than other kids that age. 

Worries are hard to control. 

Worries start to cause physical symptoms (e.g., stomach-aches, headaches, GI problems). 

Worries start to interfere with kids’ success at home, school, and/or socially. For example, they may be unable to pay attention because of worried thoughts, try to avoid situations and/ or always seek reassurance (e.g., asking lots of questions).


mom kneeling beside a teenager in a hoodie sitting on their bed having a seriousl conversation

Here are some things to watch out for:


Normal Worries Problematic Anxiety
Worries happen occasionally and are usually related to a specific event. Anxiety is experienced most days.
Worries are easily managed and do not interfere with functioning. Worries are hard to control and interfere with functioning at home, with friends, in extracurricular activities, and at school.
Worry about an upcoming test or a friendship fire that happened today. Excessive, constant, intrusive, and irrational worry that is more extreme than the situation calls for.
Initial crying when going to daycare/pre-school for the first time. Persistent worry with going places without a familiar adult, unable to engage in the new environment, or takes a long time to calm. Feelings of homesickness or not being loved.
Self-consciousness in an awkward and/or unfamiliar social situation. Fear of being judged or embarrassed in front of others. Fear of and avoidance of upcoming social situations. Fear of being called on in class. Avoid starting conversations with others.
Nervousness and sweating before a big presentation. Panic attack or preoccupation about what is to come, physical symptoms, or having a panic attack. Ongoing agitation and physical feelings such as rapid heartbeat, sweating, shaking, and dry mouth. Frequent muscle tension.
Realistic fear about something (e.g., going down a dark alley at night). Irrational fear, avoidance, and overboard reactions to things that are not dangerous (e.g., going on a playdate without a parent or intense fear of needles).
Trouble sleeping from worry right after a traumatic event. Constant troubles sleeping (either falling or staying asleep) because of worries. Ongoing nightmares or flashbacks about something that happened a long time ago.
Getting tired after a big physical task. Easily tired over minor tasks because of constant worrying. Difficulties concentrating or finishing things.
Irritable after a hard day/stressful situation. Excessive irritability, even with no apparent trigger.


Kids mental health: How you can help your child


Whether your child experiences normal worries or full-blown anxiety, there are a few key things you can do to help. The key is to help them to learn to cope on their own and turn their worrying brain into a problem-solving brain. 


Externalize worry. Avoid using language depicting your child as a worrier. Saying things like, “We are an anxious family” or “He has always been shy” are not helpful. Instead, talk about worry as a pest, “Oh, that worry is at it again!” 


When my kids were little, they gave their worries a name – Scaredy cat. By giving it a name and externalizing it outside of themselves, kids can feel empowered to take control of the worries. 


teen girl with shoulder length curly hair looking pensive with her hands folded by her chinExpect worry to happen and plan. Even though worry wants us to think everything is a crisis, worries are a normal part of life. They are predictable and redundant. And worries are temporary. Therefore, put worry in its place from this all-consuming, end-of-the-world mighty dragon status to a pesky little fly. Demoting worry and expecting it to show up also empowers kids to take control. They can say things like, “Yep worry, I knew you were going to show up this morning and try to make me think I can’t go to school. You’re so boring with all the same old stories and trying to always make me feel sick. I was ready for you and guess what, I am going to school and mom is even going to drive me!” 


Encourage bravery. Managing anxiety effectively takes practice. Aim for your kids to do something brave every day. Stretch out of their comfort zone to build their tolerance for anxiety and let them learn firsthand that their fears are not really dangerous. As a result, their anxiety will decrease, and they will feel more confident. 


Reward bravery. When they are successful, praise them for being brave. Make a big deal out of it. Sometimes acknowledgement is all that is needed. Small recognition rewards can be helpful too, ideally if somehow related to the brave act. Turning the lights off at night might translate to staying up an extra five minutes for extra stories. Social anxiety might turn into doing a fun activity out in the community. Petting a dog might turn to going to the pet store to see all sorts of cool animals. 


Create memory bridges. When kids worry, they forget about times when they were brave able to handle things. Creating bridges back to past successes is key so they can remember that they CAN  handle this. A great example is a success journal your child can add to and review daily. Or you can have a tree of bravery where you write every brave thing your child has done on a paper leaf and watch their wall bloom. 

Young girl sitting and hugging her knees with her head down looking sad

Get active and get outside. Worry often shows up physically. It can cause increased heart rate, erratic breathing, tension headaches, and even nausea. Blood flow is restricted, including to the brain, which makes it hard for kids to think rationally and get out of flight-fight mode. Play and physical activity counteracts these by helping slow the heart and breathing rates, and reduce tension thereby bringing the rational-thinking brain back online. Physical activity and outdoor play are helpful in reducing stress and improving self-regulation.


When to seek help

If you notice your child experiences more problematic anxiety than normal worries and/or your child is experiencing ongoing worries that interferes with his or her success in any area, get help for you and your child. Anxiety is not something kids outgrow and the sooner you address it, the easier it will be to overcome. In the meantime, there are things you can do to help support your kids mental health. 



For more information on kids mental health please visit these articles on our blog:


head shot of Doctor Caroline Buzanko

Dr. Caroline Buzanko is a licensed psychologist and clinical director of Koru Family Psychology. She has worked with children and their families for over 20 years, with a focus on maximizing connection, confidence, and resilience. She facilitates groups and workshops across North America to promote health and well-being among families and is an Adjunct Assistant Professor at the University of Calgary.  For more information visit: http://drcarolinebuzanko.com/ 


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