Ask the Expert: Parents get stressed over kids’ anxiety

Anxiety disorders are the most common child and teenage mental health problems. Yet, because children with anxiety problems are frequently well behaved in public and in school, they often do not get the support or attention they need. In a three part series, John Sharry will answer some of the many questions he receives about anxiety-related problems, starting this week with the needs of older children and teenagers

My 14-year-old son suffers from very bad exam stress and anxiety. He is now in second year and he finds it really hard to cope with the anxiety that exams cause him. Even though he is a straight-A student, he can get into a state about anxiety and will say he can't do it, and that he is stupid, even though none of this is true. It causes great stress at home and I would love some advice on how best we can help him.

The first step is to make sure you listen to and support your son. Don’t dismiss his worries: listen carefully, encouraging him to express his feelings. Even though they are irrational, it is helpful that he expresses the underlying worrying thoughts he might think. It is a great relief to have someone who can listen compassionately as he talks about his worries and frustrations.

Help him challenge his worrying thoughts

Ask him questions that challenge the negative thoughts that underpin his worry – “I know it feels like that at the moment, but is that really true?” “How did you mange to get the study done the last time?”

Encourage him to come up with more balanced thoughts such as, Sometimes I get anxious, but I know I can do it, or I’m just feeling a bit anxious, this helps me prepare, or I will do my best and enjoy the process.

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Sometimes it can be helpful to write these new thoughts out on coping cards that he can refer to. It is also helpful to teach him some relaxation and focusing techniques that he can learn to use during anxious times.

Problem solve around the study routine

Brainstorm with your son different study strategies that will help manage his anxiety. Having a good routine about when and where study happens and coming up with a clear realistic plan of study can keep anxiety at bay. For example, he might find it useful to start with an easier subject to get started before tackling a more difficult challenge before finally reviewing what he has learnt.

Simple things such as having regular breaks or even playing some music during study can all help him be more relaxed.

Put study and exams in perspective

Help your son keep other enjoyable interests within his routine to ensure balance and perspective. Despite the pressure of exams, encourage him to keep up one or two other enjoyable and social activities that can act as stress relievers. Make sure he integrates physical exercise and regular healthy eating into his daily routine.

My daughter, who is just 15, has always been a bit of a worrier. Just about anything can make her anxious. Recently, things have got a little worse and now she occasionally suffers with panic attacks. Could you please give some tips on how to deal with them?

A panic attack is an acute onset of anxiety symptoms such as shortness of breath, increased heart rate and dizziness. Essentially, it is a misfiring of the body’s “fight or flight” alarm system when there is no corresponding threat. Usually a panic attack represents a vicious cycle of thoughts, feelings and bodily symptoms that reinforce each other. For example, an anxious person experiences their heart beating faster and thinks, Something must be wrong with me, which increases their anxiety and thus their heart rate which further reinforces their fear.

Panic attacks are common and can be triggered in a variety of contexts and can easily become habitual.

Managing panic attacks

The key to managing panic attacks is learning to break the underlying cycle that reinforces them. The goal is to accept the feelings of anxiety without fuelling them with distressing thoughts, such as Something is wrong and to ensure the anxiety does not stop you doing important things.

Essentially, this means you notice the early signs of anxiety in the body – Oh, I feel a bit nervous – but then get on with what you are doing, letting the anxiety dissipate in its own right. Once you habitually realise that the anxiety passes in its own right then the cycle is broken. Of course, this is all easier said than done.

Increasing body awareness

Helping your daughter tune into her body and the symptoms of anxiety can be really helpful. Away from a bout of anxiety, help your daughter map out the symptoms she experiences and how they start: for example, butterflies in the stomach, leading to increased heart rate. It can also be helpful to induce some of these symptoms so you can show her how they pass in their own right.

When working with teens, I sometimes get them to do some exercise, such as jogging on the spot, before taking time to relax: this allows them to notice their increased heart rate and watch how it quietens when they relax.

Teaching relaxation and mindfulness

There are lots of great relaxation and awareness techniques for tackling panic and anxiety, such as becoming aware of and slowing one’s breathing, progressive muscular relaxation, or learning to be mindful and gently accepting one’s thoughts and feelings. You may wish to attend a class that teaches some of these techniques, such as yoga, meditation or mindfulness, with your daughter. This would be a good way to support her and to tackle the anxiety together. Once she gets experienced in these techniques, she can apply them when facing a bout of anxiety.

Take time to understand the triggers for your daughter’s anxiety and to problem solve with her to address the underlying issues and thoughts. Seek further help from mental health services if problems persist.