Kids and anxiety: Strategies to try at home

As parts of our lives transition to a "new normal," one thing may still seem "off" for many parents—their child's mood and behavior.

"We have seen dramatic increases in anxiety in various forms for children since the start of the COVID-19 pandemic," shares Sarah Long, PhD, LP, medical director of Gundersen Child/Adolescent Psychological & Therapy Services.

Routines that once gave children and adolescents a sense of control were largely lost during the pandemic. For many children, that has resulted in:

• Frequent stomachaches or headaches (physical symptoms of anxiety)
• General worry and irritability
• Panic attacks
• Eating disorders
• Lack of interest in hobbies or avoiding activities with friends and family (common with depression)

Many strategies can be used at home to help your child cope with anxiety. Dr. Long recommends:

Diaphragmatic or "belly" breathing

Have your child lie down on their back and put a stuffed animal on their belly. Have them breathe in slowly and move the stuffed animal up for a count of four; breathe out and bring the stuffed animal back down for a count of four. Repeat for at least two minutes.

Guided imagery

Ask your child to picture in their mind a place where they feel completely calm and happy. It can be a favorite spot they have seen or visited, or a pretend place. Ask what they see, hear and smell. Ask how their body feels. Be mindful not to rush and spend some time with them in this happy place. Kids can come back to this place when anxious thoughts arise.

Progressive muscle relaxation

Before starting this exercise, help your child understand what their body feels like when they are worried or upset, so they recognize tension in their body. Then, ask your child to inhale and tense a muscle group for four to ten seconds; exhale and relax the muscle group to relieve any tension.

It is best to get into a routine of practicing relaxation strategies when your child is calm. Bedtime works well. Many relaxation apps, such as Headspace and Calm, and videos on YouTube can walk you through these techniques.

Helping kids face their fears

If specific situations cause anxiety in your child, it's important to continue to encourage your child to take part. Instead of avoiding the situation—which will reinforce anxiety over the long run—talk to your child about what is frightening them. Listen and be empathetic. Remind them of their happy place or other relaxation strategies.

Keeping children active

One key intervention used for depression is called behavioral activation. Essentially, you make sure your child stays active throughout the day and spends time doing the activities they used to enjoy.

While feeling anxious from time to time is normal, it is important to involve your child's primary care provider if anxiety starts to interfere with your child's normal, day-to-day activities.

"With early intervention, we can help equip your child with coping skills to manage their anxiety and prevent long-term consequences from the COVID-19 pandemic," says Dr. Long.

Warning signs in children that require immediate medical attention—and should never be ignored—include suicidal statements or behavior, including self-harm, or major behavioral changes such as withdrawal or dropping grades. These behaviors should be discussed immediately with your child and their healthcare team.