First let me prefix by saying that it is totally normal to feel anxiety from time to time. It is part of the vast repertoire of emotional experiences we all share. This article aims to help parents and teachers spot the signs of chronic anxiety in children. For cases where intervention is needed there will usually be more than one of these signs present.

Difficulty sleeping

For children with anxiety it is often very difficult to relax and let go of the need to be hyper vigilant. Their conscious mind may know that it is safe but their body keeps reacting as if they are in danger. They are stuck in their sympathetic nervous system, rather than their parasympathetic nervous system that is needed for rest and digest processes. This may look like difficulty falling asleep, frequent awakening through the night, bedwetting, teeth grinding and fearful nightmares.

Frequent stomach aches, head aches and illness

With anxiety the body is preparing for threat and so the body’s resources are prioritised towards survival needs. The blood supply is pumped towards the legs and arms ready for fight or flight action. Therefore, the less urgent processes involved for digestion and the immune system are neglected. Tension headaches can be an issue as can headaches caused by teeth grinding during sleep. Skin conditions often flare up during times of stress too.

Reduced appetite & weight loss

When your body is sending signals that there is a life threat, eating is a lower priority. Have you ever wanted to eat a big meal before doing a big public speaking event? Or a bungee jump? Eek!

Children with anxiety may forget to eat during the day or seem very distracted and resistant at the dinner table. Resting and eating is something to be postponed once the threat is overcome and there is a feeling of safety within the body. This can be really frustrating for parents. We know that we need a good diet to grow and to maintain our immune system. Low body weight can add to fears for health. It takes a lot of energy to remain hyper vigilant like children with anxiety do. They are likely burning more calories and eating less so weight loss can become an issue.

Chronic muscle tension & posture

When in the fight or flight mode, legs and arms are mobilized and muscles are engaged. Over time this can lead to chronic contraction. Tensed up shoulders, clenched jaw (which may be accompanied with lip bitting or pressing), hunched posture with head leaning forward. I once saw a child who would unconsciously make fists throughout the day, and even when he slept, leaving fingernail marks in his palms. 

Excessive fidgeting, talking & giggling

The build up during a state of anxiety is intense and feels unbearable. Children may discharge this excessive energy by finding ways to move and use their muscles which have this surge of blood supply. Talking and giggling is another form of action that may act as seeking comfort behaviour by connecting with others. Giggling can cause whole body shaking which may cause temporary relief from the build up of sensation in their body. Teachers often mis-read these behaviours. It’s important not to make the underlying anxiety worse by reacting in a threatening way to the child. A mild mannered reflection of their behaviour should do the trick or even better an opportunity for them to move or talk could be provided.

Difficulties with peers and/or academic learning

When a child is suffering from anxiety, the more primitive emotional part of the brain is activated. There is reduced blood supply to the neo cortex. The neocortex is where the higher order thinking, problem solving, language skills are housed. When you ask your child, "what’s wrong? What happened?" and they don’t answer. They really don’t know or they don’t know how to tell you! They’re most likely trying but their language skills are offline when they’re in that stress response. Equally when they’re having a dispute with their classmates, they are not able to access their neocortex resources for negotiating with friends well. So instead they act from the emotional impulsive brain and hit, grab or push. The other side of this coin is that they withdraw altogether and stay mute.

Those are just some of the most common symptoms of anxiety that I see as a play therapist. There are always individual differences in presentation of anxiety but for the children who need therapeutic help there is usually more than one of these (or indeed all of the symptoms above). 

There is definitely hope! As you might have guessed the key is to work with the child’s body and nervous system through non verbal communication. This is something Play Therapy really taps into compared to other talking based therapies. A play therapist can help your child move through the anxiety and learnt to self regulate the strong sensations experienced with anxiety. Next post there will be some tips and tricks on how you can support the anxious child at home.