Sometimes I’m … quiet. I had nothing to say. Nothing. I could sit through an entire visit to my cousins’ in silence. Hours. Saying nothing unless someone dragged mostly mono-syllabic responses out of me.
One day, my grandmother cajoled me into relating a recent babysitting experience I had. As I got to the part about using ice to get the gum out of my charge’s hair — the dad said he would have just cut it out — I looked up at my cousins, aunt and uncle, who were all listening with masks of interest. I felt ridiculous. I clammed up.
They made comments and asked questions to show they were listening. Like my grandfather, they all obviously wanted to encourage me to keep talking, even if it was only my grandmother who found the story interesting in the first place. I fell further into myself. I’ve always hated feeling patronized. I’m just … different.
I knew my gregarious family thought my behaviour was abnormal, but, as a child, I lacked the experiences of normal social interactions and the cognitive ability to understand how far out of the ordinary my behaviour was.
As a young teen, I blamed being adopted for my quietness. I was just different from my mom’s talkative family. I also believed I had nothing worth saying, while everyone else related funny or interesting experiences and accomplishments. I accepted the label of “shy.” In my mid-teens, I felt humiliated when I was told my family considered me “socially retarded,” but understood why they came to describe me with the term.
As an adult, I learned about social anxiety and recognized it in myself. I now know that the uncomfortable, self-conscious silence of my childhood has a name: selective mutism. One reason it has been difficult to identify my anxiety as anxiety is that it so often isn’t associated with agitation. How could I have anxiety if I’m not agitated? I looked calm. In a way, I felt calm. My brain was so overwhelmed, it partly shut down. Breath to breath, I got from one moment to the next.
Children who suffer from anxiety need help recognizing symptoms of anxiety for what they are. They also need help to understand that what they are feeling, and likely the way their feelings make them behave, is extreme.
Throughout life, we experience various natural and protective fears. If we lack certain fears, we are more likely to place ourselves in dangerous and harmful situations. Moderate levels of age-appropriate anxiety are normal and can be healthy. Can you imagine what the world would be like if no circumstances made us uncomfortable and we jumped into every situation with both feet because we could not comprehend potential dangers?
If you suffer from anxiety, you know how overwhelm can strike at random. You may have certain places or situations you recognize as potential triggers. You may be one of the significant numbers of adults who end up in the ER thinking they are having a heart attack, only to find out you are suffering a panic attack. In whatever forms anxiety has found and exploited you, it is likely you recognize that your symptoms, reactions and feelings when you experience anxiety, are extreme.
A child lacks a frame of reference to understand that his reactions and feelings are extreme. The younger the onset of symptoms, the more a child will believe that what he is feeling and experiencing is normal.
“Many symptoms of childhood anxiety are the same as those of adult anxiety but can be experienced or expressed differently, sometimes in opposition or aggression.”
He has less experience with what are considered normal responses. He just knows how he feels, not how to evaluate his feelings for reasonableness. He feels his responses are normal because they are what he knows. He is less likely to recognize that his worry is excessive or that his fear is irrational.
For more information on selective mutism, check out the following resources:
• The American Speech-Language-Hearing Association (ASHA): Selective Mutism
• Psych Central: Selective Mutism Symptoms
• The U.K. National Health Service (NHS): Selective Mutism
• The National Institutes of Health, United States National Library of Medicine and National Centre for Biotechnology Information (NCBI): Selective Mutism – A Review of Etiology, Comorbidities and Treatment
As children are not as capable as adults to assess their emotional and physiological distress for appropriateness, they are not as able to articulate what they are feeling. Many symptoms of childhood anxiety are the same as those of adult anxiety but can be experienced or expressed differently, sometimes in opposition or aggression.
Symptoms of childhood anxiety include:
• stomach aches
• trouble sleeping
• sleepiness during the day
• difficulty concentrating
• excessive worry
• too much time spent in solitary play or video games
• avoidance of various typical social interactions
• refusal or inability to speak in certain social situations
• disruptive behaviour
As children grow toward young adulthood, anxiety can lead to the following issues:
• isolation and loss of friendships
• poor school performance or academic decline
• suicidal ideation
• self-destructive behaviour
• substance abuse or addiction
The most common anxiety disorders diagnosed in children are:
1. Generalized Anxiety Disorder (GAD): Excessive worry about a variety of things that could include peer relationships, family issues or academic or athletic performance. Children who suffer from GAD tend to be hard on themselves and struggle with perfectionism.
2. Separation Anxiety Disorder: It is common for children aged 18 months to three years to experience some separation anxiety and for children to cry when first dropped off at a daycare or preschool, but they can then become distracted from their discomfort by activity. Older children who cannot leave a parent or particular caregiver, and children of any age who take much longer to calm down than their peers, may suffer from separation anxiety disorder.
3. Panic Disorder: Unexpected anxiety or panic attacks that come on suddenly and for no reason, followed by concern over losing control again.
4. Social Anxiety Disorder: Typically, intense fear of social or performance situations and activities.
5. Selective Mutism: Children may be talkative and sociable in places they feel comfortable, but refuse to talk in specific situations where talking is expected or necessary.
6. Specific Phobia: Intense, irrational fear of a specific object.
7. Obsessive-Compulsive Disorder: Obsessions (unwanted and intrusive thoughts) typically paired with compulsions (feeling compelled to repeatedly perform routines and rituals) to try to ease the discomfort of anxiety.
8. Post-Traumatic Stress Disorder (PTSD): As with some adults who have experienced or witnessed a traumatic or life-threatening event, children can develop intense fear, emotional numbing, irritability and avoidance beyond feelings of fear, sadness or apprehension that are typical after such events.
How to help a child struggling with anxiety:
• Remember that telling a child not to worry will not eliminate her anxiety. The goal is to help her learn to manage it.
• Keeping a child away from potential triggers and stressors does not solve the problem, but can compound it, as the reasonableness of his anxiety is reinforced.
• Reassuring children that everything will be okay can be counterproductive. For example, if a child fears failing a test or performing poorly during a competition, you cannot guarantee that she will never fail or make a mistake. What you can do is help her understand that no matter what happens, she will be okay.
• Asking children about how they are feeling is good, but it is important to not do it the wrong way. An open-ended question like, “How are you feeling about your first soccer game?” is more helpful than feeding anxiety by asking a leading question like, “Are you worried about your first soccer game?”
• Listening and empathizing can help children understand what they are anxious about and encourage them to face their fears. Let them know you know that they are worried, that it is okay and you are there for them. It is possible to respect feelings without empowering them.
• Getting nervous about what makes children nervous can reinforce their anxiety if you betray your unease through your voice, avoidance behaviour or body language.
• Overprotecting children can keep them from learning to cope.
Anxiety is unpleasant at any age. While adults often need help to develop the tools to overcome it, children do even more so, as anxiety can impact their social and cognitive development. Helping children learn to cope with and overcome anxiety empowers them to be more independent, while also helping them gain confidence to take on their fears and other challenges.
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