Anxiety in Children

with child

By Dr. Angela Hunt, BSc ND

 When I started in naturopathic medicine I was so excited to work with kids. I assumed I would be treating lots of upset tummies and stubborn rashes. Don’t get me wrong, I do commonly treat gastrointestinal issues and eczema in little ones. Yet, there is another condition that I treat far more and it may surprise you. Anxiety is by far one of the most common ailments I see in children walking through my door. I never would have guessed that stress and anxiety are so rampant in our children, but research confirms my experience and shows that anxiety is on the rise.

Several studies show consistently that there has been a dramatic increase in anxiety and depression among children and adolescents over the past three decades. It should not be shocking that with this increase we have also seen a marked increase in the prescribing of anti-anxiety medications among pediatric populations. Children as young as two years old have been reported to be on Prozac (a common anti-anxiety medication). This is clearly alarming, and I’d like to go over what anxiety looks like in children, why it is on the rise, and some naturopathic alternatives to pharmaceuticals. 

What does anxiety look like in children?

Anxiety appears in children differently than in adults. An anxious child will have more physical complaints (e.g. sore stomach, headaches, etc.), and will often have trouble describing how they are feeling.  Many times parents arrive at my office with their children because of a “pain”, a headache or a stomach ache. After lengthy discussions we uncover that the root cause of this pain is from feelings of anxiety and worry.  It is during these times of high anxiety that the child will start feeling the physical pain.  We also see that children suffering from anxiety typically have fewer friends and poorer self-esteem, which can make their childhood feel isolating.

Fears are a common part of growing up. Sometimes these fears can be quite debilitating for a child who has a tendency to obsess about these scary ideas. I have found that children suffering from anxiety often have big imaginations, so they can imagine all the possible “what-if” scenarios which then cause them to worry. These anxiety filled children are also some of the most creative children that I meet but the issues arise when they start “creating” terrifying stories of things that could happen to them or their families.

Most of us feel some anxiety when faced with a new experience, especially when we are uncertain about what to expect.  In these circumstances anxiety is perfectly normal and to be expected. Children face new experiences all the time, which puts them at an increased risk for anxious episodes. What is important to figure out is if the anxiety is a normal part of childhood or if it is starting to influence the quality of life of your child.

 

Why is childhood anxiety on the rise?

Before we dive into some natural treatments for kids, we should ask the question: Why are our children becoming more anxious? Jean Twenge at San Diego State University and her colleagues have conducted research that has shown a significant increase in anxiety in children over the past 30 years. Twenge suggests that this increase is due to “decreases in social connectedness and increases in perceived environmental dangers”.  Also it was noted that children seem to feel they have less control over their lives, which has been shown to be a risk factor for increased anxiety. There also seems to have been a change around what goals our children find important and are striving for. Internal goals, like being a kind person, being ethical and having a high moral code seemed to slowly being replaced with external goals such as having a high marks, beauty, and material goods.

This is a really interesting change that we are seeing, a shift from internal based goals to external. Although the “goals” research was mostly done in first year college students, I feel that this shift can be applied to what is happening with school-aged children as well. If one’s sense of confidence and self-worth is based on external things (e.g. money, status, appearance), this can result in future struggles with anxiety.  These external factors that the child’s perceived self-worth is hinging on aren’t totally in their control.  For example, getting a bad grade at school should not be shattering for someone’s self-confidence, but for this generation of children that is exactly what it is. When they feel like they don’t meet these external goals, the way they value themselves crumbles. Sounds pretty anxiety provoking, right?

There are a lot of other theories out there as to why we are seeing this increase in childhood anxiety. More screen time, social media, lack of time in nature, and poor diets I am sure all play a role.  I think that the shift to external goals for young children could be one of the most impactful. Helping our children reorient how they build their self-worth is essential and often requires that we as parents do the same.

 

A Naturopathic Approach

This leads us to how we can help our kids. Don’t get me wrong, for a certain subset of children with anxiety, medication is necessary and life changing.  Finding the right medication in certain cases can improve a child’s quality of life greatly.  I do, however, feel strongly that there are many non-pharmaceutical options that could be tried first.

Family based counseling: It is paramount that a child feeling anxiety has a space to discuss their fears and worries. More often than not parents also need to reflect on their own coping mechanisms for stress and how they deal with their own anxieties.  Finding a health provider who your child feels comfortable with is essential and I highly recommend that parents do some mental-emotional work of their own.

Elimination diet and food sensitivity: For some children certain food groups seem to make their anxiety worse. This gut-brain connection is individual and needs to be explored with an elimination diet or proper food sensitivity testing. Some of the top culprits are sugar, corn, gluten and dairy but every child is different.

Protein at breakfast: So many of our children’s meals are carbohydrate heavy and there is no better example of this than at breakfast. A simple thing that a parent could try right away is adding more protein to their children’s breakfast. Things like nuts, seeds, plain greek yogurt, eggs or a green smoothie with a protein powder are all great examples. The large blood sugar fluctuations from carbohydrate heavy meals are potent anxiety provokers.

Quality sleep: This is a double edged sword because lack of sleep can cause anxiety but anxiety can cause sleep issues. Sleep is one of the first things I address with anxious children because a healthy mind can’t function on a lack of sleep. Having a solid bedtime routine with limited screen time in the evenings is really important.

Herbal support: There are so many wonderful plants that help children feel less overwhelmed. The bonus with these botanical medicines is that there is no withdrawal effect and they can be taken as needed. Botanicals like lavender, chamomile and lemonbalm can be taken as a tea but are also available in liquid form if a stronger dose is needed. Consult with your naturopathic doctor before trying these as they can interact with other medications.

Although I do find trends of anxiety in our children worrisome, it comforts me that we have a lot of tools at our disposal to help them. The focus needs to be addressing the root cause of stress and worry and supplying children with all the supports they need to cope. Childhood is a unique opportunity to teach children the skills to deal with stress and anxiety with resiliency, so that anxiety is something manageable in their adult years. Giving them the skills now will make the future seem like a far less scary place.

 

References

Twenge, J., et al., (2010). Birth cohort increases in psychopathology among young Americans, 1938-2007: A cross-temporal meta-analysis of the MMPI. In press, Clinical Psychology Review 30, 145-154.

Busko M: Anxiety linked with increased cell-phone dependence, abuse, Medscape Medical News, March 10, 2008.

Egger HL, Costello EJ, Erkanli A, Angold A. Somatic complaints psychotherapy in children and adolescents: stomach aches, musculoskeletal pain and headaches. J Am Acad Child Adolesc Psychiatry. 1999; 38(7):852-860.

Marklund B et al: Health-related quality of life in food hypersensitive schoolchildren and their families: parents’ perceptions, Health Qual Life Outcomes 4:48, 2006.

Trompetter I, Krick B, Weiss G. Herbal triplet in the treatment of nervous agitation in children. Wien Med Wochcnschr. 2013;163(3-4):52-57.