Mental Health > Managing Anxiety: Tips for Families—Mental Health Toolkit

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Managing Anxiety: Tips for Families—Mental Health Toolkit

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What is anxiety?

Anxiety is another word for feeling worried or scared. If your child is feeling anxious, they may not be able to tell you. Your child may feel bad or sick without knowing why, or you may notice they seem restless or tired.

These are some other common signs of anxiety in children.

  • Feeling as if their heart is racing

  • Sweating or blushing

  • Shaking or feeling sick to their stomach

  • Feeling very cold or hot

  • Trouble paying attention or sitting still

  • Touching the crotch area (for young boys)

It’s normal for children at any age to feel anxious sometimes, such as if they need to take a big test at school or talk in front of a group of people. But if your child’s anxiety gets in the way of normal activities, such as sleeping alone at night, playing outside, or going to school, they may need some extra support.

The good news is there are things you can do to help prevent your child from feeling anxious and help them handle worries when they happen.

How can I help my child at home?

These tips are helpful for all children, but they can be especially helpful for children with anxiety. Parenting is a busy job, so use your judgment about which tips make the most sense for your family.

Connect with your child

  • Set aside one-on-one time every day without TV or other media. Even just 10 minutes each day can make a big difference. Try gardening or taking care of houseplants, drawing, or going for a bike ride.

  • Praise your child and make them feel good about themselves. For example, “You did a great job on that homework assignment!” or “Thank you for helping me with the laundry. I’m so lucky to have your help.”

  • Find out what’s worrying your child, because stress can make them feel anxious. Things such as being bullied at school, divorce, or a death in the family can make a child feel anxious. Your child may need extra help to handle issues such as these.

Help your child learn to manage fears

When your child is calm, start a conversation about things they can do to manage fears and worries when they happen. For example, let them know that they can

  • Practice deep breathing and muscle relaxation.

  • Use positive self-talk (for example, “I can try this” instead of “I can’t do this”).

  • Think of a safe place, such as their bedroom or favorite place outdoors.

Also,

  • Gradually expose your child to feared objects or activities.

  • Praise and reward brave behavior: the goal is to cope, not avoid.

Build healthy habits

  • Get active! Encourage your child to be active for at least an hour every day. This activity can include playing outside, joining a sports team or an activity at the YMCA, biking or walking to school, or dancing at home to favorite music.

  • Eat healthy. Eat healthy meals every day, including fruits and vegetables, whole grains, and protein foods. Remember to eat breakfast!

  • Get plenty of sleep. School-aged children need 9 to 12 hours of sleep every night, and teens need 8 to 10 hours.

  • Limit screen time. Try for less than 2 hours a day of entertainment screen time. Avoid scary or violent TV shows, video games, and movies.

  • Set up family routines. Follow a regular schedule for playtime, mealtime, and bedtime. Knowing what to expect can help your child feel safe and secure.

How can I help my child at school?

Children may find it hard to focus on or even go to school when they’re feeling worried. If your child is having trouble in school, try these ways to help.

  • Gently but firmly tell your child why it’s important to go to school.

  • Talk with your child’s teachers and the guidance counselor about what to do if your child asks to go home from school early.

  • If you think family stress or pressure to do well in school is upsetting your child, let them know they are doing a good job and you’re proud of them.

  • Help your child set realistic goals for school. If they set goals that are too hard to meet, they may feel worse about themselves.

  • Remind your child that they can take steps to control their worries. For example, they can think about what to do ahead of time to handle a stressful situation.

  • Reward your child’s brave behaviors at school. Spending time doing fun activities with a parent is a very powerful reward.

Remember, you know your child best.

Whether it’s at school or the doctor’s office, you are your child’s biggest advocate. Don’t hesitate to speak up on behalf of your child.

When do I need to go back to the doctor?

If your child’s anxiety doesn’t go away or gets worse, get back in touch with the doctor. You and the doctor can make a plan to try new approaches or strategies with your child.

It’s especially important to talk with the doctor if

  • Your child starts to experience other behavior problems, such as shyness.

  • Something scary happens in your child’s life that may make their anxiety worse, such as an injury or death in the family.

  • You suspect your child’s anxiety is affecting another medical condition (for example, if your child’s asthma gets worse with anxiety).

The doctor can also help you decide whether visiting a specialist may help. For example, a type of therapy called cognitive behavioral therapy can be helpful for children with anxiety.

Make time to care for yourself too.

Parenting can be stressful. If you’re feeling overwhelmed, don’t be afraid to ask for support from family, close friends, social services, or your faith community. Children pick up on the stress and worries of adults, so getting support for yourself can help your child too.

To learn more about childhood anxiety and what you can do to help, visit these websites.

  • American Academy of Pediatrics HealthyChildren.org: www.HealthyChildren.org

  • American Academy of Child and Adolescent Psychiatry: www.aacap.org

  • American Psychological Association: www.apa.org

  • National Alliance on Mental Illness: www.nami.org

  • National Federation of Families for Children’s Mental Health: www.ffcmh.org

The information contained in this resource should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances. Original resource included as part of Addressing Mental Health Concerns in Pediatrics: A Practical Resource Toolkit for Clinicians, 2nd Edition.

Inclusion in this resource does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of the resources mentioned in this resource. Website addresses are as current as possible but may change at any time.

The American Academy of Pediatrics (AAP) does not review or endorse any modifications made to this resource and in no event shall the AAP be liable for any such changes.

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