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Anxiety in Children


Anxiety Disorders effect 1 in 8 children. (

That’s a lot of kids, right? That’s why I’ve created a video for parents, teachers, and other therapists to view so they can see some of the ways to manage the problems created by anxiety in children. Many parents seem to feel that they don’t have time to visit a therapist, so now they can see a therapist reviewing strategies and using them with children, and get a list of resources they can use themselves if they like. This is not a substitute for therapy, but a good way to get started and if the problems persist then they can seek more direct professional help. The video will be available with more related resources and information at

I will also begin posting information I hope will be helpful here on this blog, and I welcome your feedback and questions.

One of the best and most empirically supported methods of treating anxiety is cognitive behavioral therapy, so I will begin here. Remember, anxiety is a normal part of growing up and being human, so try not to worry too much about the worries!

Cognitive behavioral therapy is based on the premise that it is not what happens that creates our feelings, but how we think about what happens. So it’s our thoughts, not external events, that create the response we might label as anxiety. Here is a list of thinking errors, or cognitive distortions, that are common.


Cognitive Distortions

These are faulty or incorrect ways of thinking. By noticing and writing down your thoughts right before or during a time you are upset, you can begin to realize how often you bother yourself with your thoughts. Then you can either stop the thoughts, refuse to believe them, or replace them with thoughts that are more accurate, realistic, and helpful.


1. Overgeneralization- Nobody cares, everybody hates me, watch out for words like never, always, can’t everybody, nobody, have to, all.

2. Global labeling- All lawyers are greedy, I’m stupid, life is a rat-race, it’s hopeless.

3. Filtering- ignoring the good and focusing on the negative

4. Polarized thinking or extremism- it’s all black or it’s all white, if I make one mistake I’m no good, one strike and your out, if I don’t win this time then I’m a failure.

5. Self-blame- makes you think that every time things go wrong it must be your fault. Characterized by excessive apologizing.

6. Personalization- you think that others are blaming you for what they don’t like. When someone complains, you get defensive.

7. Mind reading- You think you know what others are thinking, it’s about you, and it’s bad.

8. Control fallacy- You think you are responsible for everything, you think you have to make others follow rules or do the right thing

9. Emotional reasoning- You think your feelings are facts and they characterize you and your life- just because you feel bad at the moment, your whole life is bad.

10. Heaven’s reward- you think you are supposed to be rewarded for living right, and maybe you think anybody who breaks the rules should be punished, that the universe is supposed to make life fair.


So the smart thing to do is to begin noticing your thoughts and to realize you are not your thoughts, you don’t have to believe them, you are the observer of your thoughts. You can identify thoughts that are in error, and replace them with thoughts that are more accurate, making yourself smarter and helping yourself feel more the way you want to more often.

Your mind is making thoughts all the time, some are automatic and take time to quell. Everybody has thoughts that are unwanted, inaccurate, or inappropriate every day. Just because you think it doesn’t mean you have to believe it or that your thoughts define who you are. It’s what you do that defines your character and personality.

Get a list of cognitive distortions, practice worksheets, short videos, and instructions in the free Mindgarden mini-course by clicking here.

Get started today with journaling your thoughts or helping that child you care about it make a record of thoughts that can be examined, questioned, and replaced with smarter thoughts.


“Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people. Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion — about 6 percent, or 1 in 17 — who suffer from a serious mental illness. In addition, mental disorders are the leading cause of disability in the U.S. and Canada for ages 15-44. Many people suffer from more than one mental disorder at a given time. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to comorbidity.” (

About 20 percent of U.S. youth during their lifetime are affected by some type of mental disorder to an extent that they have difficulty functioning, according to a new NIMH survey published in the October 2010 issue of the Journal of the American Academy of Child and Adolescent Psychiatry. The data support the observation from surveys of adults that mental disorders most commonly start in early life. About half of children suffering receive professional treatment.

I have noticed that quite a few children present at my clinic with anxiety and anger about the bullying and teasing problem in our schools. They often report being upset with peer behavior that is mean, then they dwell on the problems that occur for brief spans of time in the school day throughout the day, locking on to and magnifying the size of the problem. What follows is a description of clinical categories of anxiety disorders and a list of interventions and resources.

Obsessive-compulsive Disorder

Obsessions — unwanted intrusive thoughts

  • Constant, irrational worry about dirt, germs, or contamination.
  • Excessive concern with order, arrangement, or symmetry.
  • Fear that negative or aggressive thoughts or impulses will cause personal harm or harm to a loved one.
  • Preoccupation with losing or throwing away objects with little or no value.
  • Excessive concern about accidentally or purposefully injuring another person.
  • Feeling overly responsible for the safety of others.
  • Distasteful religious and sexual thoughts or images.
  • Doubting that is irrational or excessive.

Compulsions — ritualistic behaviors and routines to ease anxiety or distress

  • Cleaning — Repeatedly washing one’s hands, bathing, or cleaning household items, often for hours at a time.
  • Checking — Checking and re-checking several to hundreds of times a day that the doors are locked, the stove is turned off, the hairdryer is unplugged, etc.
  • Repeating — Inability to stop repeating a name, phrase, or simple activity (such as going through a doorway over and over).
  • Hoarding — Difficulty throwing away useless items such as old newspapers or magazines, bottle caps, or rubber bands.
  • Touching and arranging
  • Mental rituals — Endless reviewing of conversations, counting; repetitively calling up “good” thoughts to neutralize “bad” thoughts or obsessions; or excessive praying and using special words or phrases to neutralize obsessions.


Generalized Anxiety Disorder

People with generalized anxiety disorder (GAD) experience constant, chronic, and unsubstantiated worry, often about health, family, money, or work. This worrying goes on every day, possibly all day. It disrupts social activities and interferes with work, school, or family.

Physical symptoms of GAD include the following:

  • muscle tension
  • fatigue
  • restlessness
  • difficulty sleeping
  • irritability
  • edginess
  • gastrointestinal discomfort or diarrhea


Panic Attacks

A panic attack is defined as the abrupt onset of intense fear that reaches a peak within a few minutes and includes at least four of the following symptoms:

  • a feeling of imminent danger or doom
  • the need to escape
  • heart palpitations
  • sweating
  • trembling
  • shortness of breath or a smothering feeling
  • a feeling of choking
  • chest pain or discomfort
  • nausea or abdominal discomfort
  • dizziness or lightheadedness
  • a sense of things being unreal, depersonalization
  • a fear of losing control or “going crazy”
  • a fear of dying
  • tingling sensation
  • chills or heat flush

Since many of the symptoms of panic disorder mimic those of illnesses such as heart disease, thyroid problems, and breathing disorders, people with panic disorder often make many visits to emergency rooms or doctors’ offices, convinced they have a life-threatening illness. It often takes months or years and a great deal of frustration before receiving the correct diagnosis.

Many people suffering from panic attacks don’t know they have a real and treatable disorder


Posttraumatic Stress Disorder

Posttraumatic stress disorder is characterized by three main types of symptoms:

  • Re-experiencing the trauma through intrusive distressing recollections of the event, flashbacks, and nightmares.
  • Emotional numbness and avoidance of places, people, and activities that are reminders of the trauma.
  • Increased arousal such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated and angered.

PTSD is diagnosed after a person experiences symptoms for at least one month following a traumatic event. However symptoms may not appear until several months or even years


Social Anxiety

It’s the extreme fear of being scrutinized and judged by others in social or performance situations: Social anxiety disorder can wreak havoc on the lives of those who suffer from it.

Symptoms may be so extreme that they disrupt daily life. People with this disorder, also called social phobia, may have few or no social or romantic relationships, making them feel powerless, alone, or even ashamed.

  • About 15 million American adults have social anxiety disorder
  • Typical age of onset: 13 years old
  • 36 percent of people with social anxiety disorder report symptoms for 10 or more years before seeking help

Although they recognize that the fear is excessive and unreasonable, people with social anxiety disorder feel powerless against their anxiety. They are terrified they will humiliate or embarrass themselves.

The anxiety can interfere significantly with daily routines, occupational performance, or social life, making it difficult to complete school, interview and get a job, and have friendships and romantic relationships.

Social anxiety disorder usually begins in childhood or adolescence, and children are prone to clinging behavior, tantrums, and even mutism.

Specific Phobias

While some phobias develop in childhood, most seem to arise unexpectedly, usually during adolescence or early adulthood. Their onset is usually sudden, and they may occur in situations that previously did not cause any discomfort or anxiety.

Specific phobias commonly focus on animals, insects, heights, thunder, driving, public transportation, flying, dental or medical procedures, and elevators.

Although people with phobias realize that their fear is irrational, even thinking about it can often cause extreme anxiety.

What to do?

Seek professional help.

Cognitive Behavioral Therapy- Teach Self-talk

Exposure and Response Prevention

Systematic desensitization

Relaxation Training

1-5 Scales

Big Problem/Little Problem

Solution Focus- notice when the problem is not occurring


Routines, activity schedules

Model a calm example

Get outside


Avoid overscheduling

Vacation station, scheduled breaks

Limit exposure to upsetting media

Do not minimize their feelings

Good nutrition

Regular sleep hours



Happy Face, Sad Face

Don’t Pop Your Cork on Mondays

No More Mr. Worry

The Incredible 1-5 Scale

Exploring Feelings, also CAT-KIT by Tony Attwood




The loss of play and impact of increasingly demanding education:

By depriving children of opportunities to play on their own, away from direct adult supervision and control, we are depriving them of opportunities to learn how to take control of their own lives. We may think we are protecting them, but in fact we are diminishing their joy, diminishing their sense of self-control, preventing them from discovering and exploring the endeavors they would most love, and increasing the chance that they will suffer from anxiety, depression, and various other mental disorders.

How Coercive Schooling Deprives Young People of Personal Control, Directs Them Toward Extrinsic Goals, and Promotes Anxiety and Depression

During the same half-century or more that free play has declined, school and school-like activities (such as lessons out of school and adult-directed sports) have risen continuously in their prominence. Children today spend more hours per day, days per year, and years of their life in school than ever before. More weight is given to tests and grades than ever before. Outside of school children spend more time than ever before in settings where they are directed, protected, catered to, ranked, judged, and rewarded by adults. In all of these settings adults are in control, not children.

In school, children learn quickly that their own choices of activities and their own judgments of competence don’t count; what matters are the teachers’ choices and judgments. Teachers are not entirely predictable. You may study hard and still get a poor grade, because you didn’t figure out just exactly what the teacher wanted you to study or guess correctly what questions he or she would ask. The goal in class, in the minds of the great majority of students, is not competence but good grades.

Given a choice between really learning a subject and getting an A, the great majority of students would, without hesitation, pick the latter. That is true at every stage in the educational process, at least up to the level of graduate school. That’s not the fault of students; that’s our fault. We’ve set it up that way. Our system of constant testing and evaluation in school–which becomes increasingly intense with every passing year–is a system that very clearly substitutes extrinsic rewards and goals for intrinsic ones. It is a system that is almost designed to produce anxiety and depression.[6]

School is also a place where children have little choice about with whom they can associate. They are herded into spaces filled with other children that they did not choose, and they must spend a good portion of each school day in those spaces. In free play, children who feel harassed or bullied can leave the situation and find another group that is more compatible; but in school they cannot. Whether the bullies are other students or teachers (which is all too common), the child usually has no choice but to face those persons day after day. The results are sometimes disastrous.

A few years ago, Mihaly Csikszentmihalyi and Jeremy Hunter conducted a study of happiness and unhappiness in public school students, in 6th through 12th grades.[7] Each of the 828 participants, from 33 different schools in 12 different communities across the country, wore a special wristwatch for a week, which was programmed to provide a signal at random times between 7:30 am and 10:30 pm. Whenever the signal went off participants filled out a questionnaire indicating where they were, what they were doing, and how happy or unhappy they were at the moment. The lowest levels of happiness by far (surprise, surprise) occurred when children were at school, and the highest levels occurred when they were out of school and conversing or playing with friends. Time spent with parents fell in the middle of the happiness-unhappiness range. Average happiness increased on weekends, but then plummeted from late Sunday afternoon through the evening, in anticipation of the coming school week.

As a society we have come to the conclusion that children must spend increasing amounts of their time in the very setting where they least want to be. The cost of that belief, as measured by the happiness and mental health of our children, is enormous. It is time to re-think education.

What cultural changes might contribute to the rise in anxiety?


Less play

Less outdoors

Less exercise


Smaller families/ more divorce/more women in the workforce


Agrarian to industrial to tech/service


Inferiority Complex


Here’s another way to look at what is going on when we see anxiety. Alfred Adler, a famous early psychologist, proposes that all human behavior centers on a common goal: to avoid feeling inferior. All human beings are born helpless. No teeth, no hair, can’t move, helpless. So it’s inescapable then, that we come into the world as inferior beings, relative to the game of survival. Humans are vulnerable creatures as adults, we have great difficulty surviving in nature on our own. We need language, foresight, and a community to survive. Physically we are inferior!

As some children develop with an inferiority complex, they can go either of two routes. They can become controlling and dominating, living to win every battle, out of fear of losing and appearing inferior. They want to appear superior and powerful. Others may go the other way. Withdrawing and avoiding becomes the name of the game. That way, if you don’t try, nobody can see you fail.



Another way is to practice deep abdominal breathing. This consists of breathing in deeply and slowly through your nose, taking the air right down to you abdomen. Say the word “calm” to yourself as you breathe in. Then breathe out slowly and gently.


Anxiety affirmations

List of Affirmations to Calm Fears

  • I trust that life supports me. I am safe.


  • I am safe. I trust the process of life to bring only good to me.


  • I am always safe and protected.


  • I trust the universe to provide all that I need.


  • I release all fears. I am safe.


  • I trust the process of life to take me to my higher good. I am safe. All is well.


  • I am ably supported by the universe.


  • Life will always provide for me. It is safe here. All is well.


  • No person has any power over me. I am free.


List of Affirmations for Anxiety

  • All is well in my world.


  • I am always safe and guided by my higher self.


  • I lovingly allow change into my life and trust in my higher good.


  • I am lovingly supported by the power that created me.


  • I invite peace and harmony to dwell in me and surround me at all times.


  • I trust my inner voice. I am at peace.


List of Affirmations to Promote Peace and Relaxation

  • Divine peace and harmony surround me and dwell within me.


  • I am relaxed and peaceful because I trust the process of life. All is well in my world.


  • I release, I relax and let go. All is well in my world.


  • I am becoming calmer with every deep breath that I take


  • I am calm and relaxed.


  • I am at peace. I am calm. All is well.


  • I relax completely for I now know I am safe. I trust life and I trust myself. I am cool, calm and collected.


  • Every breath I inhale calms me and every breath I exhale takes away tension.


Every cell in my body is relaxed and oozes calmness.


  • I love myself deeply and unconditionally.


  • As the wonderful, soothing energy of the Universe enters my body, I accept myself completely and deeply, without any reservations.


  • I am confident about solving life’s problems successfully.


  • I am social and I like meeting people.


  • All is well in my world and I am safe.


  • With every breath, I release the anxiety within me and I become more and more calm.


  • The future is good. I look towards it with hope and happiness.


  • Life is wonderful. I trust in God/Universe to live a well fulfilled life.


  • I overcome my fear of anything and everything and live life courageously.


  • I acknowledge that the only constant in life is change and am prepared for it.


  • I am free of anxiety and continue to do so.

Get a list of cognitive distortions, practice worksheets, short videos, and instructions in the free Mindgarden mini-course by clicking here.

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