Managing Childhood Anxiety For Dummies

Introduction 1 Part 1: Getting Started with Managing Childhood Anxiety 5 Chapter 1: Worrying About Your Child’s Worries 7 Defining Anxiety 8 Analyzing Anxiety 8 Seeing rising rates of anxiety 9 Finding the roots of anxiety 9 Looking for Anxiety in Children 9 Appreciating child development 9 Showing, not telling 10 Checking out various anxiety types 11 Getting the Diagnosis 11 Starting with your child’s doctor 11 Considering alternative diagnoses 11 Accepting your child’s anxiety 12 Exploring Treatment 12 Leaning into therapy 13 Fueling the anxious brain 13 Providing protection 13 Considering anxiety medications 14 Finding support at school 14 Prioritizing safety 14 Helping Your Child Where You Can 15 Beginning with you 15 Seeing it through 16 Chapter 2: Recognizing That Kids Aren’t Little Adults 17 Meeting the Boss: Your Child’s Brain 18 The vital hindbrain 19 The emotional inner brain 20 The thinking outer brain 20 Appreciating Plasticity 21 Looking at Chemical Communicators 22 Examining how neurotransmitters work 22 Meeting the messengers 23 Discovering How Emotions Grow 24 Exploring Social-Emotional Milestones 25 Toddlers (2–4 years) 27 Early childhood (5–7 years) 27 Middle childhood (8–11 years) 28 Recognizing Challenges in Pediatric Mental Health 29 Chapter 3: Knowing Your Family Isn’t Alone 31 Anxious Kids Are Everywhere 32 Exploring the Rise in Child Anxiety 32 Advancing science 33 Normalizing mental health 33 Increasing screen time 34 Acknowledging the pandemic effect 34 Amplifying background stressors 34 Increasing parental stress 35 Predicting Anxiety 35 Developing brains and anxiety symptoms 36 Sharing genetics and epigenetics 36 Appreciating child temperament 37 Looking at parenting style 38 Accepting Your Child’s Anxiety 38 Identifying anxiety early matters 39 Reframing your role 39 Chapter 4: Seeing What Anxiety Looks Like in Kids 41 Recognizing That Anxiety Is the Greatest Mimicker 42 Introducing two different case studies 42 Hunting for clues 43 Looking for a chameleon 44 Monitoring for misdirection 45 Understanding Anxiety’s Three Parts 46 Emotional 46 Behavioral 47 Physical 48 Noticing How Child Anxiety Differs from Adult Anxiety 49 Physiology 49 Temperament 50 Environment 51 Time span 51 Distinguishing Types of Child Anxiety Disorders 52 Specific phobias 53 Separation anxiety disorder 53 Selective mutism 54 Generalized anxiety disorder 55 Social anxiety disorder 55 Agoraphobia 56 Panic disorder 57 Identifying Childhood Anxiety Matters 57 Chapter 5: Understanding Normal Childhood Worries and Fears 59 Appreciating the Stress Response 60 Finding signs of stress in kids 60 Recognizing childhood stress 61 Knowing It’s Normal to Worry 62 Defining age-appropriate worries 63 Supporting kids who worry 64 Differentiating worry from anxiety 65 Looking at two real-world examples 66 Tackling Fears 67 Maturing from imaginary to reality-based fears 67 Helping a scared child 69 Distinguishing fears from phobias 69 Chapter 6: Watching Out for Medical Mimickers 71 Appreciating the Brain-Body Connection 72 Responding to Tummy Troubles 73 Exploring the causes of CAP 73 Introducing the ENS 74 Looking for clues 75 Warning signs to never ignore 77 Getting the scoop on poop 77 Helping tummy pain at home 78 Managing Sleepless Nights 80 Surveying slumbering symptoms 81 Getting better zzz’s 82 Dealing with Nagging Headaches 84 Warning signs to never ignore 84 Distinguishing headache types 85 Relieving headaches at home 86 Experiencing Urinary Issues 87 Peeing too much 88 Peeing too little 89 Handling Concerning Chest Pain 90 Reacting to stress 90 Warning signs to never ignore 91 Taking Care of Tics (Not Ticks) 92 Identifying tics 92 Managing tics 93 Watching Out for Thyroid Disorders 95 Part 2: Diagnosing Child Anxiety 97 Chapter 7: Visiting the Doctor 99 Finding a Great Pediatrician 100 Preparing for the Office Visit 101 Organizing and prioritizing 101 Engaging educators 103 Including all caregivers 104 Asking for a private conversation 104 Preparing your child 105 Understanding Confidentiality 106 Optimizing Your Appointment Day 107 Avoiding “Doctor Office Don’ts” 109 Chapter 8: Walking Through the Psychological Evaluation 111 Getting Ready for a Mental Health Assessment 112 Selecting a mental health clinician 112 Preparing for the visit 114 Explaining the visit to your child 114 Understanding What a Mental Health Visit Looks Like 115 Structured interview 116 Standardized rating scales 117 Cognitive and academic testing 118 Feedback and recommendations 119 Expecting Difficult Questions 119 Social determinants of health 120 Adverse childhood experiences 120 Positive childhood experiences 121 Exploring Alternatives to an Anxiety Diagnosis 122 Attention-deficit/hyperactivity disorder (ADHD) 122 Depression 122 Learning disabilities 123 Neurodiversity or autism spectrum disorder 123 Obsessive-compulsive disorder (OCD) 123 Oppositional defiant disorder (ODD) 124 Perfectionism 124 Sensory processing issues 124 Part 3: Treating Child Anxiety 125 Chapter 9: Exploring Child Therapy Options 127 Understanding the Importance of Therapy 128 Discovering How Child Therapy Works 128 Reframing Therapy Myths 130 “Therapy didn’t work for me, so it won’t work for my kid.” 130 “Won’t a pill work faster? Let’s do that.” 131 “Can’t I do this at home? I’ve been to therapy and know how it works.” 131 “They don’t want to go to therapy, so we need something else.” 132 “Therapy is making kids weaker.” 132 Finding a Therapist 133 Affording Therapy 134 Setting Expectations for Therapy 135 Seeing What a Therapy Session Looks Like 136 Mapping out the phases of therapy 136 Choosing online versus in-person 137 Telling Your Child about Therapy 138 Distinguishing Types of Anxiety Therapy for Kids 139 Cbt 139 Act 140 Dbt-c 140 SPACE training 140 Pcit 141 Play therapy 141 Emdr 141 Preparing Yourself for After the Session 142 Chapter 10: Anxiety Medications: What Parents Need to Know 143 Considering Anxiety Medications for Kids 144 Understanding how medications work 144 Knowing when medication is needed 145 Finding a prescriber 146 Appreciating Principles in Medicine Management 146 Building a partnership 147 Respecting individuality 147 Targeting symptoms 147 Recognizing that pills are not skills 148 Starting low and going slow 148 Sticking to one change at a time 148 Preparing for Your Child’s Medical Plan 149 Knowing your family history 149 Inquiring about insurance 149 Practicing how to swallow a pill 149 Defining your goals 150 Prioritizing Safety 150 Straight talk: Suicide and kids 150 Understanding the risk 151 Reducing access to means 151 Storing medications and other substances 152 Maintaining bedroom safety 153 Completing safety planning 153 Detailing Commonly Used Anxiety Medications 154 Selective serotonin reuptake inhibitors (SSRIs) 154 Serotonin-norepinephrine reuptake inhibitors (SNRIs) 158 Alpha-agonists 159 Antihistamines 160 Practicing Successful Medication Habits 161 Prioritizing safe storage 161 Normalizing a routine 162 Avoiding self-administration 162 Expecting frequent follow-up visits 163 Looking toward your goals 163 Addressing Common Questions and Concerns 163 “I don’t want to turn my kid into a zombie.” 164 “I don’t want medicine to change who they are.” 164 “Don’t kids become dependent on these medications?” 164 “These medications never worked for me Why will they work for my kid?” 165 “I’ve heard these medications aren’t FDA-approved for anxiety Is it safe to use something ‘off label’?” 165 “My kid is so young; will they need this forever?” 166 “What about long-term side effects?” 166 “What if the medications don’t work?” 166 “This dose is the same that their father is on Isn’t that too high?” 167 “What about lab work?” 167 Chapter 11: Evaluating Supplements and Nutraceuticals 169 Navigating the Supplement Landscape 170 Distinguishing pharmaceuticals from supplements and nutraceuticals 171 Using supplements with kids 172 Supplementing Smartly 173 Starting with supplements 173 Understanding risks 174 Making better choices 175 Surveying Anxiety Supplements 177 Omega-3 blends 177 Vitamin d 178 Magnesium 178 Iron 179 Zinc 180 Complex B vitamins 181 Probiotics 181 Amino acids 182 Lavender 182 Saffron 183 Ashwagandha 183 Cbd 183 Part 4: Parenting Your Anxious Child 185 Chapter 12: Analyzing Your Parenting Style and Anxiety’s Impact 187 Determining Your Parenting Style 188 Putting Your Parenting Style into Action 189 Linking Parenting Behaviors and Anxious Kids 190 Contributing to child anxiety 191 Protecting against anxiety 192 Reflecting on your parenting behaviors 193 Parenting with Anxiety 193 Anxiety intercepts your parenting effectiveness 194 Anxiety intensifies your child’s experience with anxiety 194 Anxiety makes your emotional interpretations inaccurate 194 Anxiety is contagious 195 Anxiety changes your parenting memories 195 Anxiety interferes with your relationships 195 Anxiety steals your parenting joy 195 Anxiety is worth treating 196 Avoiding Accommodation 196 Discovering your accommodation behaviors 197 Stopping accommodation 198 Chapter 13: Optimizing Your Home Environment 199 Understanding That Anxiety Management Starts at Home 200 Prioritizing Sleep 200 Appreciating the need for sleep 201 Knowing that sleep impacts the whole family 203 Noting sleep differences in anxious kids 204 Bedsharing with anxious kids 204 Committing to healthy bedtime habits 206 Moving for Mental Health 209 Embracing the outdoors 209 Energizing family movement 210 Fueling the Anxious Body and Brain 211 Connecting anxiety and food issues 212 Making small changes 213 Succeeding with Screen Time 214 Acknowledging interference 216 Constructing safer screen time at home 217 Prioritizing Play 219 Balancing types of play 219 Valuing play for anxious kids 220 Avoiding overscheduling 220 Leaning into Routines 221 Distinguishing routines from schedules 221 Building home routines 222 Chapter 14: Thriving in School and Sports for Anxious Kids 223 Expecting Back-to-School Anxiety 224 Experiencing Anxiety in School 225 Identifying school anxiety 226 Supporting anxious kids in the classroom 226 Refusing to Go to School 227 Understanding school refusal 228 Helping a child with school refusal 228 Looking at the Landscape of Today’s Youth Sports 229 Reaping the benefits of organized sports 229 Examining anxiety in organized sports 230 Supporting Your Young Athlete 231 Keeping the fun in sport 231 Encouraging physical literacy 232 Choosing variety as long as you can 232 Prioritizing recovery 232 Modeling emotional control 233 Handling the car ride home 233 Teaming Up Against Sports Anxiety 235 Looking for signs 235 Managing sports anxiety 235 Chapter 15: Implementing Behavior Management Strategies 237 Understanding How Behaviors Are Learned 238 Recognizing a Positive Parenting Household 239 Building relationship 240 Paying attention and empathizing 240 Prioritizing safety 241 Honoring developmental skills 241 Promoting social-emotional learning 241 Creating and enforcing boundaries 242 Avoiding punishments and preparing consequences 243 Using clear communication 244 Prioritizing space for self-care 244 Choosing Effective Strategies 245 Tailoring Strategies for Kids with Anxiety 246 Searching for context 246 Creating consistency 248 Clarifying “zero tolerance” 248 Calming first 249 Modeling imperfection 249 Avoiding avoidance 250 Catching your child being brave 250 Managing Challenging Behavior 251 Chapter 16: Calming Techniques and Why They Work 253 Calming the Brain and Body 254 Managing anxiety with self-regulation 254 Building self-regulation skills 255 Teaching Calming Techniques to Your Child 255 Timing matters 256 Learning together 256 Using co-regulation 256 Trusting the process 257 Exploring Calming Techniques 257 Breath control 257 Grounding 258 Cognitive engagement 260 Putting Calming Techniques into Action 261 Dealing with Panic Attacks in Kids 263 Dissecting what happens to the body during a panic attack 263 Identifying panic 264 Appreciating panic’s uniqueness 265 Supporting your child during a panic attack 266 Chapter 17: Focusing on Specific Concerns and Worries 269 Getting an Anxious Child to Sleep 270 The Yale Program 271 The bedtime pass 271 Camping out 272 Scheduling check-ins 273 Supplementing Sleep 274 Melatonin 274 Iron 275 Magnesium 275 L-theanine 276 Examining Anxiety in Toddlers 276 Understanding toddler fears 277 Remembering your role 277 Taming toddler anxiety 278 Watching out for concerning signs 279 Changing Bodies and Anxiety 279 Co-Parenting an Anxious Child 282 Focusing on your child 282 Informing and communicating 282 Handling drop-offs and pick-ups 283 Parenting in your own home 284 Part 5: the Part of Tens 285 Chapter 18: Ten Ways to Support Kids Who Fear Needles 287 Chapter 19: Ten Signs Your Child Needs Professional Help 295 Chapter 20: Ten Things to Say to Your Anxious Child 301 Appendix: Recommended Resources 307 Index 313