As a result of the abuse or neglect a child experiences, a variety of psychological manifestations—both emotional and behavioral—may arise. The onset of anxiety is one of the most common effects seen in these children and often goes hand in hand with depression. For this reason, in practice, we tend to refer to an anxiety-depressive syndrome. You can read more about the symptoms of depression here: Depression in Children and Adolescents.

According to the Diagnostic and Statistical Manual of Mental Disorders, anxiety disorders encompass “disorders that share excessive fear and anxiety, as well as associated behavioral disturbances. […] Anxiety disorders differ from one another in the types of objects or situations that induce fear, anxiety, or avoidant behavior, as well as in the associated thoughts.”

Signs that may indicate the presence of anxiety in children and adolescents:

• excessive fear of separation from close relatives;
• inability to speak at preschool, school, or in other social situations;
• excessive worry about the future;
• avoidance of certain objects, situations, or activities;
• restlessness, fatigue, difficulty concentrating, irritability, tension, sleep problems;
• strong reactions to certain objects or situations: crying, agitation, outbursts of anger;
• panic attacks: sudden intense fear, palpitations, sweating, trembling, difficulty breathing, dizziness or fainting, fear of dying, losing control, or going crazy;

How can you help during a panic attack?

Panic attacks can be terrifying for children and adolescents because of the intense sensations they cause and their spontaneous nature, with no obvious triggers. Often, children become afraid that they will have another panic attack and start avoiding places, people, or activities they believe might trigger a new episode. That’s why it’s very important for you, as a parent, to know how to support your child in getting through these difficult moments. A panic attack isn’t a real danger and lasts only a few minutes.

1.Learn to recognize the signs of a panic attack.

First and foremost, educate yourself about panic attacks—what they are and what their specific symptoms are—so that you know how to identify them and when to intervene.

2.Talk to your child about panic attacks.

When your child understands that a panic attack is a “false alarm”—a way the brain prepares us for a danger that doesn’t actually exist—they may feel safer and be able to manage it more easily.

3.Acknowledge your child’s emotions.

When children are having a panic attack, parents tend to tell them not to worry, that everything will be okay. Unfortunately, this doesn’t help children, since that’s exactly how they feel: worried and scared. What can help them, however, is having their emotions in that moment acknowledged and being reminded that the panic attack will end soon. Example: “I understand that you’re very scared. Panic attacks are scary, but they eventually pass. I’m here with you…”;

4.Apply appropriate coping strategies.
Help the child divert their attention from the sensations in their body and stay present in the “here and now.” You can do this through breathing exercises or grounding techniques. For example, you can ask the child to touch an object and describe its texture in detail, to count to 3 while inhaling and to 5 while exhaling, to name the objects they see around them, to count backward in increments of 7, starting from 100, to imagine a place where they would feel safe and describe what they see, hear, smell, etc. These strategies can help your child calm down. It’s important to practice them daily, because these techniques are like a muscle: the more you practice them, the more effective they’ll be!

Recommendations for Parents of Children or Teens with Anxiety

Help your child manage anxiety; don’t encourage avoidance

Many parents become overprotective of their anxious children because they don’t want them to suffer. As a result, they end up removing every obstacle or source of stress from their path. Unfortunately, this kind of behavior can make things worse in the long run instead of helping, and children become even more anxious, even if they feel better in the moment. What you can do instead is encourage your child to face their fears and tolerate a certain level of anxiety that will inevitably arise when they step outside their comfort zone. What your child learns from this is that they can cope with life’s challenges and manage their anxiety.

Set realistic expectations

Reassure your child that, no matter what happens, everything will be okay, they’ll be able to handle things, and their anxiety will lessen over time if they make the necessary effort. Don’t promise them that there won’t be times when they won’t achieve what they set out to do or that others won’t laugh at them, because those are unrealistic expectations.

Respect your child’s emotions without exaggerating them

Often, parents tell their children not to feel a certain way because there’s no reason to. This conveys to children that their emotions aren’t important, and they may feel misunderstood or even rejected. In such moments, children need to be listened to with empathy and understood. It’s important to listen to your child, help them understand why they’re feeling anxious, and make them feel confident that they’ll be able to overcome their fears. Example: “I know you’re scared, and that’s okay. I’m here, and I’ll help you get through this.”

Shorten the waiting period as much as possible

The hardest moment for an anxious child is the time right before the event. Try to make sure the child doesn’t have too much time to think before doing something they’re afraid of, because that will increase their anxiety through various negative thoughts or worst-case scenarios.

Create a plan together

It can be helpful to think through with your child what might happen if one of their fears were to come true. You can work together to find solutions to these scenarios, giving your child a plan they can put into action. This can help them feel more in control and reduce their anxiety.

Recognize Their Successes and Praise Them

Pay attention to the moments when your child manages their anxiety in a healthy way and highlight them. Praise what they’ve done, point out their strengths, and direct their attention to the benefits of their actions and the success they’ve achieved.

Set a healthy example for managing anxiety

Children often follow their parents’ example. If you manage your own anxiety in an unhealthy way, your child will learn to do the same. Provide them with healthy strategies for coping with stressful situations. Show them that you can tolerate unpleasant emotions and successfully navigate tense moments.

A psychiatric diagnosis can only be made by a psychiatrist. This article is intended solely as informational material for parents and adults who come into contact with minors suspected of having been exposed to abuse and who exhibit signs that may indicate specific symptoms of anxiety.

Bibliography:

American Psychiatric Association, DSM-5, Diagnostic and Statistical Manual of Mental Disorders, Revised Text, Callisto Publishing, 2024;

https://www.nami.org/about-mental-illness/mental-health-conditions/anxiety-disorders/

https://www.nspcc.org.uk/keeping-children-safe/childrens-mental-health/depression-anxiety-mental-health/

No need to panic! How to help your child during a panic attack

https://childmind.org/article/what-to-do-and-not-do-when-children-are-anxious/

Article written by Diana Munteanu, clinical psychologist & psychotherapist, Barnahus Center