What made you specialize in anxiety in children and teenagers
I love to obviously help children. I think something that makes me really excited about it is anxiety can be really treatable. And it’s so nice to see the difference in the child when I see them for a first session, versus when we kind of towards the end of the process. Or even if we don’t ever overcome the anxiety. The fact that anxiety can be so much more manageable in children. So yeah, that’s probably why I like to work with it. Childhood anxiety specifically because I only do work with children and adolescents in my practice. So I wouldn’t be the best person to give you a lot of anxiety tip for adults, but for children, adolescents, I’ve got that down.
In terms of the signs of anxiety, I think this is where it can be really tricky. I think anxiety especially in a child, and more so in a young child can be very unnoticed. It’s not like one of our behavioral disorders where a child is going to always be acting out or maybe the child throwing a tantrum or poking someone at school, often anxiety is very silent. In that respect, a lot of your teens will often speak up and say like, I can feel something. This isn’t right, but with our little children, this can go very unnoticed. I think another big reason for that is there’s a thing called normal anxiety. We’re supposed to have some level of anxiety in our lives.
Normal Anxiety vs Anxiety Disorder
We’re supposed to have certain fears, especially as we grow up as that’s what we would call normal fears for children. And when they have them in that age group. It’s not something unless it’s excessive, it’s not something we would really be concerned about.
So when I talk about normal anxiety, a classic example is if I’m standing at an edge of a cliff. And I’m feeling zero anxiety about being there, I could potentially maybe make a mistake or joke around to the friend I’m going to fall off and I’m going to die. So the reason I have that anxiety there is so that I keep myself alive. Our bodies are ultimately designed to protect themselves at the end of the day. Another reason why it can be really normal is it motivates us to get things done.
As a childhood example, if I have a test coming up. Having a little bit of anxiety is totally fine, because that’s going to motivate me to study harder. Or if I don’t know my work, I might go ask a friend or a teacher. The problem is when that goes from a normal level of anxiety to a more abnormal level. Where we could potentially be looking at like an anxiety disorder would be, if it’s something that starts becoming very excessive.
I’m going to go back to my child studying for a test example if now I sit down and study for my test. But am worrying about the test so much that now I can’t study. Or have a feeling the whole time I’m going to be a failure. I’m definitely going to fail and have lots of very negative thoughts. To the point that I probably don’t even study for the test. Or I don’t sleep well, I will then get in write the test and I’ll probably do really badly because I haven’t studied. That then just makes anxiety stronger, because now I’ve confirmed I can’t do it.
What signs would a parent look out for regarding anxiety in children and teenagers
So children and adolescents, even adults, we get stuck in these anxiety cycles. But looking at the parents asking What Sign Am I going to see in my child. There are a whole lot that they could see. And you got to remember when I list some of them now that just because a child does this one thing doesn’t mean the child has anxiety. There could be other reasons, obviously, to explain this.
Something we see a lot in young children is that my tummy sore, and you’ll see it, especially if it’s coming up to an event. So I know schools just started for many kids. And I’ve actually had a few moms phoned me and say, for the last three, four days, this sore tummy has come back. Or the child’s been vomiting for no reason, for example. And that is a classic sign, especially in your younger kids, they don’t really understand what the anxiety feeling is. And they definitely don’t know how to articulate it. So it’s very, very common. But it doesn’t mean if your child has a sore tummy, they definitely anxious.
Sepertation Anxiety
And something that you would also see very commonly in young kids is lots of clinginess. So separation anxiety is probably the biggest thing I see seeing kids. Want to be with the caregiver, or near them. You also see, feeling just generally overwhelmed, a bit sad. Some parents will report that their child’s been a little bit tearier, for example. But then we can also see it in terms of bad behaviour if you want to call it that. So a child is being quite difficult, quite oppositional, and always wanting to know what’s going on. Mom’s answer is not good enough, I need to know exactly, or, they push back.
Avoidance and concerntration difficulties
Another big one would be avoidance, I don’t want to do it, I don’t want to go to school, I can’t do school, it’s scary for them. Then we’ll see obviously, things like sleep issues, not being able to sleep. Or things like not eating, whether it’s eating more, or eating less. I always say a change in the eating pattern is something that I should look at.
Other things like difficulty concentrating, especially with both age groups, a lot of my teens will be like, I just can’t focus at school. And I don’t know why I don’t have something like ADD or ADHD just can’t concentrate. And other signs would be kids that are very eager to please, can often be quite anxious children. Obviously shy children can also be anxious doesn’t mean every shy child is anxious. There are a lot of shy children that are actually very confident kids.
Anxiety in teenagers
And in a lot of situations, looking more now as our teen, they will often withdraw. So your teenagers sitting in the bedroom all day never wanting to come out. However, that is also a normal thing for teens to do sometimes. So I wouldn’t necessarily panic about that all the time.
But a big one would be I’m not doing extra-murals anymore. Or I don’t want to go to that party or not wanting to go to school, so withdrawing from things that they would normally enjoy doing. Looking a lot for things like reassurance. So kids who say they’re worried about safety, for example, “Mom, have you locked the door”. “Mom are you sure you locked the door” or they go check the door. Those kinds of things that we see, that’s definitely your major anxiety, also looking at things like just general fears. So again, excessive fears. So like, for routine things like getting in the car. Now they are scared they might die. That’s not a normal fear that a teen should normally have those kinds of things would all definitely be warning signs to me.
When would you recommend that a child or teenager is brought in for therapy for their anxiety.
I think it really depends on your child and is this a problem that they’ve had before. So if they have been prone to anxiety before. But this is a new one coming up, then I would probably say, the sooner the better. Because it’s a long-lasting issue.
However, if it’s a new anxiety, and your child’s never really been like an anxious child. But there’s a big event coming up. So maybe it’s your first time ever going overseas, your child has never been on an aeroplane before. And they’re feeling a bit anxious about that. I wouldn’t be too concerned, I wouldn’t rush straight to a psychologist. There are still things that you can do to help them manage and assist.
Does anxiety in children and teenagers have a certain age group where it manifests.
I would say, it can really appear at any age, like if you say, what’s the onset, I wouldn’t give you an exact age. There are also some times that we see if more often. One of those times would be, say around 5 to 7-year-olds. And the reason for that is the child is at school-going age. Some children do go to school a little bit younger but say you’re going to school for like the first time. It’s really the first time I’ve got to separate from mom and dad for such a long time. And at that age, obviously, we do see heightened separation anxiety.
But it’s also the first time I ever have to kind of perform outside of my family. So an example would be, often kids will do things at home. And parents always say it’s great. And even sometimes it isn’t great, that’s what we do as parents. Now what happens is I go to school, and the kid looks at me and goes, What’s that drawing of that’s terrible. Or your teacher doesn’t give you a good mark on a test, for example, or you’re not the fastest swimmer. So it’s the first time you’re getting this communication that actually maybe you aren’t good enough in certain aspects. Even though mom and dad have always told you, you are. And that can bring on a lot of anxiety for a child. So we see them quite a bit.
And then also in like our adolescent phase, and that is obviously just because in adolescence, there’s a lot going on, our bodies are changing, there’s a lot of peer pressure, trying to fit in where I am, so it can come up quite a lot in that age group as well.
How do you treat anxiety in children and teenagers.
Firstly we would have to get the kid in would get a whole lot of information from parents first. How I work in my practice is I always meet the parent’s first. We discuss the whole background history, just so by the time I’m working with your child, I already have a good idea of what I want to do with them. I know their whole backstory, and I think about play therapy, if they little or talk therapy, if it’s an adolescent.
Cognitive
It can really really ease anxiety we were used like our cognitive behavioral therapy quite a lot. Also, especially with my littlies, I do a lot of externalization but it’s almost like anxiety is separate from us. In this room, we talk a lot about Mr Worry. And Mr Worry, he told us the bad things he told us I’m not good enough or he tells me that I’m going to fail my test but I know that’s not true.
So I equip them in kind of in a fun way of you know. How do we push back at anxiety and how do we fight back and also prove anxiety wrong? I always tell my kids you know, Mr. Worry, he’s a big liar. And the best way we can beat him is by telling him the truth. What we really know what we can prove. And then obviously, I also have a whole bunch of tips that I will then help parents with to equip them with stuff that they can use at home, as well, just to help ease anxiety.
Does anxiety in children and teenagers go away after a while.
Definitely, I think, you know, a lot of the coping skills you teach for one area can filter out everywhere? I think going back to your question, can this go away? It’s a very difficult question to answer because every child is going to be so different.
You know, if you had to do just some basic research, it will some places say it’s very curable, some places it will tell you that it’s not curable. I think for me, it’s very normal anxiety when I speak about normal, you know, very normal in terms of this is the kind of fears or anxieties a child have at this age, maybe it’s slightly excessive. And we could look at that, you know, definitely going away, definitely something that can be cured. I’ve worked with kids before, where we’ve gone through like a kind of a patch. And because we’ve dealt with it quickly and early, and we’ve equipped them with tools, we haven’t seen it ever come back.
But then you do obviously have, childhood anxiety, which is diagnosable anxiety as well. And it is just something that the person is going to have with them for their entire life. It doesn’t mean it’s going to be this terrible anxiety all the time. It’s all about getting that anxiety to a very manageable level. And a lot of people in their lives or teens or kids, that anxiety is so manageable that they don’t even notice the habits if that makes sense.
Only if maybe there’s something traumatic or another trigger does come up, and I maybe need to go see Dave for a few sessions, or, you know, I need to go speak to mom and mom’s going to help me also looking at does it go into adulthood. Your anxious kids do often become anxious adults, it is something that does stay with us. But again, it can be so manageable, I don’t want to say that sometimes it can’t be cured. I don’t want this to be like a negative thing, it doesn’t mean that we’re doom and gloom, there’s so much we can do. And, so many people who live with anxiety every day, that you would never know, because of how well they are able to manage it, and how well they’re able to look after themselves.
What things would be a trigger for children and teenagers with anxiety
I think your most obvious ones would be any kind of trauma that a child goes through any time they’re under stress. Because obviously when we are under threat, we are supposed to have anxiety. But then obviously if I’m more prone to an anxiety disorder, it’s going to just continue and I’m not going to be able to stop thinking about it.
But a normal day to day stressor can really trigger anxiety as well. So something that might not be stressful for you might not be stressful for me, but it’s stressful for that person that can definitely trigger. So I think also where as adults we forget with kids is something that are really stressful for children but they not for us.
I know once I was trying to motivate for a medical aid that I needed sessions for a child because he had a really stressful hospital admission. Where he’d gone through a lot of stressful testing and he was exhibiting, all these kinds of stress response symptoms. And the medical aid response was “going to the hospital isn’t stressful”. I said “it is for a four-year-old not for me but it’s definitely for a four-year-old”.
So we do need to also think of that in their shoes going to school is stressful. Standing up and giving an oral if that’s not something I’m into that is very stressed provoking. And those kinds of things as small as they can be, can bring on anxiety. Something I have been seeing a lot lately, and I think it’s just a world we living in at the moment with COVID we living in a very anxious world.
You know, it’s there’s all this uncertainty with COVID, I do think we’re getting a lot better. I practice Durban as well. So we had those riots really badly. So that was also very anxiety triggering, and even a lot of my teens, can’t tell me why they’re feeling anxious or sad. There’s like a certain trigger. But I think it’s just this whole climate. We are living in this constant state of maybe like fear or uncertainty, and then something that I do every day, like go to school, and it’s never been a problem. But because I’m carrying all these extra things it is now.
Do you teach anxious children and teenagers stress management tools.
Definitely, and it will be different from case to case. But it’s definitely a case of some children are a lot more stressed out than others. And then when we’re looking at the long term treatment.
It’s not just giving tools for the immediate anxiety right now, it’s also looking long term. Your stress is not manageable, especially for a lot of the teens, the ones who push themselves in school. It’s like, you can’t keep up that way, because you’re going to keep ending up in the cycle. So it’s also looking at how do we manage that long term? How do we, do something for ourselves as well, self-care. A lot of your very anxious people feel especially your teens, they feel like they have to do everything. And it’s also telling them, you don’t have to, you need to take time for yourself, as well.
How do we expain what is happening in the world now to children or teenages with anxiety
I definitely think so. And I think just because the world is so weird right now, I think that’s the only way I can actually explain it. You know, I think we need to be very honest with children. And I think parenting has changed quite a lot over the years. When I was raised, for example, it was kids aren’t supposed to know certain things and it’s just slot in and go with it.
And if a child is prone to anxiety as an example again, that is going to make the anxiety so much worse. So sit down with them and be very honest. Let’s use the masks as an example. This is why we are wearing masks it’s to keep us safe. Because the government says so, obviously keeping it extremely age-appropriate. You never ever want to actually make your kids fearful of that.
But also I think being vulnerable with your children sometimes. Not obviously letting them take on your own emotions. But kind of being like, mom also does feel a little bit nervous sometimes. Or I also don’t like wearing a mask I also actually worry about COVID. Showing them that it’s normal to have these feelings, but then also modelling how you deal with it, I’m not allowing it to let me get so overwhelmed that I can’t do the things that I enjoy doing.
And even if it does, that’s okay. But try to not show that to your child, because in these moments, you don’t want to make, their anxieties bigger. For them you want to be the stable person, you want to be the rock for so that they can come and talk to you. So I think honestly, with kids, goes a long way. Because they figure it out anyway, they pick it up, they go to school, and their friends tell them. Why not rather hear from your parents in a very controlled safe environment to start?
Can devices help with anxiety in children and teenagers
Definitely, I think devices is a tricky one, I think devices can be so great, in somethings. And also there’s a whole negative sighs too. So using it as a coping tool, and my space to just kind of, sit by myself and go through some stuff, I don’t think that’s necessarily a bad thing. I’m definitely not a psychologist that is like ban all devices, I think they definitely have a place in our lives.
And if the child or the adolescent is sitting on their device, maybe they’re talking to friends, or they’re looking at very appropriate content. I mean, a lot of these platforms like Tik Tok, and your Instagram that have had a lot of motivational great stuff as well. So for you seen in that sense, I think it’s totally fine.
Obviously, not sitting on it all day, but you know, sitting on it for an appropriate amount of time. But I think as a parent, you also have to be very careful, because that can trip over very quickly, to getting you know, into a more negative space. I’ve also seen you know, when I speak to my teens, they will tell me stuff about depression or anxiety and I’m like, How do you know that? And they say, “No, I saw it on Tik Tok”, and I’m happy to be like, “you know, tick tock not reliable, that’s not true.” That’s not what actually happens. So it can also be there’s that whole sense to it.
Then there’s also the cyberbullying that can come out and it can also be quite anxiety-provoking. In the sense that, you know, thinking, of the stereotypical example of a teenage girl looking at all these perfect people on Instagram and Tiktok and feeling like. Well, I’m not comfortable in my body. Why? Why is everyone else beautiful? And I’m not?
I think it’s kind of a bit of both and I think that’s where parents need to fit in to monitor what purpose is the device serving for my child. And if it’s that healthy purpose that little bit of a like downtime appropriate escape thing, great, but if it’s serving that other kind of purpose where it’s, you know, self-defeating the kind of behavior. Then that’s when I would step in and say, Okay, we need to be changed something so yeah, I have a love-hate relationship with devices.
Can the home environment be a cause of anxiety in children and teenagers
I’m gonna say yes, it can. And I’m not going to say definitely yes, some kids are resilient, they can grow up and fight adverse environments, and you don’t see any anxieties coming out. But we do also see trends. But then also in saying that, you know, anxiety is quite hereditary, first of all. So your environment might be perfect, but if it’s kind of in your genes you’re really going to be predisposed to it.
And, some children, just due to their temperament, are more prone to anxiety. They could have the perfect home and life perfect parents. But obviously, also we can’t control things like school and the outside world. So we will still see it. But generally, if we’re looking at what kind of environment could maybe give us a worse outcome in terms of like a child having anxiety. Definitely your parents that are very, harsh or overly critical. So the “Why are you wearing that or why did you do that?” “Why didn’t you do as well as your friend?” a lot of that kind of talk to kids can really trigger anxiety.
A lot of the teens I work with, whether it’s real pressure from mom or dad, or they perceive mom and dad put that pressure on. Especially with teens they often perceive something that’s not there. It said major pressure to perform at school, that is a big one a lot of time next, that can definitely come from the home environment.
And then obviously, things like growing up with very anxious parents. That anxiety can also be put onto a child and I know parents who’ve got anxiety ever would choose to do that to their child. But it’s something that can happen as well. And then obviously, an environment if I’m living an environment, that’s very stressful, a very traumatic environment. And again, parents can’t always control for that, like, I can’t control if we’re going to be robbed. For example, those kinds of things will definitely also bring about it. So yeah, definitely doesn’t mean it always will, though.
What tips can you give a parent of an anxious child or teenager
So I’m going to use the plane example as I go through it, but you could apply to anything that’s new, something that the child has never done that they’re feeling anxious about. And I would say you know, prepping a child for any situation is amazing. We know what a plane is like because we went on one for the first time sometime when we were young. We also have to think of anxiety, anxiety, likes to be in control anxiety likes to know what’s going on.
So we can often ease a lot of anxiety by doing that in the appropriate way. As adults, sometimes we wonder why kids are worried about this. I always say to parents is because as adults we make the plan, I make the plan. I know what time I’m going on the aeroplane because I booked the ticket I know what I need. And we just expect kids to follow along with us and wonder why they worried about this.
So sitting a child down and saying okay this is the plan. This is what we’re going to do we’re going to pack our suitcases and we’re going to go in the car for quite a long trip to the airport. When we get there, the next step is, we will get our boarding passes, we’re going to go through the gates where we put all our bags through the machine. So really step by step, what can they expect to happen? And obviously, I know how tricky is because we can’t always control everything. But the best we can do is to explain what we expect to happen. But then also trying to make it fun and exciting.
So kids I know I prepped recently them for an overseas trip. I spoke to them a lot about how the overseas planes have the TVs and so you’re going to be watching movies. And did you know you can watch movies on those that aren’t even in the cinema at the moment just to get them really excited. If you’re going on a normal plane can be stuff like, prepping them that their ears might pop, but for that we bought you this really awesome sucker. But to try and make it as exciting. As well as telling them step by step, this is what you are going to expect.
And also if it’s a safety thing, I always tell kids, it’s okay to be worried about safety. If they are worried the plane going to crash or anything like that. I’ve always give them all the facts like statistically, a plane is not going to crash but always say that is mom and dad’s worry it’s their job. If something has to go wrong, if there was a car accident, it’s their job to jump out and make sure you’re okay. So that’s not a child’s worry. That’s mom and dad. And mom and dad are always going to have a plan.
Because I think also we often talk it on it’s never gonna happen. And it backfires. One of the psychologists I know she, told the child that they’ll never get robbed he was robbed the next day. So we got also you know, kind of control for that in like situations that can technically happen. But that’s yeah, it’s an adults worry. It’s not a child worry, mom and dad have it sorted.
Do you think medicication can help with anxiety in children and teenagers
So your medication can always be really great. You know, it doesn’t mean every child that got anxiety needs medication, definitely not. And working with children, definitely cautious when it comes to sending them for medication.
So obviously, as a psychologist, I can’t actually prescribe but I would then refer parents to a psychiatrist. And the times I would maybe suggest medication is when you know, it’s very severe. This child is not able to go to school, they feel like they drowning, and they’re not coping at all. And the reason for that is to take that edge off so they can get to a point of where it is going to be more manageable. You know, your, your general anxiety that kids come in with, and they struggle with now and again, I would never rush to medicate that that can be dealt with very effectively with, you know, Parent Training and parents doing tips of home and just therapy.
But in your most severe cases, it is proven that the best course of treatment is when we have therapy and we have the medication hand in hand. I think it just takes that edge off so that I can sit in a therapy session and I can understand the stuff. And I can work through it and I can apply these skills. Whereas if I’m just feeling so overwhelmed, I’m giving coping skills, and then we work into this but that feeling of, it’s never going to help. It’s never going to work. And so medication and therapy can align really nicely.
You know, my goal was kids as well is if we can wean off the medicine. That is always going to be our goal, obviously, again, the psychiatrist would be the one that would have to dictate that. But for me, it would be the absolute win. If it is just a short term medication where we can get it to a manageable limit. And then hopefully, use the therapy use the tools to keep it kind of at that manageable space. And hopefully not go on medication again though obviously, every child is so different.
But also about if your child responds really well to the medication, I’m totally aware that medications can also have, side effects. And for me, it’s all meeting in the middle, what is going to be the best fit for my specific child at the time. Where maybe we’re not going to get the perfect quality of life. Maybe we have a side effect that we don’t like so much. But am I getting to a better quality of life where my child is happier? That’s definitely a win for me.
To listen to the podcast please click here
Contact Details for Jayde Green
Mobile Number :: 081 385 4431
Email Address :: jayde@greenpsych.co.za