Articles of Interest

Developmental Phases of Anxiety for Families

By Charlotte Batcha, LCSW, Licensed Clinical Social Worker

Starting a family involves making decisions with long term consequences for the baby and parents. Trying to become pregnant or coping with an unplanned pregnancy is not always an easy accomplishment, not to mention carrying a baby full-term. Labor and delivery are stressful for the mother. If the baby’s vagus nerve is compressed during labor, the digestion and nervous system can be compromised, resulting in stress on the baby. Often, the baby is introduced to breast feeding, which is not always as natural as one would like to believe for the newborn and mother.

There is a genetic predisposition to the development of anxiety symptoms in children. At times, parents enter therapy since they don’t want to pass on their anxiety issues to their children. When younger children attend therapy, the parents are included in the sessions which help to decrease the anxiety level for the child and parents. The parents function as the coach at home since both are taught the skills.

At 8 months to 2 ½ years, separation anxiety is a normal occurrence. Children fear abandonment since the concept of time is not understood. Some indications of anxiety are when the child is not sleeping in his/her own bed and fears the dark. Other stressors can be a new sibling and change in child care.

Separation anxiety also poses a problem when children enter school; children might sob and cling to their parents. It can be difficult for the child to participate in class. Middle school can be a challenge for children who struggle with age appropriate independence: adjusting to different teachers and changing classrooms. Anxious children frequently have upset stomachs, headaches, and feelings of panic which result in visits to the nurse. It is always important to make sure that medical origins such as allergies, sleep disorders, and poor diet are not factors causing or contributing to the anxiety symptoms.

Anxious children are prone to somaticize more due to peer, academic, and family stressors. Also, social anxiety is displayed by an avoidance of social situations to the point that personal development is hindered. Social anxiety usually does not improve without professional help. Environmental factors need to be examined at the home, school, and neighborhood. It is often difficult for children to report that they are being bullied or abused due to threats from the aggressor.

Entering high school and preparing for the future can be a challenge on students who are trying to figure out what they want to be when they grow up. I have often felt a support group for parents would also be helpful. Unfortunately, students have to contend with peer pressures, which have heightened with cyber bullying.

Disruption in schedules with summer vacations can be stressful. Long car trips, change in diets, and sleeping away from home can trigger panic-like symptoms in children who do not like changes. An anxious child can make it difficult for a family to take a vacation. Another common disruption is a parent’s return to work or change in work schedule that impacts time spent with the child.

Children are sensitive to their parents’ financial and relationship problems along with their status with their siblings. It is not uncommon for children to be worried about their parents’ divorce, their family’s ability to remain in their home, or how to further their education. Death of a grandparent, medical illness of a parent and news of violence are not unusual concerns. Today, children worry about school violence, world peace and health of the planet.

Another type of anxiety disorder is phobia, which could be the fear of public speaking, flying, snakes, or heights. When someone has been bitten by a dog, that person may develop a phobia of dogs. To address this fear, the person may begin with visualizing a dog and then progress from incremental exposure to full exposure to a dog.

Family physicians often see patients who suffer from anxiety since the symptoms are felt in the body as heart palpitations, shortness of breath, dizziness, and heaviness on the chest. Emergency departments may refer to therapy individuals who fear they are having heart problems but are medically-cleared. Most likely, these physical symptoms indicate a panic attack. Other adults who enter therapy are often experiencing focusing problems, sleep disturbance, or excessive worrying about multiple stressors.

Stressed adult clients will often say to the therapist, “If you had everything on my plate, you would be feeling the same way.” My response is that “I correct my distorted thinking with coping statements and have tools to reduce my anxiety.” With reduction of anxiety, the distorted thinking is minimized. Therapists have tools to teach clients how to manage their anxiety, learn to relax, and improve their problem-solving skills. Some approaches used are Cognitive-Behavioral Therapy, Mindfulness, and Trauma Informed Therapy with an emphasis on developing resilience.

Everyone experiences stress, but when there are symptoms of sleep disturbance, feeling overwhelmed, or difficulty completing tasks, it may be time to seek professional help. Fears of failure and vulnerability can be barriers for receiving therapy. It is common for people to tell the therapist, “I know I should have come in a long time ago, but I thought it would get better.” It is strength to know when you need help.