Ask the Experts: When is Anxiety a Bigger Issue?

How to address anxiety at home, and when it's necessary to consult a professional

Q: My son is 7 and has been having a hard time lately with anxiety. Mostly this rears up at night, when he can’t settle down to go to bed and says he’s afraid of being alone. He is very aware of fears — dangers, bad guys, being alone — at various points in his day. Is this a phase? How can we help him calm down?

anxious boy at nightA: Seven is a typical age for anxiety to show up. It is a good idea to explore with your child possible causes of the anxiety. Start with sleep time, because this is happening more at night. If the room is frightening, parents can make it feel safer with a nightlight, pre-bedtime room inspections and reassurances. Medical issues (restless legs, sleep apnea, bedwetting) can mean poor sleep that manifests as anxiousness. Ensure the bedtime routine is consistent; many 7-year-olds do better with a regular routine.

Nighttime anxiousness can also signify daytime stressors. It is important to assess whether your child feels safe in their home, neighborhood and school. Is your child being bullied? Are they struggling with a teacher or subject? Is the neighborhood safe? Is there familial discord? Does your child feel safe with every person he or she spends time with? Does your child watch violent movies or games?

To look for signs of something more concerning, explore how anxiousness is impacting your child’s life. Does he or she isolate themselves from people or activities that used to be fun? Does your child repeatedly do things like wash their hands? Is there a family history of mood or behavior problems? Is anything happening with their body, like weight or hair loss? How do they cope with big changes, sudden plan changes? [How do they] communicate worry? Whom does he or she see as good people to talk with? Parents are no. 1, but whom would do they talk to at school?

Even with no red flags, explore your child’s environment for consistency. Think about “descheduling” if there are too many activities. Create a regular, casual check-in time, say, during meals or drives to school. Some children blame themselves for things unrelated to their actions (a sibling’s illness). If this is the case, help alleviate unwarranted guilt.

Finally, have an “if then” plan. If anxiousness worsens or your child discloses something serious later, discuss this with your health care provider. This may lead to a referral for a child behavior specialist.

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