Simple Strategies for Big Worries
Supporting Students with Anxiety
by Tiffany Creager
Last December I wrote about prioritizing our adult mental wellness during times of stress and uncertainty. I was hopeful at the time that this year would feel better! Somehow, however, the stress lingers at the same, if not heightened levels.
Another year of collective and personal loss, another year of quick changes, and increasingly stressed brain states of many of the adults and children we serve have left us all exhausted. While I still believe deeply and strongly that your wellness must remain a top priority, today I want to talk about the kids. They, too, have been on this wild ride of unpredictability, change, and loss.
Emotions are contagious and while our stress levels undoubtedly impact our students, the opposite may be true as well. California surgeon general, Dr. Nadine Burke Harris, recently spoke about the number of children with anxiety and depression doubling globally prompting the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry to declare a state of emergency for our children and youth mental health.
So, what can we do? How can we support the mental wellness of these children who are struggling? Specifically, let’s talk about how to address anxiety.
Anxiety disorders are the most common mental health challenge in children with 7.1% of children, approximately 4.4 million children, having been diagnosed with an anxiety disorder. Of those children, more than one in three also have behavior problems and about one in three also have depression.
Furthermore, it is estimated that only 59% receive treatment. Inevitably we have these children in our schools and classrooms and may see signs or symptoms of anxiety emerge in a number of ways. It is increasingly difficult to connect with and teach students who are struggling with anxiety whether they are internalizing it with avoidance and detachment or externalizing it with behaviors that interrupt their and their peers’ learning.
Signs or Symptoms
Below we will look at the signs and symptoms and discuss how to help, using relatively simple strategies proven to lessen anxiety! It may seem like an overwhelming problem to tackle, especially in the schools, but, there are small changes we can make that will have a big and lasting impact. Want to view my video on supporting children with anxiety? Click here.
According to the National Institute of Mental Health, many children diagnosed with anxiety disorders between the ages of 13 and 18 began showing symptoms around the age of six. This encompasses students all throughout our school system from kindergarten to high school. So, what does it look like? Anxiety can present in many different ways. Here are some common signs or symptoms:
- Decreased attention span or ability to concentrate
- Excessive worry
- Avoidance of difficult tasks
- Perfectionist traits
- Irritability or anger
- Somatic symptoms (I’ve seen so many stomach aches lead back to anxiety)
- Increased rate of speech
- School refusal
As you can see, there are quite a few ways in which anxiety might present in our students. It might be easy to mistake the signs of anxiety for things such as laziness, defiance, or even attention deficit hyperactivity disorder. Rather than trying to name or diagnose a child, it is helpful to simply notice changes in behaviors.
When we recognize a change in behavior or any of the above symptoms interfering with a child’s daily life, we can intervene in meaningful ways to promote regulation and management of stress. Their anxiety is likely affecting their school performance and their relationships. They don’t want that any more than you do!
3 R’s – regulate, relate, reason
If you are met with a child who is dysregulated and struggling to connect or engage, it is important to turn to the 3 Rs introduced to us by Dr. Bruce Perry.
When a child is dysregulated due to fear or anxiety, they are operating from the lower part of their brain. They may be more reactive and emotional and less able to listen to and comprehend adult logic or reason.
When we respond with this in mind, we address the brain from the bottom up, starting with regulation. Here, you may use very few words if any at all. Get on the child’s level, keep yourself regulated by practicing deep breaths. The goal here is to remind the child they are safe and cared for. If you’ve done some pre-teaching or practiced regulating techniques as part of your coursework, you may be able to use visual prompts to help the child engage in self-regulation.
As you breathe deeply, they may mirror those breaths or you might gently encourage grounding activities such as the 5,4,3,2,1. This is where we see all of that great applied educational neuroscience you have been teaching in action!
Next, relate or connect to the child. Validate their feelings with statements like, “I see you’re upset right now. This is tough.” Focus on connection. Finally, reason. This is where a conversation may take place about how things can be done differently next time. Remind the student of your support and also your expectations during this time. For some students, the debriefing has to come hours later.
Talk about it
This is where we can begin the work that is both preventative and intervention. I’ve seen great strides in breaking the stigma of mental illness in recent years. Much of this stems from simple conversations! We understand now that just as we all have physical health, we all have mental health and both need attention and both may move from well to unwell and back again at different points in our lives.
I was a very anxious kid and I had no idea other people were also sometimes consumed by their worries. I thought I was broken and kept my worries quiet until they externalized in sometimes aggressive behaviors at home. Hearing from a counselor that she had big worries too AND could give me tools to manage them was life-changing.
Talking about anxiety empowers our students to understand what’s happening and teaches them that they possess the tools that can bring them peace or comfort. When we talk about what happens in the mind and the body in moments of anxiety, we are giving language to a collection of sensations that may not have made sense before or perhaps weren’t even noticed! We can’t tame what we can’t name.
The first step in building awareness is to talk about it. With awareness comes healing and children who are empowered to heal are students who are primed for learning. So, start talking!
Discussing anxiety can be made easier with the use of books such as Guts by Raina Telgemeier or Wilma Jean the Worry Machine, The Anti-Test Anxiety Society, or I’m Not Scared, I’m Prepared all by Julia Cook. Conversations can also start with personal experience stories. Share these books during community circle or begin your class with a prompt such as “I feel worried when….” or “what is one thing that helps you when you feel anxious?”
A helpful idea for limiting time spent on worries is containment. I have found designated worry times and things like worry boxes to be most helpful here. Perhaps a conversation with a parent or school social worker will help the student decide on a designated worry time.
When a worry arises, they can write it down and put it in a safe place such as a journal or a physical worry box. Writing it down takes a lot of the power away, stopping the worry in its tracks. Knowing that it is safe and secure and will be addressed brings comfort. When the designated worry time arrives, the student can sit with a safe adult for a set period of time – 10 or 15 minutes. This strategy takes some time and may start with a lot of worries. Eventually, there will be fewer worries to discuss and this can be designated connection time which will reinforce emotional safety for the child.
Challenge negative thoughts
It is important to talk to our students with anxiety about how the brain sometimes lies to us. It may even create automatic negative thoughts to keep us worried about things that aren’t necessarily true. Picture Fear from Inside Out and his stack of potential things that could go wrong on the first day of school! By personifying the worry, it is easier to understand that it is something we can challenge and question. Students may like to draw their worry as a monster or bully and even name it. When anxiety arises, the worry monster can be addressed directly!
To learn more about the automatic negative thoughts our brains produce, I highly recommend Dr. Daniel Amen’s book, Captain Snout and the Super Power Questions. This picture book beautifully depicts cognitive distortions such as all or nothing thinking, blaming, mind reading, and more. Additionally, Captain Snout, the ANTeater (A.utomatic N.egative T.houghts), empowers students to challenge those thoughts in a productive and helpful way. In all honesty, this is a book I have used with children and adults (myself included). Negative thoughts are particularly tough for kids with anxiety.
Carrying anxiety around can be exhausting. After students have worked through the worry using the skills above, talk to them about resetting their minds and bodies. Even though the stressor has been addressed, there may still be some stress hormones sticking around. Resetting the body will help release that stress, readying the brain to connect, learn, and live more presently.
Generally, a reset happens in one of two categories: activity or rest. Brainstorm some ideas for each and encourage your students individually or as a class to practice the reset after experiencing stress! Activities such as running, playing, or jumping jacks are all helpful. Rest resets may come in the form of breath work, recalling a happy memory, or brief meditations. Again, the more we pre-teach these skills by integrating them into our classroom routines, the more prepared our students will be to tackle inevitable anxiety or stress in the future.
If the anxiety you see in students is debilitating or leading to suicidal ideations or other worrisome behaviors, reach out to your mental health partners for immediate and more intensive support. Talk to your school counselors and school social workers for local support. Another handy resource to post in your classrooms or make available to students and parent is a 24/7, anonymous, free crisis counseling service accessible by texting “IN” to 741-741.
Anxiety is not new to today’s youth. We have seen it on the rise for years. Children can feel overwhelmed by anxiety and may shut down or act out in ways that make it difficult for them to connect, create relationships, or learn. Teachers and school staff are in a great position to recognize changes in behavior. The earlier we notice a challenge, the sooner we can intervene. With a few supportive techniques, we can give them a strong foundation in navigating big worries. This foundation will empower them to strengthen self-awareness, self-regulation, and even increased self-esteem.
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