Speaker 1: 0:00

Welcome everybody. This week we're going to get more into what anxiety is. Before we start talking more about separation anxiety in children of separated parents specifically, it's a good idea for us to have an understanding of anxiety in kids generally, so then we can make better use of the specific context of separation anxiety and come up with some more comprehensive ways to help address separation anxiety in children of separated parents. Anxiety and fear are both evolutionarily developed early warning systems, essentially, that are adaptive and helpful when they occur at appropriate levels and in appropriate circumstances. Anxiety and fear are different though. Anxiety is worrying about something that may happen in the future. Fear is an immediate reaction to an actual or perceived threat. Now, both fear and anxiety to some degree are normal in kids. Mild fears are very common in kids. Younger children are dealing with just a rush of new experiences and tend to have more fears as they're trying to understand the world. The number of fears tends to decline as children get older. Younger children have a higher number of fears. They're worried about more things, in part because they understand fewer things about the world. As children get older, they have fewer specific fears because they're starting to understand the world better. Let's talk about what some normal fears are at different ages so that we can then have a baseline from which to consider things that are abnormal or unhelpful. Let's start with infancy and so with infants. Stranger anxiety or stranger fears are very common. When an infant first becomes able to differentiate between people, they recognize that this person is somebody new and it's not their parent that will make them anxious. They also are afraid of loud noises.

Speaker 1: 2:01

In early childhood the normal fear changes and some of that becomes separation anxiety. That becomes much more common. Kids really are attached to their parents or other important caregiving figures in their lives and they become afraid about something bad happening to them or getting separated from them. Children ages, you know, two, three, four years old and even older, can spend a lot of time worrying about their parent. They recognize it's this idea of object permanence. They recognize that the person still exists when they're not in their periphery and they're worried about what's going to happen to them while they're gone. At this age, kids also start being afraid of things like monsters. You know, things that are in the closet, under the bed, in the dark, and it seems like that's because kids are starting to hear about things like monsters, maybe from siblings, or from hearing something on the TV or the YouTube or whatever it is, but they haven't had enough experience to realize that there really isn't a likelihood that there's a monster under their bed. So they're dealing with learning that something like that exists in some way and being afraid that it exists actually where they are when they are.

Speaker 1: 3:16

As children get older, as they start to get into school and they're meeting other kids, they start to learn more about the world. Their fears and anxieties change again as the child's world expands. They start to learn about new things to be afraid of and it takes some time for their experience to catch up and show them that it's likely not going to harm them. So there's always this sort of pull and lag, it seems, with anxiety in kids. Just look at the last few months. Kids are hearing about school shootings, kidnappings, hurricanes, tornadoes. They see this happening in the world and they can start to worry about how it's going to affect them. They can also start worrying more about school and how well they're doing, you know, because all of a sudden school and academics it becomes more important for them and it becomes more difficult for them as they grow towards adolescence, as children get to adolescence. This is a time when their focus is more on their social and peer group. Their anxiety tends to be more related to their relationship to other kids and their standing in their peer group. Also, as school becomes even more difficult, with even higher stakes, it's very common for children to have anxiety about their performance in school and what they're going to be doing after they graduate.

Speaker 1: 4:38

As we've briefly discussed these fears, many of them are very normal fears. At the given developmental stages they learn about new potential threats out there in the world, whether they're realistic or not. They internalize that anxiety about that thing happening to them and it takes some time for them to experience and understand that the monster's not under the bed or it's unlikely they're going to have a hurricane in Oklahoma, whatever it is. Having anxieties and fears that are mild but broad spectrum about many things are very common in kids and everybody has different fears or anxieties at different points in their maturation, given the experiences that they've had in their maturation, given the experiences that they've had.

Speaker 1: 5:28

As children get older, the number of their fears tend to decline. Young kids have lots of mild worries about lots of things. As you get older, you tend to have fewer specific worries because you're starting to have a better understanding of the world and your place in it, the kinds of things that are likely going to be there to harm you, and the things that aren't. When you're young and you hear a sound in the night, you may be concerned that that's a monster. As you get a little bit older, you start to realize it's just your dad going to the bathroom at 2 am. So as your experience of the world expands, you start to have less of these fears. You start understanding that there are actual logical explanations for what you used to be afraid of, and the way in which children express their fears changes as they grow older too.

Speaker 1: 6:14

Young kids are more likely to express their fears or anxieties by clinging to their parent, by crying or having a tantrum, by experiencing actually stomach aches and headaches and other physical symptoms. As children get older, they become increasingly mature cognitively and so they start to be more able to express their fears and to talk about their feelings. And those fears often change as they grow older. They move from concrete fears like a monster in the closet to more abstract fears like do my kids in my peer group like me? Am I going to be successful, you know, am I going to graduate high school? So these fears that these kids have as they get older are starting to be more abstract. They're starting to be able to think more abstractly. They're starting to worry about the future. So as kids get older, they have fewer fears about the monster in the closet and other direct threats to them physically that they don't understand. They start having more anxieties about the future and their role in it. Now, certainly, children younger children can have social anxiety and shyness, and kids who are older can still have very specific fears similar to there may be a monster in my closet Phobias and specific fears of things like maybe of dogs or of snakes. Things like that can develop. But if you look at the population as a whole, specific fears tend to be more common in younger children and more anxiety about future abstractions and about social fears tend to be more common in older kids.

Speaker 1: 7:54

There are also gender differences. Prior to puberty, boys and girls experience anxiety at similar rates. Beginning with puberty, girls tend to experience greater levels of anxiety. In preparing for this episode, I read several research articles to get an idea of why that's the case. I didn't see anything that I considered to be a definitive answer, but there are lots of factors considered to be relevant and it's possible very likely in fact that there is a pretty strong answer that I'm just too dumb to understand from what I've read. So here are some of the factors considered to be relevant Girls and women tend to be more sensitive to interpersonal stress than boys and men.

Speaker 1: 8:35

So a girl and girl who can tell me the who, what, when, where, why and how of every argument in the home and the boy didn't hear pretty much anything except for the sounds of Call of Duty in his headphones. Girls tend to cope with their problems by thinking about it over and over, which is referred to as ruminating. They also tend to seek support from other people and to talk about their problems. They also tend to seek support from other people and to talk about their problems. This coping style can increase symptoms of anxiety in girls, which may not appear in boys, because the boys are coping in other ways, which often takes the form of negative, externalizing behaviors. So an anxious girl may appear anxious or depressed, an anxious boy may appear hyperactive or disruptive. And then here's the part where I really felt out of my depth, so I'm just going to mention words and please understand that I don't fully understand them. So apparently there are also biological factors that are related to estrogen and progesterone receptors and changes to the amygdala that occur during puberty, and those in combination, may be related to estrogen and progesterone receptors, and changes to the amygdala that occur during puberty, and those in combination, may be related to the increase in anxiety among women. So there are a combination of social factors, behavioral factors, biological factors, all of which work together to make it so that girls, starting around puberty, do in fact tend to have greater issues with anxiety than boys do.

Speaker 1: 10:16

If we have all of these very common and developmentally appropriate anxieties and fears at different stages in their development, how do we know when that anxiety or fear is becoming problematic? In trying to figure out when it becomes problematic, we're going to talk about multiple different things. We're going to talk about intensity, duration, context. So when you have a toddler, you know it's very common to have meltdowns. It's very common for a child beginning school to be anxious and upset on the first day of school. Being scared about the first day of school and expressing that maybe with sadness or crying, even a short-lived tantrum. That's very typical.

Speaker 1: 11:00

But after the child has attended school for a few days and they got to know the teacher, they're starting to know the kids in the class, they get to know the process of how you go to school, then continued anxiety at a high intensity level would not be adaptive and would not be helpful and would start to be concerning. If you have a child who's going to a birthday party for a bunch of kids that you know she doesn't really know, you would anticipate that that child would be anxious and have some shyness and some social anxiety. But if she's going to a birthday party with just all of her friends and she knows every single one of them and they all have a great time, but she's still reflecting the same kind of anxiety, then that would be maladaptive and potentially problematic. And if let's say that the child goes to the birthday party with kids that she doesn't know and after 15 or 20 minutes everyone is being kind and polite and they're having fun and playing games, but she just can't let go of that anxiety, that also will typically be on the less helpful, maladaptive side of things. So once a child has an opportunity to get more comfortable and have an opportunity to understand what's expected of them and see that they can actually do what's expected. You expect that the anxiety is going to go away.

Speaker 1: 12:22

So short-term episodes of anxiety, small outbursts of emotion that are kind of predictable and tied to specific events, that's normal and not something to be worried about. One of the first things you want to think about is the intensity of the anxiety that they're feeling. So is it a child's fear response or anxiety response? Is it normal? Is it something that you would expect? Is it being nervous on the first day of school or is it refusing to go in the door? I'm nervous, I don't want to go to school. I'm being a little extra clingy, maybe a little bit of crying. That's normal. Is it on the ground, kicking and screaming, throwing a tantrum in front of the school, trying to break things? You know, meaning to be stopped from running out of the school?

Speaker 1: 13:16

That intensity level is not typical and it's not healthy and it's not expected of a normal child. You know, if you have a child who's nervous around dogs, if you have a huge barking dog, anyone would be nervous around that dog. But if it's a little teacup poodle and it's cute and cuddly and everyone's coming up and petting it and the dog's just loving it and no one seems to be concerned about it. Even small children think the dog is cute and they aren't nervous about it at all. But your child is having an intense anxiety reaction, maybe runs away crying from that little teacup poodle. Well, that's maladaptive and it's something that's out of proportion to the possible threat that's being posed by that little poodle. So intensity becomes problematic when there are intense fear or anxiety reactions that are surprising because they seem totally outsized compared to even the potential threat of the situation and if you also notice that the intensity of the anxiety is not diminishing as the opportunity for the child to be comfortable with the situation increases.

Speaker 1: 14:32

So anxiety on the first day of school totally normal. Kicking and screaming on the ground in front of the school doors, in front of all the parents and other students and teachers not normal. Anxiety on the first day normal. Same level of anxiety two weeks in not normal, even if it's not the level of kicking and screaming, even if it's a much lower, tamped down level of anxiety. If it's not subsiding over the weeks as a child gets used to the classmates and the teacher in the school process. That is not normal and likely could use some intervention. It's kind of difficult for adults to put a finger on really.

Speaker 1: 15:11

But one of the ways that can be helpful to understand if your child's anxiety is not helpful and is not normal or properly adaptive is if it's just totally surprising. Certainly as adults we're not going to be as concerned or afraid of things as children are and we're not going to be as anxious about the same things that kids are. But if we are watching our child and they're having a very high intensity reaction to a situation that feels completely innocuous running in terror from a teacup poodle right that's a surprising response, especially when other children the same age are enjoying the dog then I think it's a good idea to say to yourself I'm surprised by that reaction. Let me think more about why that reaction occurred. If your child is still anxious and scared about going to school a couple weeks in, then it's a good idea to think to yourself what's going on at school, because it could be the case that your child is just improperly anxious about a completely benign situation. It could also be the case that the situation is not as benign as you assume. So either way, it's helpful to notice that surprising reaction and to investigate the reaction, not assuming that your child is doing something that's inappropriate, thinking to yourself, it's either the situation that there's something my child should actually be nervous about and need to figure out what that is, or there's nothing to be nervous about in a real practical sense, compared to other children their same age, and so I need to give my child some help to help them understand how to feel more calm in that benign circumstance. So we've talked about normal anxiety and we've talked about problematic anxiety.

Speaker 1: 17:00

So when does anxiety actually become a disorder? Anxiety becomes a disorder when it leads to significant disruptions in a child's life, when it leads to avoidance. So if your child refuses to go to school or refuses to go play soccer, refuses to go to a friend's house for a birthday party, then that anxiety is disrupting their lives, preventing them from enjoying the kinds of things that a child their age should be able to enjoy, and, similarly, that anxiety is interfering with what's important in a child's life. School is a big one. Lots of kids are anxious about going to school, but school is something that children have to be involved with. Children have to be involved with.

Speaker 1: 17:52

So if anxiety is causing a child to be just so completely upset at school that they can't be involved in the activities, they can't concentrate on their work, they're missing lots of school because of the physical manifestations of the anxiety that they're experiencing, then it's time to consider that they have an anxiety disorder that needs to have some professional assistance. Kind of look at it this way as a child, your job is to go to school to learn how to socialize with other people and to start being prepared to be an adult in this world. If the anxiety that a child is experiencing is interfering with that core function of being a child, then it's maladaptive and disruptive and your child needs some assistance so that they can then move on with the job of being a kid Learning how to learn, learning how to get along with groups of people, learning how to negotiate with others, learning how to organize their lives. Anxious children start avoiding those kinds of situations. It starts interfering with their ability to learn and grow, and so at that point you need to start looking at treatment.

Speaker 1: 19:01

So that's it for this week's introduction to the idea of anxiety in children generally. Today we talked about what is normal and what is abnormal in terms of children experiencing anxiety. Next week we are going to get into the specific circumstance of separation anxiety for children who are in separated families. We'll look at separation anxiety a little bit more closely in terms of children generally. We'll compare the circumstances in which the children find themselves to the circumstances in which children are in separated families. We'll talk about how those changed circumstances can lead to changed experiences of separation anxiety for kids. Thank you very much. We'll talk to you next time.