Anxiety: A good teacher
Anxiety is a “bad” word in may of our vocabularies. Who wants to think about something that gives us so much discomfort? But anxiety has been one of my greatest teachers, and I want to share what I've learned, expecially because the good news is that it's truly treatable. If your kid (or you) has anxiety, understanding its lessons and getting appropriate help will better your life.
I recall having anxiety my entire life. I was the four-year-old little girl who got upset when the puppet I made wasn't "perfect," who went into catastrophic thinking when my mother showed up late to pick me up at school. Even though I was a good student, I dreaded every Sunday night and developed a pit in my stomach at the end of every August. I had insomnia in college and still have dreams that I missed a class or exam. Does this happen to you, too?
When I became a mother and watched my own children inherit similar struggles, I realized anxiety was trying to teach our family something crucial. When I went to graduate school to study social work, I sought training specialized training in anxiety at Yale Child Study Center Anxiety Program, learning from experts like Drs. Wendy Silverman and Eli Leibowitz, who have been developing interventions to treat anxiety in children and families for decades.
To Understand Anxiety, You Need to Understand the Brain
To understand what anxiety teaches us, we first need to understand the biology behind why it's so powerful. As adults, anxiety speaks through our bodies first - the tight chest, churning stomach, lump in the throat. For children, it looks like tummy aches, trouble sleeping, school avoidance, tantrums over seemingly small things, or sudden isolation from friends.
Our brains have different layers that evolved over millions of years. The deepest layer is the reptilian brain - the most ancient part that controls survival and threat detection. Above that is the limbic system, which processes emotions. At the top is the prefrontal cortex - our most evolved part that handles logic, reasoning, and problem-solving.
When anxiety kicks in, the reptilian brain takes over completely. Think about slamming on brakes to avoid a car accident - you don't think, you just react. That's your reptilian brain, and it's the same system triggered by anxiety, even when there's no real physical danger.
This hijacking happens because the reptilian brain processes information much faster than our thinking brain. When it perceives a threat - real or imagined - it floods the body with stress hormones within milliseconds. Blood flow redirects away from the prefrontal cortex toward muscles needed for fight or flight.
This is why both children and adults can't access their coping skills when anxiety is high - those abilities live in the higher parts of the brain that have been temporarily shut down. In children, this hijacking is even more dramatic because their prefrontal cortex isn't fully developed until age 25. That child who normally knows their multiplication tables suddenly can't remember 2+2 during a test.
Lesson One: Anxiety Can Mask Deeper Struggles
The first lesson anxiety taught me is that it can be masking a deeper story, a deeper struggle that when understood, can be treated appropriately. Anxiety is exceptionally comorbid, meaning it co-exists with other conditions.
Research shows that one-third of children with ADHD also struggle with anxiety (Pliszka, 2019). For children with autism, up to 40% struggle with anxiety or OCD (White et al., 2009). In children with ADHD, anxiety often compounds existing executive function deficits. For children with autism, anxiety stems from sensory overload, routine changes, and difficulty expressing feelings.
OCD has a particularly striking connection - up to 75% of individuals with OCD also meet criteria for at least one anxiety disorder. The anxiety fuels the obsessions, and the compulsions temporarily reduce the anxiety, creating a vicious cycle.
This is why diagnostic clarity is crucial - it helps us target interventions to address the source of the struggle, whether that's anxiety itself or underlying challenges like executive function deficits creating the anxious response. I often recommend comprehensive neuropsychological evaluations to tease apart these complex presentations.
Lesson Two: Anxiety Is a Master of Disguise
The second lesson anxiety teaches us is that it's a master of disguise. When children experience anxiety, it rarely looks like fear. Instead, it manifests as explosive behavior, school avoidance, defiance, or physical complaints with no medical cause. What we interpret as "poor behavior" is frequently anxiety speaking.
That child who suddenly can't go to school, who has meltdowns about homework, or who becomes "sick" before tests isn't being manipulative - they're experiencing genuine distress. School refusal and avoidance are particularly common anxiety manifestations. The Monday morning stomach aches, the homework battles, the sudden "illnesses" before big events - these are anxiety's way of protecting the child from perceived threats.
Most parents don't recognize anxiety when they see it because it shows up as behaviors that look like defiance, not fear.
Lesson Three: Avoidance Makes Anxiety Stronger
The third lesson is perhaps the hardest to accept: anxiety gets worse, more entrenched, and more difficult to alleviate if it is avoided. While your child is genuinely distressed by their anxiety, the anxiety itself cannot physically harm them.
However, this doesn't mean we accommodate their distress. Children need to learn to feel comfort in the discomfort. This is counterintuitive for parents whose instinct is to remove their child's pain, but it's essential for recovery. When we constantly rescue children from anxious feelings, we send the message that anxiety is dangerous and that they're incapable of handling it.
The paradox is that avoidance teaches the brain that the feared situation truly is dangerous, reinforcing the anxiety cycle. But when children learn to sit with uncomfortable feelings, they discover that anxiety peaks and then naturally decreases.
When Children Try to Numb the Discomfort
When children don't learn healthy coping, they often find their own ways to numb the discomfort. For younger children, this looks like excessive screen time or compulsive social media use. For adolescents, the risks escalate to experimenting with substances.
These numbing behaviors provide immediate relief, which makes them appealing and potentially addictive. But they prevent children from developing genuine coping skills and can lead to dependency on external substances or behaviors to manage normal emotions.
Lesson Four: The Only Way Through Is Through
Through my training at Yale and professional experience, anxiety taught me that the only way through is through. The key is teaching children that it's okay to be uncomfortable, that they are capable of handling those anxious feelings, and that they can do the very things that trigger the distressing emotions they're trying to avoid.
This means holding space for their difficult feelings while maintaining confidence in their ability to cope. We validate their experience ("This feels really scary for you") while empowering them to face it ("AND you can handle this"). These are the core principles behind the SPACE intervention, developed by Dr. Eli Lebowitz, a professor at Yale. Dr. Lebowitz has devoted decades of his career to helping kids and their families with debilitating anxiety and OCD. I highly recommend his book below.
When we teach children that they can tolerate anxiety without numbing it, we're giving them tools that will serve them for life. If children don't learn this essential skill, the anxiety will fester and become more entrenched, often resulting in withdrawal from life and possibly developing depression or substance use issues.
Anxiety Treatment Options": The Good News - They Work!
The most hopeful lesson anxiety teaches is that it's incredibly treatable. Anxiety interventions are exceptionally evidence-based with decades of research proving these therapies work. Tools include breathing techniques, cognitive reframing, and therapies like CBT, DBT, ACT, and ERP.
Many parents resist medication, but I've seen families where it gave children enough relief to actually benefit from therapy and coping strategies. There are interventions that are parent only, where parents learn how to validate, but not accommodate their child’s anxiety. To find a SPACE-trained therapist, go here.
Special Considerations for Children with Autism and Anxiety:
Children with autism often face heightened anxiety, but specific strategies work particularly well. Creating predictable routines with visual supports helps them understand what to expect. Teaching emotional recognition through identifying physical sensations using emotion charts builds emotional literacy. Relaxation techniques like deep breathing or physical activities serve as effective calming strategies.
As a clinical social worker with honed expertise in anxiety disorders and comorbidity, I provide therapeutic solutions for children struggling with anxiety symptoms. Working with an experienced professional can make an extraordinary difference. Sometimes more intensive intervention is needed, but the research is clear - with the right support, children can learn to manage their anxiety effectively.
Resources forAnxiety for Children & Adults
Understanding what anxiety teaches us is the first step toward helping our children manage it. When we can name what anxiety is teaching us, we can tame it.
If you're struggling with your own anxiety, helpful resources include Thich Nhat Hanh's book on Fear, literature from Dr. Claire Weekes, the founder of anxiety treatment, and Brené Brown's podcast on anxiety.
For children, helpful tools include the Mightier Games and books like What to Do When You Worry Too Much: A Kid's Guide to Overcoming Anxiety .
Anxiety is incredibly common, highly treatable, and doesn't have to run your family's show. Sometimes our greatest struggles become our greatest teachers.
My list of resources for anxiety is too long for this blog, let me know if you wish to learn more: jennifer@teamcrossbridge.com.
Please reach out to us if you're seeking solutions and need some guidance.
References:
Abramowitz, J. S., Taylor, S., & McKay, D. (2009). Obsessive-compulsive disorder. The Lancet, 374(9688), 491-499.
Advanced Autism. (n.d.). How to address anxiety in children with autism. https://www.advancedautism.com/post/how-to-address-anxiety-in-children-with-autism
Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in Clinical Neuroscience, 19(2), 93-107.
Brown, B. (2020). Brené on anxiety, calm, and over/under-functioning [Audio podcast episode]. In Unlocking Us. https://brenebrown.com/podcast/brene-on-anxiety-calm-over-under-functioning/
Nhat Hanh, T. (2012). Fear: Essential wisdom for getting through the storm. Plum Village. https://plumvillage.org/books/fear
Pallanti, S., Grassi, G., Sarrecchia, E. D., Cantisani, A., & Pellegrini, M. (2011). Obsessive-compulsive disorder comorbidity: Clinical assessment and therapeutic implications. Frontiers in Psychiatry, 2, 70.
Pliszka, S. R. (2019). ADHD and anxiety: Clinical implications. Journal of Attention Disorders, 23(3), 203-205.
SPACE Treatment. (n.d.). https://www.spacetreatment.net/
Weekes, C. (n.d.). Resources. Claire Weekes Publications. https://www.claireweekespublications.com/resources.html
White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29(3), 216-229.
Yale Child Study Center. (n.d.). Anxiety and mood disorders. https://medicine.yale.edu/childstudy/research/clinical-innovations/anxiety-and-mood-disorders/
