Ask Dr Justin: Has My Daughter got Anxiety?

Dear Dr Justin, 

“My 10-year-old (nearly 11) daughter gets very anxious. Yesterday she dropped something and said:

“I’m sorry. I’m so, so sorry. I’m really sorry.” She would have continued if I hadn’t stopped her.

She was upset I didn’t buy the right type of ham and said it had ruined her day. Then she can switch and be her normal, happy self. Is she getting hormonal? Is it anxiety? Could she be bipolar?”

For years there have been warnings that depression will soon be – or is – the leading contributor to global disability. We have watched as more and more young people have been diagnosed at earlier and earlier ages. But in recent times the World Health Organisation has highlighted that anxiety is fast catching up, and is particularly common in our youth – especially girls. Parents are becoming increasingly anxious about their children’s anxiety.

Anxiety

Children with anxiety worry persistently, excessively, and unrealistically about things most other kids their age don’t worry about. To be diagnosed with anxiety requires 6 months of this type of worry, where your child struggles to control the worry. They might be restless, fatigued, irritable, struggle to concentrate, feel tense, or not be sleeping well. The worry needs to impact unhelpfully in various areas of their life, and not be explained by medical issues, drugs, or other psychological challenges.

I don’t have nearly enough information from you to identify whether your daughter could be labelled with anxiety (or bipolar). Labels can help in some instances, but at this stage, I’d suggest that a label is not in your daughter’s best interest. So now that we know what anxiety is, let’s be open to other possible explanations for her behaviour.

Physical Factors

Girls experience puberty earlier than boys (on average), usually around age 9-11. Strong emotions (including mood swings, tears, and excitement/elation) are a normal response to the tremendous hormonal and physical changes that are occurring. Children can be scared of puberty. Some mourn as they recognise they’re not a little kid anymore.

In addition to puberty, evidence shows that poor sleep can contribute to the challenges you’re describing. As screens invade our children’s lives – particularly at night – evidence shows they’re sleeping fewer hours than ever before, and also getting lower quality sleep. Setting appropriate limits around screens and getting screens out of rooms, especially at night time, may be helpful.

School Factors

Research suggests that school is increasingly stressful for many of our children. Worries about grades, keeping up, and staying on top of homework can leave children feeling overwhelmed. They might hold it together at school, but then lose the plot when they get home – often over the tiniest things.

Relationships can also trigger big emotions and challenging behaviour. Bullying, isolation, or the cattiness characterising so many girls’ relationships might also be creating the behaviour you’re seeing.

Family Factors

From time to time our children get worried about what’s happening at home. If there is parental conflict or separation, a new sibling, someone being affected by a serious illness, each of these can trigger the behaviour you’re seeing.

Any of these factors, or a combination of these and other factors, might explain the challenging behaviour you’re experiencing without needing to look at anxiety as a potential cause. There might be something medically wrong. Your daughter’s unique personality might be a little perfectionistic or overly conscientious. Or there may be nothing wrong at all, and she’s just been feeling a little ordinary lately.

What do you do?

You can’t control your daughter’s reactions, but you can help her to work through them. I’d suggest that you take a validating, empathic approach to her outbursts and struggles. This will be helpful whether she has anxiety or not.

When she becomes deeply apologetic, play “guess that emotion” by saying, “You’re worried you’ll be in trouble because you dropped the plate.” Name what she feels. Then instead of correcting her (or getting her in trouble for being clumsy), hug her. Tell her you love her. Ask if she needs a hand. Be supportive.

When she is upset that you bought the wrong ham, do the same. “You’re frustrated that I bought the wrong ham. That’s so annoying. You want honey ham and I bought the smoked stuff. That’s so frustrating isn’t it.”

You’re not saying it’s ok. You’re just letting her know you get it. The reality is that you probably get emotional when you drop something. Or perhaps you feel frustrated when you are hoping for one kind of chocolate and your hubby buys you a different one. See the emotion as a chance to understand, not reprimand. Get curious, not cranky. Connect, label the emotion, and be there for her. (And if she needs space or is non-responsive, back away and leave her for a while before trying again.)

Validation and empathy can help when life gets overwhelming for young kids (and even for us big kids). Our children want to do the right thing, and they want things to be right. Our understanding and compassionate responses to their challenges and mini-meltdowns go a long way to helping them regulate their emotions and respond well to the challenges they experience.

If things continue to deteriorate and you see evidence of anxiety, seek professional help.