Anxiety In Kids - does my child have anxiety?
In 2007 a casual comment from my boss stopped me in my tracks and launched me in an entirely new direction.
I was a teacher and was meeting with my principal to discuss how to help our staff integrate new assessment tools we had been given.
What my principal casually mentioned was this: 60% of the students in our high school needed medication to get through their day.
WTAF??? "Say that again?" I asked.
Whether it was for something physical like acne, pooping, sleeping, or chronic pain, or something behavioral like inattention, anxiety, fear, or focus, more of these 12-17 year-olds needed meds than didn't and I needed to know why.
Kids Are Not Alright
That conversation that shifted me towards a new career in functional nutrition happened more than ten years ago. And things have steadily gotten worse.
Don't shoot the messenger, but kids are not nearly as resilient as we think they are and they need our help.
Reports out of the US tell us that 30-40% of young people now say they feel anxious, depressed, or stressed (up from 20% in 2020).
Visits to emerg for suspected suicide attempts are up 51%.
It's happening in the US, Italy, France, Canada, UK. Anywhere they have cared to ask the question, "how are kids doing?"
They're not ok. They're in crisis. Maybe one of them is yours, or a friend of yours. Anxiety in kids is touching us all.
Think of a class of 30 kids. Statistically, between 9-12 of them are struggling to make it through their day.
55% of children who had mental or emotional struggles before the pandemic say they feel more sad, depressed, or unhappy now than they did in 2020.
So what's going on and what can we do for anxious kids?
If your child has anxiety please read on because it's time for a fresh, whole-child approach; one that helps ease anxiety with skills, tools and tactics kids can use to calm their mind, but that also leverages decades' worth of research on the body-brain connection.
What Is Anxiety In Kids?
Fundamentally, anxiety in kids is intense insecurity and worry in face of the unknown. But it can look like a lot of different things and is often tied to other conditions or diagnoses.
Robin Karr-Morse in her amazing book Scared Sick characterizes anxiety and depression as "the twin siblings of fear"; anxiety being more about fear of the future while depression tends to be more about ruminating in the past. Twins, but rooted in fear.
About half of adults with ADHD also carry an anxiety disorder diagnosis. Kids with defiance disorders, developmental diagnoses like ASD, learning struggles like dyslexia, and addictive tendencies also commonly have anxiety. A lot of physical health issues like heart issues (in adults), constipation, and autoimmune diseases have anxiety as a component. About half of all patients with Irritable Bowel Syndrome also report anxiety or depression.
Anxiety in kids might show up as feelings
- worry and bad dreams
- anger and panic when things aren't predicable
- feeling incapable or incompetent
- feeling unloved or nervous
- feeling sad or unsettled
Anxiety in kids might show up as behavior patterns
- school avoidance
- obsessive routines
- social withdrawal
- pushing people away
- bullying or being disruptive
Anxiety in kids might show up as physical symptoms
- constipation or diarrhea
- persistent nausea
- physical or verbal tics
- skin rashes or breakouts
From my perspective, anxiety as a whole is a symptom of a child stuck in a state of chronic stress. To help them move through their lives with more calm and ease, we can do three things for kids:
- figure out what's causing them stress from the outside and ease that pressure by creating a positive environment for them
- figure out what's causing stress inside their bodies and ease that pressure (more on those stressors here)
- improve their capacity to tolerate stress by nourishing their nervous system
Our functional nutrition approach to anxiety is to reduce their stress while we also work to improve their stress tolerance by nourishing their nervous system.
How Do I Know If My Child Has Anxiety?
The average onset of anxiety is now age 6, which is a time of life many kids don't have the language to really express how they're feeling. Anxiety in younger kids tends to look different than anxiety in teens. So it can be hard to tease out what's normal kid behavior and what's problematic.
Getting a diagnosis is between you and your doctor but here's some of what I see in the anxious kids I work with.
- Feeling exhausted and depleted after engaging socially (or shutting people out completely, preferring to be alone)
- Panic or aggression if details aren't well thought out or known
- Ruminating in "what if" thoughts
- Not wanting to go to sleep; feeling worried or fearful at night or delaying sleep by getting hyper or needy before bed
- Feeling unloved or out of place despite being assured otherwise
- Starting projects but then self-sabotaging so it all falls apart (or not wanting to start hobbies in the first place for fear of failing)
- Experiencing persistent tummy pains or constipation/diarrhea
- Lashing out in anger or rage when they feel uncomfortable
- Bullying or being disruptive at school
- Nail biting, tics, scratching, picking
- Being shy and preferring to quietly blend into the background
- Wanting to please
- Wanting to get in trouble
- Obsessing over getting something just right before they can move on; perfectionist tendencies
- Having bad dreams full of worry and angst
- Being guarded and not expressing emotions much
- Being very dramatic
- Being extremely sensitive to sounds, tastes and textures
- Being very empathetic and taking on the stress of others
Anxious kids get called...
- Worry wort
- Oppositional (ODD)
- High achiever
- "Mama's boy" or "mama's girl"
- Drama Queen
Kids are masterful at making the unpredictable predictable so they can feel a bit more safe. Kids with different temperaments will find different strategies to make themselves feel more calm and stable. Teen anxiety tends to have a more self-conscious edge to it while for younger kids it tends to be more about other people and expectations.
So anxiety can look like a lot of things but at the root is a feeling of unsettledness and worry in the face of the unknown because we have a nervous system that is struggling to find a state of calm.
Anxiety is a really nice example of what I call Eroded Resilience... a reduced capacity to grow from stress. And it lives at the intersection of a child's biology, their psychology, their genetics and early experiences, and their environment. There's a lot we can do to help them.
Easing Anxiety in Kids From The Inside Out
This is where functional nutrition shines and let me explain why.
Most therapies for anxiety involve a heavy focus on tools and tactics to help kids change their state of mind. Therapists and teachers (even parents) often do a great job of helping kids with positive reinforcement, positive self-talk, helping them name emotions, and giving them management tools for their anxiety.
These are all great, but back when I was a high school teacher I got curious about this question: why can one child access and use their tools to move through stress and grow from it, while another gets thrown into anxiety and panic by the same situation?
What I learned is that there is a very strong biological piece to anxiety. What's going on inside a child's body matters. When missed, this biology makes everything worse and creates a "ceiling" for therapists and educators. When addressed, kids can break through their patterns and actually feel differently and show up differently in their lives.
Biological Factors That Cause Anxiety In Kids
When I work with families who want to find natural solutions to ease the anxiety in their kids I find there always to be at least one of the following forces at play inside the child's body. Once we find and relive that internal pressure, the management tools and tactics they're learning from their teachers and therapists become much more effective and actually stick.
The most common nutrition-related forces I see influencing kids' anxiety are...
- Nutritional imbalances
- Key nutrients like zinc and B vitamins are important for the nervous system to regulate. Nutrients like fiber and fat help keep blood sugar stable and avoid spikes in stress hormones. High copper can contribute to feelings like anger and rage. We need to make sure nutrients are coming in through good foods, are being absorbed well, and are in balance.
- Sugar intolerance (and sugar cravings)
- Sugar's not great for any of us, but some kids are particularly sensitive because they don't metabolize it very well. This can be because of their genetics or it can be more digestion-related. But when sugar intolerant kids eat too much sugar they get thrown into a state of hormonal discord and this can trigger and exacerbate anxiety.
- Food sensitivities
- When foods are not digested well they can stimulate inflammation and immune activity in a child's gut. Inflammatory messages can then travel around the body, keep the nervous system stuck in a stress response and keep a child from finding calm.
- Poor detoxification capacity
- The body has an amazing built-in system for clearing waste and toxins from the body, but when it can't keep up with the load toxins build up, cause inflammation and interfere with brain activity.
- Excessive Pyrroles
- Pyrroles are a byproduct of red blood cell production. When they are overproduced they will pull important nutrients out through the urine and lead to a chronic deficiency. Excessive pyrroles are strongly correlated to social anxiety, sleep disturbances, tension, and digestive upset related to worry.
- Low Serotonin
- Known as our "feel-good hormone", serotonin is created in the gut and in the brain from the nutritional building block called tryptophan. Low serotonin has been linked to feelings of anxiety, fear, and worry. It can become low because of genetics, poor protein intake or digestion, other factors in the gut that derail its production, excessive stress, or lack of the nutrients the body needs to create it.
- Methylation imbalances
- Methylation is a biochemical process that happens thousands of times per second and influences our mood, our detoxification capacity, our digestion, our sleep.... pretty much everything. Methylation capacity is partly governed by genetics, but since it is driven by nutrients we can also support the process with certain diet and lifestyle choices. Poor methylation can be linked to anxiety.
- Low GABA and/or high Glutamate
- Glutamate is an amino acid that comes from protein. The body will convert glutamate into GABA with the help of enzymes, keeping the two in a nice balance. GABA helps us feel calm and secure and cope with stress while glutamate revs us up. Kids with anxiety often have high glutamate and low GABA, and as we balance that out they feel better.
- Infections like Lyme, Babesia, strep, Mycoplasma, and Coxsackie can initiate immune activity and inflammation that affects mood and behavior.
- Poor digestion
- The digestive system needs to be in good working order to liberate nutrients from food so the body can use them. If digestion's not running smoothly, a child will lack the nutritional building blocks they need to regulate their nervous system and they will stay stuck in a stressed state.
- This is a clear sign that digestion is not up to snuff and there is inflammation and imbalance in the gut microbiome. Not only can the physical discomfort of constipation keep a child stressed, but their gut, which should be a source of nourishment, is now a source of further stress as waste sits in the colon and festers.
- Poor microbial balance and/or parasites in the gut
- There is a literal highway that connects the gut and the brain and messages are constantly being passed back and forth between them. As we balance out the gut ecosystem, kids feel better emotionally.
When even one of these forces is at play, kids get stuck. Tools, tactics, and strategies from their teachers and therapists work for a while, but they are exhausting.
When we work from the inside out by addressing some of these factors, an anxious child can not only think differently about situations, but they can also feel differently and know things are going to be ok even in the face of stressful situations.
The Bottom Line
We don't need to fix kids. They're not broken. They're not the problem. But their anxiety is reflecting back to us a clear message that something is terribly off.
I also don't think there is a "root cause" of anxiety in kids. Anxious kids are caught in a vicious cyclone that is conspiring to keep them stuck. To help them we need to peel back the layers. We need to give them skills, tools, and tactics and surround them with a positive environment so they feel loved and connected, but we also need to support their biology and relieve the hidden stress that is making it hard for them to cope.
We have power beyond belief to collectively elevate children's health and literally shift the future for them into one that feels more hopeful, bright, engaging, and light. But we need to do this work from the outside-in and the inside-out, bringing the powerful therapy tools we have with the powerful functional nutrition tools we have to finally help them feel their best and express the best version of themselves.
The Child Mind Institute The Children’s Mental Health Report; The Impact of the COVID-19 Pandemic on Children’s Mental Health: What We Know So Far.