Talking to Your Pediatrician About Anxiety

When does anxiety in children become a medical concern?

You may notice that your child is a worrier. When you schedule a babysitter, your kid has prepared a list of interview questions to ask the sitter before being ok with it. When you're 5 minutes late to picking them up, they're in tears. They need to walk through any potential problems and come up with five solutions whenever faced with a new situation. You're happy to help! But when is it too much?

Anxiety is a concern when it gets in the way of "typical" functioning.

While some kids are more prone to worries than others, anxiety becomes a concern when it impacts their day-to-day functioning. So, instead of being in tears that you're five minutes late, they've had a huge blow-up and are waiting for you in the principal's office. Or, walking in to school on the first day, they're paralyzed and can't move from your side. They have trouble maintaining friendships. They consistently experience stomachaches and headaches, due to their ongoing stress.

When to consult with your pediatrician:

Stomach aches and headaches, while oftentimes linked to anxiety disorders, need to be checked out by the pediatrician to ensure there are no other medical causes to treat. 

Also make sure to talk with the pediatrician about certain events that seem to trigger these big responses. Does your child react this way to all new situations, or only some? Is there a low level of stress throughout the day, or does your child seem only impacted by, say, attending swim lessons? This will help your pediatrician explore if the anxiety is generalized or if it is tied to certain events, which may change treatment recommendations.

Your doctor may recommend counseling.

Meeting with an anxiety or anger management specialist, depending on how anxiety presents or looks in your child, may be a good next step. The counselor can assess for the level of anxiety, and create a coping plan to help manage these anxious symptoms.

Some counselors can also create gradual exposure plans, to help your child experience events that they find scary, and gradually build up the skills to experience less anxiety. 

I have previously worked with a child who experienced severe separation anxiety. Whenever he was dropped off at school in the morning, his mom had to stay with him for the first 30 minutes of the school day - and when she left, he had a melt down. Consistently. 

How does gradual exposure work?

How did we help this kid? We decided to come up with a list of most scary to least scary experiences of his mom leaving him at school, and we built up coping skills. So the least scary version of being left was having his mom in the classroom for five minutes. We ran this for a week, until he was ok with it.

The next step was having mom drop him off at the classroom door. Again, this was anxiety provoking at first, but became easier when we practiced coping skills along with it.

Eventually, we worked our way to mom dropping him off at the regular check in point, with the rest of the kids at school. He was able to run to the doors with his friends, and go about his day. 

This success was possible because of his pediatrician recommending counseling.

So, discuss questions and next steps with your doctor, to hear what they recommend!

If you're curious about counseling, contact Kelsey at compassionatecounselingstl@gmail.com to schedule a free, 15 minute phonecall and talk about next steps. Kelsey is an anxiety and anger management specialist for kids and teens ages 4-19. She works in St. Louis, MO, helping families in Webster Groves, Kirkwood, Brentwood, and Maplewood.