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Dear Dr. Batya, My 13-year-old daughter has become increasingly anxious and fearful. Tests stress her out, she cries easily and is very moody. She seems concerned about her own health and also that of others and she worries about everything. Help!
- M.W., Jerusalem
The teenage years can be difficult for kids. No longer a child and not yet an adult, their changing body can be perceived as new, exciting, awful and frightening all at the same time. Some children wonder if they are indeed normal and if the new sensations they are experiencing are normal as well. Add to this perhaps a new school, a change in friends and any number of other stressors, and life can feel remarkably out of control. It is no wonder that children seem to worry more, have a harder time holding it together and appear one minute on top of the world and the next minute to be falling apart and completely overwhelmed. As a parent, it can be as confusing to you as it is to your child.
Here are a few areas to explore: Can you identify what makes your daughter's stress and anxiety better? What makes it worse? Are there activities that she can eliminate? When you chat openly can you identify what is wrong and what might fix it? Bear in mind that you may not be the one to fix it.
Look at your daughter's daily schedule. Is she stressed because she has no time or has too many extracurricular activities? Does she do and does she understand her school work? How does she spend her free time? How does she relax? Is there down time?
What can you do to make next year a good year for her? What is her general health and well-being like? Does she eat too much or too little and is it healthy? Does she bite her nails or have any nervous tics? What is her sleep like? When does she go to bed and does she sleep well? Does she have nightmares? Does she seem happy most of the time? Does she have friends and what are her friendships like? Is she well liked? Is she competitive and if so, is it done in a healthy way? Is she jealous and if so, of whom?
What is her physical health like? Does she complain of chest pain, breathing problems, stomachaches, sleep problems or headaches? If so, when do these occur? What is her personal hygiene like? Does she care about how she looks? Is she into deodorant, bathing, showering, nail and hair care?
What is her level of anxiety like? Are her fears age appropriate and reasonable or do they seem out of line and interfere with her daily functioning? Has she changed how she acts because of them? For example, is she afraid to go out, calls home frequently, has trouble going to school, won't go to certain places or has a set of ritual and avoidant behaviors?
What is her memory like? Does she forget to do things, have difficulty focusing and concentrating, obsess over small things, and get upset if things don't go her way? Does she have a low tolerance to frustration? What is her support system like? Is she withdrawn and socially isolated or does she have people who she can reach out to? How are things at home? How does she get along with her siblings? Her parents? Does she like to talk?
What are your personal goals for your daughter? Are your expectations realistic and do they match hers? Do you inadvertently pressure her? What is your stress level like? How do you stress her out and how does she deal with it? How healthy is your family and do her problems reflect the family's?
What can you do?
1. Never dismiss or make fun of her fears and concerns. While they may seem silly to you, they're very real for her.
2. See which stressors can be eliminated, changed or improved. Let your daughter know that it's your job to keep her safe. Whether it is a change to a new classroom, a different approach to studying for tests, turning off the TV or offering reassurance, make your game plan together for dealing with the stressors and then set a reasonable time to evaluate how things have been resolved.
3. Teach your daughter techniques for mastering stress. Breathing exercises, imagery (it's hard to feel tense when you imagine yourself feeling like a limp noodle), positive self talk, role plays and imaginary reviews and the use of a safe place (a calm spot that is hers to imagine and go back to as a way to reduce anxiety) all can work wonders.
4. Suggest keeping a journal as a way to monitor daily thoughts and feelings. Have her rate her day so she can see progress or lack thereof over time. Give her as much control as she can have in making things better.
Finally, as a parent, remember, some children feel much better once they have unburdened themselves to you. So while you may think that they are having serious troubles and they have dissolved into tears, by simply sharing their mood with you, they may be feeling great. If that is the case, make sure that you too are able to let go of it and move on. If your daughter continues to be anxious, fearful and unhappy, take it seriously and get outside intervention.
All kids have stress. The question becomes whether they can control it or whether the high levels of stress are controlling them. Good luck!
The writer is a licensed clinical psychologist in private practice in Ra'anana.