We all know we need to sleep eight hours a night to stay mentally and physically healthy, but this isn’t always possible. If you’ve ever been overly stressed about an upcoming event or a personal matter, you’ve probably found yourself tossing and turning without relief from time to time. For those of us with generalised anxiety, the pain of sleeplessness can be a much more frequent issue. We need sleep for our brain to recuperate and rationally deal with day to day problems and so if we go a night without it, any underlying feelings of anxiety can be exacerbated. This in turn creates further anxiety about not sleeping the following night and so anxiety-induced insomnia can develop into a vicious cycle of restlessness and fatigue. I struggled with this problem for several months during my first year of university but managed to find some ways to tackle it; sleep is no longer so much of an issue for me and I’ve found my anxiety has subsided as a result. For all of you suffering with sleep anxiety, here are some of my top tips to make your way to recovery.
Be realistic
Eight hours of sleep sounds ideal but it is not realistically attainable every single night. Some nights we will naturally sleep less; others you will sleep much longer. If you’re worrying about not sleeping enough, try and be more realistic about your sleep goals. You’ve survived years without sleeping a full eight hours consistently and you can survive now. Always remember that sleep is a biological process that will naturally occur– you will eventually be able to get some rest even if it is for a short period of time!
Reframe your mindset
Sleep anxiety can be make bedtime feel distressing but it’s important that you reframe your perceptions of it and transform it into a relaxing time of day. Try and look forward to bedtime as a period for your body and mind to rest, regardless of how fast you fall asleep. Bedtime can also been reframed as a time for mindfully processing the day you have just had. The Sleep Book: How to Sleep Well Every Night by Dr Guy Meadows provided me with bedtime mindfulness techniques that helped me change sleep into a time for me to let go of my worries and frustrations, which subsequently helped me sleep more soundly every night. I’d highly recommend this book if you feel a lot of pressure when trying to sleep and you want to make bedtime less stressful.
Create a relaxing bedtime routine
We all need to wind down before bed in order for the sleep hormone melatonin to be produced. You could calm your nervous system by doing several of the following:
-Having a hot bath/shower
-Avoiding coffee and alcohol near bedtime
-Watching a calming show that you love (a sitcom for example)
-Listening to relaxing music, audiobooks or ‘Sleepcasts’ on the app Headspace
-Avoiding scrolling on your phone
-Speaking to loved ones
-Read a book!
Have a plan B
Have a plan B for when you find yourself unable to sleep. Rather than simply lying there feeling frustrated, you should think of various calming activities to do as an alternative. If I’m struggling to sleep, I’ll read a book or a magazine until I find myself feeling tired. Other things that have worked for me include jigsaws and word searches; these have distracted me from any anxious thoughts and have helped me calm down before attempting to sleep again. It’s important to get out of bed and do something else if you can’t sleep because otherwise you may begin to associate your bedroom with negative feelings of anger, upset and distress.
Make sleep less of a pressing issue
As hard as it sounds, try not to centre your life around sleep. I remember spending hours agonising over my lack of sleep and boring my friends and family with my anxiety over it. To tackle my insomnia, I got into more of a routine at uni, joined societies, exercised more, and saw my friends as frequently as possible. Soon my life had become so busy that my sleep anxiety was at the back of my mind! Find ways of distracting yourself about these worries and you’ll soon realise that sleep is not the be all and end all of your life; in fact, it’s rather unimportant in the scheme of things.
Anxiety is a form of mental health disorder that is commonly related to worry, nervousness, or fearfulness, that is intense enough to affect a person’s level of social functioning. Specific phobias are considered a kind of anxiety disorder, that is characterised by a solid and unreasonable fear of an object, place, or situation.
Importance of the Topic
Ensuring good knowledge of anxiety and phobias in children is vital, since these ailments can distort a child’s development process, academic progress, and social engagement. Both delayed development, and mental problems, can be avoided by the early identification and management of such symptoms to enhance the child’s functioning.
Figure 1: Anxiety and Phobias
Source: (Davis et al., 2019)
Different Forms of Anxiety and Phobia in Children
Generalised Anxiety Disorder (GAD)
According to DSM IV criteria, children with GAD worry excessively and inappropriately about objects, people, and events. The topics of worry include school, friends, and their family (Davis et al., 2019). This disorder, when it occurs, will take place over a few months during the year.
Separation Anxiety Disorder
Separation Anxiety Disorder is a type of anxiety disorder. It may be observed in children who show an abnormally high amount of distress concerning separation from caregivers, or separation from their home environment (Clefberg Liberman and Öst, 2017). It commonly affects children below five years of age, but may occur in school-age children.
Social Anxiety Disorder
Social anxious children may suffer from social anxiety disorder, which is characterised by a fear of particular social or performance situations, and experiencing distress when in these situations (Davis et al., 2019). They may also worry that other people will stare or laugh at them.
Specific Phobias
These are extreme phobias or irrational fears, which are pegged on specific things or circumstances, like animals, or a certain height, or a fear of being vaccinated (Clefberg Liberman and Öst, 2017). Most of the time, anxiety will result in avoidance reactions.
Causes and Risk Factors
Genetic Factors
Research points out that if a child has been exposed to a family history of anxiety disorders, then there are bigger chances that the child, too, will be a victim (Boyd et al., 2019). These disorders are known to be closely associated with one’s genetics, because they determine the likelihood of being effected.
Environmental Factors
External factors, including any stressful event in the life of a child, may lead to a development of anxiety and phobic responses, ranging from the prospect of losing a parent to divorce, to exposure to violence, and so on (Blanco et al., 2020).
Developmental Factors
There is, also, an interaction of specific age-related factors that see children become prone to anxiety disorders (Boyd et al., 2019). For example, this could lead to young students developing separation anxiety, while older students may develop social anxiety.
Symptoms and Diagnosis
Emotional Symptoms
The symptoms that parents might observe, in children with anxiety disorders, include cases of excessive worrying, fear, or nervousness (REICH et al., 2018). The child may look or behave like they are more stressed than usual, or even as if they are losing their temper quickly.
Physical Symptoms
Specifically, anxiety can include physical symptoms, such as head or stomach-ache, or as experiencing tightened body muscles. This may cause the child to visit the school nurse repeatedly, or involve a need to visit a general practitioner.
Behavioural Symptoms
The individual may exhibit certain behaviours, including refraining from situations like school, social events, or other activities (Heimberg et al., 2017). The child may also likely to show signs of poor concentration, and signs of being agitated.
Diagnostic Criteria
Categorised under anxiety disorders are anxiety and phobias, whereby medical professionals will diagnose a label through interviews, observation and questionnaires. They will evaluate the usual occurrence, length, and severity of the symptoms, to diagnose the presence of an anxiety disorder.
Impact on Daily Life
Academic Performance
Anxiety may result in the suppression of a child’s learning capacity. Anxiety can cause poor concentration which may lead to poor grades, at a period of time when the learner is least able to engage in activities (Wittchen and Beloch, 2018). Childhood anxiety may be a worry for parents. Play therapy is another beneficial strategy that may assist children, since it allows them to communicate fear reduction via play (Gillian et al., 2019).
Social Interactions
Anxiety may make it difficult for children to have, and sustain, relationships with other children. Symptoms, such as avoiding other students, may lead to loneliness, and in an extreme circumstance, they may remain isolated from other people.
Family Dynamics
Anxiety disorders can severely test relationships within the family. Alongside this, research has found that issues, such as pressure placed on the parents, and neglect of other siblings, may also be observed (Bowlby, 2021). One may need to fill in the requirements of the family, for one or another reason, to comprehend and react to the child’s state.
Treatment and Management
Psychological Therapies
CBT is helpful in the treatment of anxiety in children. Anxiety is a common childhood concern. CBT may assist them in noticing self-sabotaging thoughts. Other helpful interventions include play therapy, which can benefit younger children, since they can express their decline in fear through play (Gillian et al., 2019).
Lifestyle Change
Lifestyle changes should include maintaining a healthy diet, exercising regularly, and getting enough sleep. These changes are beneficial to overall mental and physical well-being.
Parental Support
Parents are the pivotal figures in the decision making process. Responding positively to the child, listening to what they say, and engaging in therapy will greatly help the child.
Case Studies or Examples
Real-life Examples
Emmanuela, a ten-year-old female child who has social anxiety, developed a phobia and was unable to speak in class. Emma’s parents took her to CBT sessions, and Emma was gradually able to get better at controlling her anxiety, and progressively become more perceptive to social situations.
Success Stories
An example includes a twelve-year-old boy named Jake, who was diagnosed with a specific phobia of dogs. Exposure therapy gradually made Jake confront his fear. The support provided was pivotal, as it would have been difficult for him to face the fear on his own (Elbert et al., 2022). He eventually became well-acquainted with dogs, and as time passed, he received a dog as a pet.
Conclusion
Summary of Key Points
Childhood anxiety and phobias are a rampant problem for many children, and young people, but it can be addressed. This paper identified the various types of these disorders, their causes and symptoms, which are essential factors to consider if an early assessment is required.
Call to Action
It is also necessary to discuss childhood anxieties and phobias, and remind people that in such cases, it may be necessary to see a specialist. Some children with disabilities may require the services of personal assistants, and early intervention may positively impact the learner, and their families, as well.
References
Blanco, C., Rubio, J., Wall, M., Wang, S., Jiu, C.J. and Kendler, K.S., (2020). Risk factors for anxiety disorders: common and specific effects in a national sample. Depression and anxiety, 31(9), pp.756-764.
Bowlby, J., (2021). Violence in the family as a disorder of the attachment and caregiving systems. American journal of psychoanalysis, 44(1), p.9.
Boyd, J.H., Rae, D.S., Thompson, J.W., Burns, B.J., Bourdon, K., Locke, B.Z. and Regier, D.A., (2019). Phobia: prevalence and risk factors. Social psychiatry and psychiatric epidemiology, 25, pp.314-323.
Clefberg Liberman, L. and Öst, L.G., (2017). The relation between fears and anxiety in children with specific phobia and parental fears and anxiety. Journal of Child and Family Studies, 25, pp.598-606.
Davis, T.E., Munson, M.S. and Tarcza, E.V., (2019). Anxiety disorders and phobias. Social behavior and skills in children, pp.219-243.
Elbert, T., Schauer, M. and Neuner, F., (2022). Narrative exposure therapy (NET): Reorganizing memories of traumatic stress, fear, and violence. In Evidence based treatments for trauma-related psychological disorders: A practical guide for clinicians (pp. 255-280). Cham: Springer International Publishing.
Gillian, B., Anne, C., Mary, M., Peter, A. and Michael, G., (2019). Exposure and anxiety management in the treatment of social phobia. Journal of consulting and clinical Psychology, 52(4), p.642.
Heimberg, R.G., Holt, C.S., Schneier, F.R., Spitzer, R.L. and Liebowitz, M.R., (2017). The issue of subtypes in the diagnosis of social phobia. Journal of Anxiety Disorders, 7(3), pp.249-269.
REICH, J., Noyes, R. and Yates, W., (2018). Anxiety symptoms distinguishing social phobia from panic and generalized anxiety disorders. The Journal of nervous and mental disease, 176(8), pp.510-513.
Wittchen, H.U. and Beloch, E., (2018). The impact of social phobia on quality of life. International clinical psychopharmacology, 11, pp.15-23.
