Understanding your daughter's anxiety

Your daughter is conscientious, dependable and eager to please. And you know for sure that she is smart. But when her anxiety ramps up, doesn't it seem like everything briefly flips to the opposite?

She can become frustratingly uncooperative, to the point that you're both held hostage by her fears. And she doesn't seem able to think logically at all.

Perhaps you're all-too-familiar with some of the behaviours on this list – the typical ways that anxiety can show up. Your daughter may:

• pester you with questions about upcoming events
  
  
• show perplexing indecisiveness over tasks as simple as choosing what to wear
  
  
• be obsessively diligent about her schoolwork, becoming completely undone when an assignment is deemed “too hard” or is not completed perfectly
  
  
• fiercely insist on routines or rituals that “magically” protect her or help her feel in control of her world
  
  
• lash out at you over things that seem inconsequential to relieve her pent-up stress
  
  
• completely lose it when there’s an unexpected change of plans
  
  
• keep you in her bedroom, soothing her worries, till long after she should be asleep
  
  
• become hysterical over intimidating situations, like starting a new school year or preparing for exams.

Why does anxiety have such a powerful hold on your daughter? And given her above-average intelligence, why is it so difficult to convince her that her fears just aren’t rational?

Counsellor Sissy Goff has the answers many parents are seeking. Now the director of child and adolescent counselling at Daystar Counseling Ministries in Nashville, Tennessee, Goff has been helping children and teens overcome anxiety disorders for over 25 years – and she’s seen rates of anxiety in children rise alarmingly in the last decade.

At present, as many as one in five children develop an anxiety disorder, with girls twice as likely as boys to struggle with anxiety. “When something goes wrong in a girl’s world, she usually blames herself,” notes Goff. “Boys are much more likely to blame someone else, such as Mom.” In Goff’s experience, the average age of onset for girls is six years old.

There are many factors that might be contributing to your daughter’s anxiety. However, Goff sees some recurring traits in girls who are beset by disabling anxiety. Goff describes these traits in her book Raising Worry-Free Girls – a book that also provides parents with important tools to help their child.

Commonalities in temperament

While many anxiety-prone girls are shy and introverted, anxiety can plague more outgoing personalities too.

On the whole, girls who struggle with anxiety tend to be conscientious, highly dependable, and very likeable kids. “The girls I see who live with anxiety are some of the most hardworking, caring, intentional, kind, brilliant girls I know,” writes Goff. “Things matter to them. Everything matters to them, which can make life hard. And it can make it hard to know when or how to turn that kind of care off.”

Below the surface, anxiety-ridden girls have two significant stressors in common.

Your anxious daughter is likely feeling an immense amount of pressure, both internally and externally, says Goff. “She wants to please you. . . . She doesn’t want to let you down. She doesn’t want to let her teacher down. She doesn’t want to let her friends down. And she really hates to fail.”

The second stressor is a struggle with recurring worries about the possibility of a catastrophic event befalling her.

Almost universally, anxious girls are reluctant to talk about the worries that harass them. They know that the things they worry about may seem weird to others, and so they stay silent, even as their intrusive, worrying thoughts become more and more difficult to manage.

What are those obsessive worries? They tend to grow out of fears that are normal for the developmental age of the child. For elementary age children, overwhelming anxiety about illness or death of a parent is common. In middle school – when peer approval becomes important – fear of vomiting in class, failing a test or letting down their sports team can become all-consuming. High schoolers worry most intensely about their relationships with peers, or their performance in academics or other arenas. Fears around sexual issues or being a victim of violence (or even a perpetrator) are also prevalent.

Anxious girls tend to fixate on the worst thing they can imagine at their age, explains Goff, so worries about suicide are common in both children and teens. “It’s not that they’re suicidal. It’s more that they’re afraid they might accidentally do the scariest thing they’ve ever heard of.”

Girls lacking an accurate perspective

“Girls with anxiety overestimate the threat and underestimate themselves and their ability to cope. The worst-case scenario becomes a normal life perspective,” says Goff.

As a group, they share a diminished sense of their own competency. “Children who have anxiety feel like they’re ‘less than’ other kids,” notes Goff. “They feel less capable, less durable, less hopeful, less able, less confident.”

Goff frequently counsels girls who are overstretched as well. “The most anxious girls I see are often the busiest,” says Goff. These girls don’t have time to relax, reflect, exercise, connect with friends and get adequate sleep – all of which are important for mental health and building resilience.

Linked to genetics and parental modelling

This may be hard to face at first, but one of the biggest predictors of anxiety in kids is anxiety in parents. “Children of anxious parents are as much as seven times more likely to develop an anxiety disorder than children who don’t have anxious parents,” says Goff. Experts believe genetics is responsible for about one third of the anxiety seen in kids, with anxious behaviour modelled by parents also playing a significant additional role.

Triggered by trauma

Perhaps none of these traits seem to fit your daughter. If so, it may be possible that her anxiety was triggered by a traumatic life event. Victims of a serious car accident, violent crime or sexual abuse, for example, or girls who recently lost a loved one, can suddenly develop anxiety issues.

Competencies anxious girls need

In Goff’s experience, the girls she works with are tremendously relieved to learn that they’re not “weird” after all – that many girls are plagued by fearful thoughts. Where they need substantial help, however, is in building the conviction that they can squelch those fearful thoughts and push past them. And they need the tools that help them do that.

Tools that help her control panic

You may not notice your daughter’s anxiety is building until she’s already quite upset. By then, your logical arguments won’t help. Once her heart’s racing and her palms are sweaty, she’s likely incapable of rational thought. First, she needs to calm the “alarm centre” in her brain – the amygdala – and fear’s physical response in her body.

Goff recommends deep breathing exercises and mindfulness exercises (see the 3 x 5 + 1 method here) that help her focus on her present environment, rather than her worrying thoughts. Slowly repeating a comforting verse of Scripture is helpful here too. These kinds of exercises slow her heart and allow blood back into the prefrontal cortex, the “thinking centre” of her brain. If a child is too upset for breathing exercises, intense physical exercise first can help, advises Goff.

Tools that help her recognize triggering thoughts

Anxiety is always triggered by an alarming thought, but fleeting thoughts are eclipsed by panicky feelings so quickly, it can be hard for girls to capture and evaluate the initial distressing thought.

Goff finds girls can more easily capture those triggering thoughts by attributing them to a “worry monster” who is trying to trick them. “We want her to recognize the Worry Monster’s voice, and then separate that voice from her own. Giving him a name is part of what separates him from her, and his voice from hers.”

The “Worry Monster” label can be helpful for you, too, as you encourage your daughter to capture her thoughts and challenge them: Is the Worry Monster bothering you again? What is the Worry Monster saying? What are you going to say back to him?

Watch for patterns, advises Goff. “Your daughter has certain times and certain situations that trigger her worry. The more she anticipates those triggers, the more quickly she can catch the thoughts once those triggers are set.”

Tools that help her challenge triggering thoughts

Anxious girls need to learn to argue back against the Worry Monster, says Goff. Parents can help by learning about catastrophic thinking and how to help children think optimistically. For some background, see these resources:

Your kids can avoid negative thinking traps

Healthy thinking for younger children

Four lies that fuel anxiety and depression in teens

Helping kids bounce back from setbacks

In her office, Goff helps girls:

• Find perspective – Is that just a little worry, a medium worry or a big worry?
  
  
• Look for evidence – How many times has this awful thing really happened? What's already in place to stop it from happening?
  
  
• Think it through – What's the best that can happen? What's the worst that can happen? What's most likely to happen? If the worst really happened, how would she cope? (Having a plan for the worst-case scenario is empowering and helps her see that she would still be okay.)
  
  
• Remember that she is brave – Recalling other times when she pushed past her fears is helpful.
  
  

Other areas for development

Helping your anxious girl feel confident and capable in many areas of her life is important. “Ask her questions. Elicit her opinions. . . . Give her responsibilities at home . . . Chores are actually empowering for kids,” says Goff.

Let her know that you’re not expecting perfection in everything, and that it’s okay to make mistakes. She needs to start enjoying the process of learning, creating and contributing, rather than stressing about the final result. Praise her for effort, not outcome.

Try to focus your attention – and hers – on all the times she shows she is courageous, rather than focusing on the times when she is anxious. “Sit with her at some point each day and let her tell you where she’s felt brave or like she’s made a step against the Worry Monster,” advises Goff.

Having compassion and empathy for your daughter is essential, yet you need to resist the urge to overprotect her and solve her problems for her. She needs to see that you’re confident that she can overcome her fears herself as she builds her skills. If you or your spouse also struggle with anxiety, it will be very helpful for your daughter to see you learning to manage your own stress too, using many of the same tools she will need.

Left untreated, anxiety usually gets worse. Fortunately though, kids can make remarkable progress once they’re empowered to fight back against it. “Just as I’ve seen an anxiety epidemic in my office,” says Goff, “I’ve also seen thousands of girls who have beaten their Worry Monsters.”

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Sissy Goff's book Raising Worry-Free Girls has wonderful tools and advice for parents, and helpful insights into how to encourage your daughter's faith throughout the battle. Additionally, Goff has a book for girls ages 6 to 11 called Braver, Stronger, Smarter: A Girl’s Guide to Overcoming Worry and Anxiety, plus a book for teen girls called Brave: A Teen Girl's Guide to Beating Worry and Anxiety.

AnxietyCanada.com also has a very comprehensive (and free) online course on how to help your son or daughter. Look for My Anxiety Plan (MAP) for Children and Teens.

Additional resources

Catherine Wilson is an associate editor at Focus on the Family Canada.