Cindi is trained as an elementary school teacher and was teaching the third grade in the school her home church operated when she met Greg, the man she would marry. He’s an electrical engineer and has a salary stable enough to allow Cindi to be a stay-at-home mom who homeschools their five children. During the academic year, their home is a-flurry with subjects ranging from eighth-grade science to second-grade spelling happening all at the same time in their basement classroom.
Emma, age fourteen, is their eldest. She’s mature and responsible; she loves school, makes good grades, and helps out with other kids. Cindi started to notice that Emma had bald spots in certain areas on her head. Emma was also using a makeup pencil to draw in her eyebrows because she no longer had any.
One evening, Cindi decided to ask Emma some questions. Emma reluctantly and embarrassingly admitted to her mom that she was plucking out her own hair.
Cindi was floored. She couldn’t figure out why Emma would do such a thing. She tried to talk with her daughter about this, and thought up various ways to try to help her to stop pulling out her hair. Even though Emma tried to cooperate with her mom’s plans, nothing stopped her behavior. In fact, it only got worse. Finally, at Greg’s insistence, Cindi made an appointment with a counselor.
Both Cindi and Emma were nervous during the first appointment, and the second appointment was just as nerve-racking for both of them. In the third session, the counselor asked Emma some very pointed questions. With her head down and in a whispered voice, Emma revealed that she was really stressed out and felt out of control.
“Pulling my hair makes me feel better,” she said. She said it had become a habit, so much so that she was no longer even aware of doing it.
Cindi was shocked that her daughter would be diagnosed with an anxiety disorder called trichotillomania. She was even more shocked when the counselor said Cindi had generalized anxiety disorder.
Like depression, anxiety is a major mental health problem in modern America. If left untreated it can lead to a number of serious complications. At the extreme end of the spectrum these can include suicidal thoughts, feelings, and behaviors. This is especially true among children and teens and those who are physically, psychologically, and philosophically prone to depression or despair.
In this section we’ll take a close look at the potential link between anxiety and suicide.
Let’s begin by pinpointing exactly what we mean by anxiety. This word is part of a constellation of related terms that need to be carefully distinguished from one another:
Fear: An intense emotional reaction to a legitimate, present danger—something that’s happening right now. It’s a healthy reaction because it activates our survival instincts and motivates us to take necessary action.
Anxiety: An emotional reaction to a perceived, anticipated, or future danger. It’s unhealthy in that it’s incapable of producing any kind of constructive action. That’s because the danger is not here (now or yet) so you can’t respond. Clinical anxiety can produce symptoms such as trembling and shaking, restlessness, sleeplessness, fatigue, anger, and depression.
Worry: A nonclinical term for anxiety.
Concern: This word has two meanings. 1. A “Christian” euphemism for worry. 2. Positive and engaged involvement with another person. Concern is more of an action than an emotion.
Panic: A negative behavioral response to either fear or anxiety.
In essence, anxiety or worry is a thinking process. It’s a bad brain habit that almost always expresses itself in the form of a “what if?” question. The problem with “what if?” thinking is that it shifts your focus. It pulls you out of the present moment (the real moment) and into the future (not a real moment). The future doesn’t exist (yet), and you have zero control over things that don’t exist. As a result, “what if ” thinking causes you to feel out of control. This is the physiological sensation we most commonly associate with anxiety.
As you probably know, anxiety can be mild or severe—or somewhere in between. At the mild end, it can be compared to a couple of Yorkie pups nipping at your heels. At the other extreme, it feels more like a Tyrannosaurus Rex screaming in your face. The range of intensity stretches from harmless at one end of the emotional scale to paralyzing at the other:
Most of us worry about things from time to time. That’s not unusual. It’s when the anxious thinking cripples us so that we can no longer handle daily routines that some kind of serious intervention is needed.
Examples of “What if?” Thinking
“What if my husband loses his job?”
“What if Amy doesn’t like me?”
“What if our son ends up in jail?”
“What if I don’t get the scholarship?”
“What if Gary’s suicide was my fault?”
“What if we come down too hard on our teenager and she runs away?”
“What if I don’t score high enough on the SAT?”
“What if Johnny fails this Friday’s algebra test and never goes to college?”
Where Does Anxiety Come From?
The origins of anxiety are not quite as easy to identify as those of depression. Some researchers suggest a biological component, but there isn’t proof of a biological cause. The most we can say is that some individuals may be born with a greater predisposition to worry than others.
Meanwhile, we know for a fact that anxiety can be taught by example within the context of the family. If you’re an anxious parent, chances are you’ll raise anxious kids, especially if you have a mentality that leads you to say things like this: “Always wear clean underwear in case you get into a car accident and end up in the hospital!”
Stress can also produce anxiety, though not necessarily in every instance. It’s common nowadays to say, “I’m stressed out,” when what you really mean is “I’m anxious.” Stress and anxiety are not the same thing. Stress is pressure imposed on you from the outside. Anxiety is one of a number of possible reactions to stress, and it comes from the inside.
Perfectionism is another possible source of anxiety. Firstborn children are more prone to worry and to be perfectionistic than their younger siblings. Perfectionism and anxiety don’t always go hand in hand, and the cause-and-effect relationship runs only in one direction: you can worry without being a perfectionist, but perfectionists are almost always anxious people too.
Signs and Symptoms
If we want to protect our kids against suicidal tendencies, we need to be intentional about eliminating anxiety. The first step in that process is identifying the problem. This can be a challenge, since anxiety expresses itself in a number of different ways. How can you tell if one of your children is struggling in this area? Here are a few warning signs:
Skewed perspective. Anxiety prevents us from hearing, seeing, and processing clearly. Look for indications of irrationality in your child’s way of looking at the world, such as statements like:
“Nobody likes me! I’m a loser.”
“I’ll never get asked out, ever.”
“I haven’t done anything right, ever.”
Restlessness. If a kid seems edgy or finds it difficult to keep still, there’s a good chance he’s worried about something.
Fatigue. Anxious people feel tired a lot of the time. Falling asleep at inopportune moments is a good way to escape internal worrying.
Lack of focus. Does your child have difficulty concentrating or staying on task? Does she ever sit and stare as if her mind has suddenly gone blank? These, too, can be symptoms of persistent anxiety.
Irritability. This would include excitability, touchiness, and hypersensitivity, as well as outbursts of anger.
Muscle tension. Keep an eye out for nervous ticks and twitches.
Sleep disorders. This includes insomnia as well as a tendency to sleep too much.
Avoidance and isolation. Like a depressed person, the anxious child often finds it difficult to engage in social situations. A tendency to withdraw or self-isolate—especially if it’s a new development—may be a sign of problems in this area.
There’s a difference between true clinical anxiety and the hormone-induced ups and downs of the average child. Here are signs of normal behavior:
- Edgy, jumpy, or tense stomach sensations come and go.
- Physical and/or emotional symptoms are temporary.
- Thoughts are related to a legitimate current situation the child is experiencing.
- Sleep is for the most part consistent.
- Physical and/or emotional symptoms don’t cause any significant inability to perform normal daily routines.
Here are warning signs of anxiety:
- Worry, edginess, jumpiness, or tense stomach sensations occur more days than not and persist for several months.
- Muscle tension tends to be a consistent problem.
- Concentration is difficult, when not the norm for this child.
- Anxiety seems to be excessive for the present situation.
- Anxiety is focused on a possible future situation that may or may not occur.
- It’s difficult for the child to control or contain worried thoughts or feelings.
- Nontypical disturbances in sleep occur (restlessness, difficulty falling or staying asleep).
- A child is easily fatigued for no physically apparent reason.
- Physical and/or emotional symptoms cause significant impairment in social, academic, or other important areas of functioning.
Be aware that introverted kids don’t always show signs of anxiety through their outward behavior. Where they’re concerned, parents may need to take a closer look.
Strategies for Reducing Anxiety
Anxiety, as we’ve said, is basically a bad brain habit. The good news is that habits can be changed and brains retrained, at least in most situations. Anxiety accomplishes nothing because it removes the individual from the present moment and throws him into an imaginary future where he’s powerless to act. This suggests that a strong emphasis on the here and now can be a powerful antidote to anxiety. Matthew 6:34 reminds us of this principle: “Therefore do not be anxious about tomorrow”—the “what if ” of tomorrow—“for tomorrow will be anxious for itself.” The idea is to stay focused on the present moment of today.
Responding to Clinical Anxiety and Panic Attacks
Panic attacks are very different from standard, run-of-the-mill anxiety. They often have no apparent cause. To make matters worse, once a panic attack begins, there’s no way to stop it. All you can do is ride it out—like a bad roller-coaster ride. While this isn’t a great answer, it’s the real, in-the-moment, workable answer to a panic attack. Here’s what you and your kids need to know about panic attacks:
- Once the bar comes down across your lap, the ride’s on and you can’t stop it.
- It will eventually come to an end. It always does.
- As uncomfortable as it is, you won’t die. No one has ever died from a panic attack.
- To the extent you’re able, try to relax your breathing until the attack is over.
A Way of Escape
Severe anxiety is so debilitating that, in some cases, the sufferer can’t think about anything but finding an avenue of escape. Young people who believe they don’t have many choices may be tempted to seek the easy way out by taking their own lives. That’s a temptation the rest of us need to overturn in any way we can.
We need to remind kids with this problem of what Paul said in 1 Corinthians 10:13: “God is faithful, and he will not let you be tempted beyond your ability, but with the temptation he will also provide the way of escape, that you may be able to endure it.”
As parents, as well as teachers, pastors, youth leaders, and other responsible adults, we have the power to show our kids that there are other ways of escaping the pressure. This is a task that can be accomplished, and it will make a huge difference in our world. All it takes is a little bit of practical know-how and a whole lot of love.
You can help your anxious child by implementing a few simple grounding techniques. Begin by urging her to slow down and take deep breaths. She can also burn off some of the energy generated by anxiety by doing something physical, like walking around the room. After that, help her focus her attention on the immediate situation by employing the “3 x 5 + 1” technique. All she has to do is answer the following questions:
- What are five colors I see right now?
- What are five sounds I hear right now?
- What are five things I physically feel right now (not emotions, but sensations like wind in the hair, the room temperature, etc.)?
- What do I need to be doing or thinking about—right now?
This exercise utilizes her senses to pull her back into the present. It can also be used to retrain the brain over longer periods of time. Have her write the four questions on an index card and put it on her nightstand or dresser.
Every morning, after naming the five colors, sounds, and sensations, she asks herself, “What do I need to do right now? Go to the bathroom? Put on my robe?” Once she has the answer, she goes and does that one thing. This is a great way to eliminate “what if ” thinking and get the mind moving in an entirely new direction.
Have your child practice this four-question technique three to five times throughout the day. It doesn’t matter when or where. The object is practice, practice, and more practice. Finally, as she gets ready for bed at night, have her go through the four questions one last time. If your child practices this technique over a two- to three-month period as consistently as
possible, it will effectively retrain her brain to be more naturally grounded in the present moment and reduce her level of anxiety tremendously, if not completely.