Introduction 1

Part 1: Getting Started with Managing Childhood Anxiety 5

Chapter 1: Worrying About Your Child's Worries 7

Defining Anxiety 8

Analyzing Anxiety 8

Seeing rising rates of anxiety 9

Finding the roots of anxiety 9

Looking for Anxiety in Children 9

Appreciating child development 9

Showing, not telling 10

Checking out various anxiety types 11

Getting the Diagnosis 11

Starting with your child's doctor 11

Considering alternative diagnoses 11

Accepting your child's anxiety 12

Exploring Treatment 12

Leaning into therapy 13

Fueling the anxious brain 13

Providing protection 13

Considering anxiety medications 14

Finding support at school 14

Prioritizing safety 14

Helping Your Child Where You Can 15

Beginning with you 15

Seeing it through 16

Chapter 2: Recognizing That Kids Aren't Little Adults 17

Meeting the Boss: Your Child's Brain 18

The vital hindbrain 19

The emotional inner brain 20

The thinking outer brain 20

Appreciating Plasticity 21

Looking at Chemical Communicators 22

Examining how neurotransmitters work 22

Meeting the messengers 23

Discovering How Emotions Grow 24

Exploring Social-Emotional Milestones 25

Toddlers (2-4 years) 27

Early childhood (5-7 years) 27

Middle childhood (8-11 years) 28

Recognizing Challenges in Pediatric Mental Health 29

Chapter 3: Knowing Your Family Isn't Alone 31

Anxious Kids Are Everywhere 32

Exploring the Rise in Child Anxiety 32

Advancing science 33

Normalizing mental health 33

Increasing screen time 34

Acknowledging the pandemic effect 34

Amplifying background stressors 34

Increasing parental stress 35

Predicting Anxiety 35

Developing brains and anxiety symptoms 36

Sharing genetics and epigenetics 36

Appreciating child temperament 37

Looking at parenting style 38

Accepting Your Child's Anxiety 38

Identifying anxiety early matters 39

Reframing your role 39

Chapter 4: Seeing What Anxiety Looks Like in Kids 41

Recognizing That Anxiety Is the Greatest Mimicker 42

Introducing two different case studies 42

Hunting for clues 43

Looking for a chameleon 44

Monitoring for misdirection 45

Understanding Anxiety's Three Parts 46

Emotional 46

Behavioral 47

Physical 48

Noticing How Child Anxiety Differs from Adult Anxiety 49

Physiology 49

Temperament 50

Environment 51

Time span 51

Distinguishing Types of Child Anxiety Disorders 52

Specific phobias 53

Separation anxiety disorder 53

Selective mutism 54

Generalized anxiety disorder 55

Social anxiety disorder 55

Agoraphobia 56

Panic disorder 57

Identifying Childhood Anxiety Matters 57

Chapter 5: Understanding Normal Childhood Worries and Fears 59

Appreciating the Stress Response 60

Finding signs of stress in kids 60

Recognizing childhood stress 61

Knowing It's Normal to Worry 62

Defining age-appropriate worries 63

Supporting kids who worry 64

Differentiating worry from anxiety 65

Looking at two real-world examples 66

Tackling Fears 67

Maturing from imaginary to reality-based fears 67

Helping a scared child 69

Distinguishing fears from phobias 69

Chapter 6: Watching Out for Medical Mimickers 71

Appreciating the Brain-Body Connection 72

Responding to Tummy Troubles 73

Exploring the causes of CAP 73

Introducing the ENS 74

Looking for clues 75

Warning signs to never ignore 77

Getting the scoop on poop 77

Helping tummy pain at home 78

Managing Sleepless Nights 80

Surveying slumbering symptoms 81

Getting better zzz's 82

Dealing with Nagging Headaches 84

Warning signs to never ignore 84

Distinguishing headache types 85

Relieving headaches at home 86

Experiencing Urinary Issues 87

Peeing too much 88

Peeing too little 89

Handling Concerning Chest Pain 90

Reacting to stress 90

Warning signs to never ignore 91

Taking Care of Tics (Not Ticks) 92

Identifying tics 92

Managing tics 93

Watching Out for Thyroid Disorders 95

Part 2: Diagnosing Child Anxiety 97

Chapter 7: Visiting the Doctor 99

Finding a Great Pediatrician 100

Preparing for the Office Visit 101

Organizing and prioritizing 101

Engaging educators 103

Including all caregivers 104

Asking for a private conversation 104

Preparing your child 105

Understanding Confidentiality 106

Optimizing Your Appointment Day 107

Avoiding "Doctor Office Don'ts" 109

Chapter 8: Walking Through the Psychological Evaluation 111

Getting Ready for a Mental Health Assessment 112

Selecting a mental health clinician 112

Preparing for the visit 114

Explaining the visit to your child 114

Understanding What a Mental Health Visit Looks Like 115

Structured interview 116

Standardized rating scales 117

Cognitive and academic testing 118

Feedback and recommendations 119

Expecting Difficult Questions 119

Social determinants of health 120

Adverse childhood experiences 120

Positive childhood experiences 121

Exploring Alternatives to an Anxiety Diagnosis 122

Attention-deficit/hyperactivity disorder (ADHD) 122

Depression 122

Learning disabilities 123

Neurodiversity or autism spectrum disorder 123

Obsessive-compulsive disorder (OCD) 123

Oppositional defiant disorder (ODD) 124

Perfectionism 124

Sensory processing issues 124

Part 3: Treating Child Anxiety 125

Chapter 9: Exploring Child Therapy Options 127

Understanding the Importance of Therapy 128

Discovering How Child Therapy Works 128

Reframing Therapy Myths 130

"Therapy didn't work for me, so it won't work for my kid." 130

"Won't a pill work faster? Let's do that." 131

"Can't I do this at home? I've been to therapy and know how it works." 131

"They don't want to go to therapy, so we need something else." 132

"Therapy is making kids weaker." 132

Finding a Therapist 133

Affording Therapy 134

Setting Expectations for Therapy 135

Seeing What a Therapy Session Looks Like 136

Mapping out the phases of therapy 136

Choosing online versus in-person 137

Telling Your Child about Therapy 138

Distinguishing Types of Anxiety Therapy for Kids 139

Cbt 139

Act 140

Dbt-c 140

SPACE training 140

Pcit 141

Play therapy 141

Emdr 141

Preparing Yourself for After the Session 142

Chapter 10: Anxiety Medications: What Parents Need to Know 143

Considering Anxiety Medications for Kids 144

Understanding how medications work 144

Knowing when medication is needed 145

Finding a prescriber 146

Appreciating Principles in Medicine Management 146

Building a partnership 147

Respecting individuality 147

Targeting symptoms 147

Recognizing that pills are not skills 148

Starting low and going slow 148

Sticking to one change at a time 148

Preparing for Your Child's Medical Plan 149

Knowing your family history 149

Inquiring about insurance 149

Practicing how to swallow a pill 149

Defining your goals 150

Prioritizing Safety 150

Straight talk: Suicide and kids 150

Understanding the risk 151

Reducing access to means 151

Storing medications and other substances 152

Maintaining bedroom safety 153

Completing safety planning 153

Detailing Commonly Used Anxiety Medications 154

Selective serotonin reuptake inhibitors (SSRIs) 154

Serotonin-norepinephrine reuptake inhibitors (SNRIs) 158

Alpha-agonists 159

Antihistamines 160

Practicing Successful Medication Habits 161

Prioritizing safe storage 161

Normalizing a routine 162

Avoiding self-administration 162

Expecting frequent follow-up visits 163

Looking toward your goals 163

Addressing Common Questions and Concerns 163

"I don't want to turn my kid into a zombie." 164

"I don't want medicine to change who they are." 164

"Don't kids become dependent on these medications?" 164

"These medications never worked for me Why will they work for my kid?" 165

"I've heard these medications aren't FDA-approved for anxiety Is it safe to use something 'off label'?" 165

"My kid is so young; will they need this forever?" 166

"What about long-term side effects?" 166

"What if the medications don't work?" 166

"This dose is the same that their father is on Isn't that too high?" 167

"What about lab work?" 167

Chapter 11: Evaluating Supplements and Nutraceuticals 169

Navigating the Supplement Landscape 170

Distinguishing pharmaceuticals from supplements and nutraceuticals 171

Using supplements with kids 172

Supplementing Smartly 173

Starting with supplements 173

Understanding risks 174

Making better choices 175

Surveying Anxiety Supplements 177

Omega-3 blends 177

Vitamin d 178

Magnesium 178

Iron 179

Zinc 180

Complex B vitamins 181

Probiotics 181