4 Steps For Dealing With Anxiety Episodes

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Guest Blog by “A Foster Dad”

The Day Starts

It’s 7:25am on a school day and the transport worker scheduled to pickup David (fictional name used) the 12 year old boy currently in our care is waiting in the driveway. While we aim to have him ready and on his way by 7:15am as long as he leaves by 7:30am he should get to school on time. Mornings are a struggle at the best of times but this morning wasn’t so bad as David is in the final stages of getting ready and just needs to get his shoes on and fix his hair. On an impulse David decides he wants to take his black hoodie to school with him so he goes into his room to find it.

The Anxiety Storm

As it always does the anxiety storm hits us without warning and escalates quickly. A few seconds after entering his room to grab his hoodie we hear loudly “No, no, no, no, no, no, I can’t find it! Where is it!?” in a suddenly panicked tone. My wife and I endeavour to remain calm (even though our own anxiety about getting to work on time is increasing) and start looking around for the hoodie in places we expect it to be. After a thorough search comes up empty we gently ask him where he remembers having it last. Within the short space of probably barely 1-2min things have escalated quickly. David is rapidly pacing back and forth in quite a state. We can tell his heart rate is through the roof. He appears to be attempting to search for the hoodie but is randomly pacing around in a state of confusion. His verbalisations are rapidly switch between yelling no’s, denying in a defensive and angry tone that he has not lost it and shouting at us to “find it now” and “where is it”. Trying to verbally talk him through calming down or asking him to take deep breaths is met with a condescending “I know how to breath” or “how can I be calm at a time like this!?”. Eventually we decide the only things we can do is he can check at school once he gets there. It takes him a while to accept this but eventually after us answering the same questions in the same way David leaves for school at about 7:45am. It probably isn’t going to be a good day at school today.

We had been regular respite carers for David for about a year, earlier this year his current placement broke down and we accepted him as a temporary emergency placement, but he is still with us for the moment. We are not new experiencing the brunt of these anxiety episodes but this doesn’t make it any easier to deal with. They can come from a genuine and reasonable concern that at times we can predict, other times they are completely irrational over mundane things. We have seen major anxiety episodes leading up to planned respite, being in trouble with school, failing to make friends when attending activities, thinking or talking about previous carers, losing small amount of money, not remembering where he put his hat to taking too long tying his own shoelaces. They can come after a good or bad day, or if he is well rested or over-tired. About the only pattern to the episodes is they escalate extremely quickly.

Strategies for Dealing with Anxiety Episodes

Caring for David has meant focusing on helping him through these anxiety episodes and learning a lot in the process. While our approach may not be perfect there are a few specific things we are trying to focus on which I thought worth sharing. Specific situations can require different approaches and while we still are working through anxiety episodes mostly multiple times a day applying the following strategies have helped to reduce the frequency, duration and severity of anxiety episodes.

  • Step 1 – Brace yourself
    Once you recognize the anxiety storm is coming it’s critical to brace yourself. What I mean is be consciously aware of what is happening. Initially when anxious behaviour starts escalating I identify it from the perspective of my non-anxious self – so I see the behaviour as an over-reaction, silly, dramatic, unnecessary or inconvenient. So without even thinking about it I am frustrated by the behaviour and my instinct is to react to my interpretation of the behaviour. This natural reaction could include things like saying “you’re being silly/dramatic/over-reacting”, raising the tone of my voice to exceed or match the panic I’m faced with, be dismissive or just get frustrated or angry. But none of these things may help to de-escalate the situation and in fact will likely only make things worse.

    “Almost always it’s vitally important to stay calm… take a deep breath to calm yourself before you even try and think through how to handle the situation.”

    Almost always it’s vitally important to stay calm. Identify that this is anxiety and it is likely to escalate quickly and take a deep breath to calm yourself before you even try and think through how to handle the situation. If you match or increase the level of panic things will only get worse. By staying calm you are actually modelling a technique to help the child reduce their own anxiety.
    Staying calm is so easy to say but so hard to do, but it needs to be emphasised because if you get caught up in the panic and are unable to stay calm then it is likely the next steps will be far less effective. Don’t beat yourself up if you failed to stay calm when anxiety comes at the worst time, you were tired or just didn’t recognise it until too late. Just make an effort to think through what you need to do to keep yourself calm. It could be as simple as taking a deep breath or walking out of the room for a few seconds to help you remain calm while you handle the situation.

  • Step 2 – Identify the source
    As the situation naturally starts to escalate you need to try and determine what is the source of the anxiety. This can be challenging as it can often be completely unrelated to the immediate concern being raised. In this case anxiety about a missing hoodie could be triggered by something he is worried about in the coming school day, maybe reminded that he did leave it somewhere and worried about being in trouble for losing clothing, maybe other kids at school the day before had hoodies and he is anxious about not wearing the same clothing, maybe he is anxious about something coming up on the weekend in the back of his mind, or just some other completely random thought. The possibilities are endless and it isn’t always possible to identify the source of the anxiety but with practice it can get easier.
  • Step 3 – Determine immediate action to take.
    This can vary widely depending on if you are able to identify the source of the anxiety but essentially the goal is to de-escalate the situation and remove the anxiety. Different techniques will have varying levels of success for different children and just to make it even more challenging we find it is not as simple as doing the same thing every time, as sometimes something will work and other times it could make the situation worse.
    Some things we have tried include staying calm, removing the source (trigger) of the anxiety (when identified), providing reassurance in a calm tone, trying to logically talk through the concern, deflecting or providing distraction, dismiss the concern, ignore the concern and focus on encouraging them to calm down. Unfortunately it’s not as simple as providing a single suggestion as each child and situation is unique but I encourage you to try different things to see what might work best.
  • Step 4 – Talk through what happened
    After the storm has passed it is tempting to put it behind you and forget about it but you might be missing out on an opportunity to discuss what happened in a calm and logical manner. This could be shortly after, but more often than not is hours later or could even be the next day. Obviously the child needs to be in a calm and cooperative mood before you start raising earlier anxieties, otherwise you risk triggering another anxiety episode.

    “We have found providing empathy and offering support can help provide a safe atmosphere to talk through the concerns openly.”

    The way I approach the conversation is to ask them questions to encourage them to think about what happened while making it clear they are not in trouble but my interest is to provide them with support. I might open the conversation with something like “remember this morning when you got really worked up about losing your hoodie? It made me sad to see you get upset and anxious like that and I was wondering if there is anything we could have done to help you work through that a little bit easier?”. We have found providing empathy and offering support can help provide a safe atmosphere to talk through the concerns openly. They might reveal what they were feeling or why they were feeling anxious. However it is also important to recognise that they may have been worked up and genuinely have no idea why, so if it appears that way acknowledge that this might be the case and it’s fine but you still want to help them work through that.

  • Step 5 – Reflect on what happened
    Think through the events leading up to the outburst and see if you can identify any triggers. Triggers can be incredibly elusive but if you stay perceptive observing patterns and manage to identify a trigger it can offer valuable insight into certain behaviours. From this information it can help you to avoid triggers, be prepared for when you know a trigger will happen or think through some strategies to mitigate the impact of a specific trigger.

    “Triggers can be incredibly elusive but if you stay perceptive observing patterns and manage to identify a trigger it can offer valuable insight into certain behaviours.”

    Consider carefully what came up in conversation following the reaction (if this step was possible), did the child hint at any underlying anxieties or offer suggestions on what might help calm them if it happens again? What suggestions worked and what suggestions escalated the situation? Don’t be so quick to rule out possible things which did not work, as sometimes consistency is important and it may take multiple attempts before progressive is seen.

Invest In The Child

Caring for a child with anxiety is incredibly challenging, but recognize that however difficult it is for you it is worse for the child experiencing it. Don’t just weather the storms but learn from them and be more prepared for when the next one hits. Help your child to identify that what they are experiencing is anxiety and support them to have those difficult conversations about how they are feeling, why they are feeling like that and what practical steps can be done to help calm them. Praise them once they do calm down (no matter how long it takes or how frustrating the experience is) to help give them confidence in their ability to calm down.

I hope some of what I’ve shared here gives you some good ideas for dealing with your own situations. We are only two months in with David and are under no illusions that anxiety will a large part of his life for many years to come. However we have a lot of hope that by investing the time in helping David work through his anxiety he will be better equipped to work through situations on his own and anxiety won’t be a daily challenge getting in the way of his true potential.

About "A Foster Dad":
I’m an Australian in my thirties, married,  and recently started foster
caring. We’ve been married for over 10 years but we have no biological
children. We both work full-time and currently providing respite care
on weekends. Discover more about my life learning to care for kids at:
www.afosterdad.com

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