Difficulty sleeping. Wanting to skip school. Stomach problems. Acting out. If your child struggles with anxiety, it’s hard to watch him or her suffer. You wonder how to help. And sometimes your best intentions backfire and make things worse. UNC Health child psychiatrist Nadia E. Charguia, MD offers six tips to make life a bit less stressful for you and your child.

1. Try to anticipate situations that may cause your child anxiety. Dr. Charguia says it’s helpful to try to anticipate when your child might get anxious and talk to him or her about it. For example, if your son is worried about having to do a presentation in front of his class, encourage him to open up to you about his apprehension and what might be behind it. “Bring up the situation that may cause anxiety and ask open-ended questions about it, such as, ‘I wonder how you’re thinking about it and how you’re feeling about it,’” Dr. Charguia says. But while talking about the anxiety is helpful, labeling it isn’t, she adds. Don’t say, “Is this making you anxious?” or “Are you scared about this?” These types of questions can feed the cycle of anxiety. Instead, encourage your child to start to identify and talk about his or her feelings.

2. Gradually expose your child to what may be causing his or her anxiety. If you can identify a situation that may cause your child anxiety, try to expose him or her to that situation early. Start with minimal exposure. For example, if your daughter is going to transition from preschool to kindergarten and that change may cause anxiety, begin reading books about school and show her pictures of kids in kindergarten. During the summer, visit the school (if it’s open and guidelines allow entry) or just take a walk by the school. “There are ways to gradually expose your child to a situation that may cause anxiety and then help your child work on coping skills,” Dr. Charguia says. “First, they are coping with the idea.”

3. Know that avoidance is not the answer. It can be difficult to see a child anxious, so parents often try to avoid situations that may cause anxiety. “A pattern parents sometimes get into is making changes on their child’s behalf so they won’t feel anxious, but that can be very limiting for a child,” Dr. Charguia says. “If they don’t learn how to face the anxiety and cope with it at an earlier age, then we’re setting them up to become anxious teenagers and adults.” Dr. Charguia says it’s important to have your child proceed with the situation that is causing the anxiety. For example, if your son does not want to attend a school event, encourage him to attend for a pre-determined amount of time and then pick him up if he still wants to go home at the agreed-upon time. He may surprise you and decide to stay. “It is fine for children to know you are there as emotional support so they know there is a fallback, but you need to help them move forward and through the anxiety,” Dr. Charguia says.

4. Don’t downplay his or her anxiety. A key to understanding your child’s anxiety is validating it. “We often either minimize their fears or tell them they’ll be fine,” Dr. Charguia says. “But this can shut down the conversation with your child and make him or her not feel heard.” For example, if your daughter is struggling with stress, let her know that you understand she is feeling anxious and help her explore why she might feel this way. Try to see it through her eyes. “It could be that they’re associating an outcome with a situation that to a parent may seem to be an irrational or overdramatic connection, but for them it is real,” she says. “By understanding the importance of helping your child feel validated, you can help them learn to better understand and work through such struggles.”

5. Practice self-awareness. Sometimes even the most well-meaning parents can make things worse for their anxious child by projecting their own fears onto the child. Instead of sharing your fears with your child, Dr. Charguia says it’s important to talk to another adult such as a co-parent, friend, or mental health professional. “A child is a product of his or her environment. If anxiety exists within the home, then it’s very common that the child will also exhibit that same level of anxiety,” Dr. Charguia says. “To help combat this, we can work with families to provide support, education, and awareness of the patterns that may be causing the anxiety.”

6. Make sure your own needs are met. Typically, young, developing children form a bond with their caregiver that allows them to seek reassurance as needed and eventually develop their own ability to self-soothe. This is called attachment. However, if a parent is suffering from anxiety, depression, or another psychiatric illness and is not receiving adequate treatment and support, there is a risk that attachment with their young child can be challenged. “If a parent’s needs remain unmet and the child does not have an appropriate attachment experience in early periods of development, then that can lead to an increased risk for anxiety or other mood disorders, such as depression, as they grow older,” Dr. Charguia says. She stresses the importance of parents making sure they take steps to care for themselves, in addition to their children.

If you think your child may have a problem with anxiety, talk to your child’s pediatrician.