Can Bad Behaviour be Masking Anxiety?

Disruptive Behaviour

A 9 year – old boy called Thomas has a really bad meltdown in class. He got upset by something one of his class friends had said about him. He shoves the other boy and a fight breaks out. The teacher tries to break them up and calm it down but Thomas goes absolutely crazy and throws all sorts of things around the class room – books – chairs – and then he tips up the tables. He ends up lashing out at the headmaster before falling and banging his head. The secretary calls the emergency services and the boy ends up in A&E.

Most people looking at that scenario would just think that the boy has horrific anger issues, and after all its not the first time that a similar event has occurred.

But, what’s REALLY happening here? Well, after he had been assessed by a Psychiatrist, it turned out that Thomas was suffering with severe social anxiety. Thomas is actually terrified of criticism, even constructive criticism. He is petrified of being embarrassed, so when someone says something that makes him feel uncomfortable, he can’t cope with it, doesn’t have any skills to deal with it, and goes completely off the scale! It’s the same reaction as fight or flight.

You see, disruptive behaviour is often the cause of untreated anxiety. Depending on the child’s age, for example if he were a toddler, Thomas would be throwing a tantrum, as he doesn’t know how to verbalise his feelings.

The fact that he is older means that even though he can probably verbalise his feelings a bit more – it’s a case that he may not actually recognise what those feelings are so it’s even more confusing for him and also the people close to him.

When we normally think of anxiety, we associate it with things like: not sleeping, separation anxiety from mum, bedwetting, stool-holding, going off his food etc. However, in other cases the anxiety can be hidden. Its very common for a child with severe anxiety to suddenly become very angry and lash out at his peers, family and even in some cases his or her teachers, when up until that time they have been as good as gold.

School Problems

It’s not unusual for a child who has severe undiagnosed anxiety to be angry and have meltdowns at school. This is due to the stress and demands they are met with at school, and they can’t handle it. Then naturally the teachers really have no idea what’s causing this anger, which of course looks like it’s just come out of the blue!

At my two clinics (London and Berkshire) I see children virtually everyday with some form of anxiety, and mums and dads are always saying

“I just don’t know what’s got into him/her – he’s usually such a placid little thing”

Children whose parents are going through a separation or divorce are a prime example of the above – they don’t want to make a fuss at home because mummy and daddy are already upset/angry. So, they hold it all in and when they are at school it all comes out as anger.

One of the mums whose little boy I treated recently said:

“Nathan’s dad and I were going through a separation and we actually thought we were doing everything right. We didn’t argue in front of the children. I didn’t let them see or hear me cry at night (or so I thought) we sat them all down and told them what was going on, so they were kept in the loop and they all knew they could talk to either one of us at any time about their worries. However, Nathan took it very badly and became so angry I couldn’t believe the change in him. His teachers were extremely worried as they have never even heard him lose his temper at all! Someone told me about Elaine’s work with children, so I took him and to be honest it was the best thing I have ever done. He opened up to Elaine even on the very first session and she helped him enormously! She taught him loads of techniques that he could use when he felt himself getting anxious. The school were great too!”

Melanie Foreman, Berkshire

Anxiety also causes a lot of symptoms which are very similar to ADHD and ODD (Oppositional Defiant Disorder) and children can quite often be wrongly diagnosed. So how do we tell if it IS anxiety?

The first thing to do is collect a lot of information – from school, from grandparents (other family members who are frequently with the child) and see if the behaviour is the same at school as it is at home. Some children behave like angels at home and like mini terrorists at school (or vice versa).

Look for signs of OCD as these can cause a lot of anxiety for the child. Anxiety is one of the most common emotional problems in children. Some children follow in their mum’s footsteps and pick up their worrying personality. They can develop very severe worries from fear of vomiting to their mum and dad being swept away by a tsunami!

What to look for:

  • Insomnia
  • Loss of appetite
  • Symptoms of OCD – hand washing, intrusive thoughts
  • Separation anxiety
  • Unexplained tummy aches
  • Unexplained headaches
  • Panic attacks
  • Pulling eyelashes/hair/eyebrows out
  • Constantly asking reassuring questions like “Mum you are not going to die, are you?
  • Not wanting to get out of bed
  • Not wanting to go to school
  • Constantly crying

So, what do I do if I think my child has anxiety?

The first thing you should do is to let your child know that you understand that they are feeling worried and anxious and reassure them that you are going to get them some help. Explain to him/her that anxiety is just another feeling – just like anger or sadness, and we can learn to help ourselves overcome it. There are different avenues to go down – the GP may be able to suggest some help, perhaps some talking therapies. Hypnotherapy is also brilliant but if you are really worried do contact:

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