Performance Anxiety in Children

A child in a state of severe anxiety before exams is a familiar sight in every school, coaching class and mental health clinic.

Being well prepared and being one of the better students in the class somehow goes hand in hand with this form of fear.
These kids develop severe physical and mental symptoms of anxiety close to their exam. Even for trivial exams and assessments.
Stomach aches, headaches, vomiting, restlessness, sweating, breathing trouble, altered behavior to outright panic all symptoms are seen.
It is also customary to BLAME parents, schools and “system” for this phenomenon.
This is far from truth. Because there are other chilled out kids in the same system, school and even home. Same parents have two kids who are polar opposites. I have even seen one of the twins paralyzed by this anxiety and other being an iceberg!
Conventional and popular model of anxiety says that “external agents” are necessary for anxiety. This model is scientifically incorrect.
A large part of anxiety is driven “internally” !
This means that temperament of the child (inborn part of personality), epi-genetics (environmental factors unlocking or shutting down gene expression), and other biological components of their nervous system decide what will be seen as threat by them and how will body react to this threat.
There¬† is “learning” as well. High anxiety in near relatives in the family provides a model for perceiving and expressing threat / fear. Vulnerable children under influence of this model “learn” anxiety in early life and continue to unfold this program all through their life.
This is a scientific explanation of how anxiety develops and perpetuates.
Unfortunately our society has a distorted model of mind that can be described as “romantic” model. It assumes that everyone of us is equal and brilliant. Only circumstances de-compensate us. So this model focuses on changing “environment”
While changing the environment helps a bit, it does not eliminate generation of anxiety.
So treatment of this anxiety must include biological changes, environmental changes (mainly response of near family and school) , psychological training (coping mechanisms, thought change, etc).
Unless all three (bio-psycho-social) components are addressed , treatment is not effective. Contribution of each component varies in each case, it needs to be teased out and treated accordingly.
Romantic models that blame schools and parents for EVERYTHING that goes wrong are unscientific.¬† They undermine child’s best resource – Their family!
Many times anxiety is so severe and incapacitating that medications are needed to create ground for further family and psychological work.
Blind resistance to medications (sometimes for right reasons, but mostly out of misconceptions) keeps the child from getting appropriate help.
No single remedy (medicines, family training or psychological therapies) works except when anxiety is very mild.
I do hope that parents are not unfairly blamed for every anxious child.

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