Anticipatory anxiety

As a parent, you may be familiar with anticipatory anxiety, even if you haven’t heard the term before. Anticipatory anxiety is what’s at play when your child spends weeks dreading her vaccination appointment, yet when the day arrives, she sails through it like a champ. "What was that about?" you wonder. Or when your son negotiates for days trying to get out of attending a friend’s birthday but eventually gives in and goes, and has a great time! Just like us, children and teens experience anticipatory anxiety, which is the body’s normal response to perceived future threats. In the days and hours leading up to an important event your child or teen may be a bundle of nerves, which is the fight-flight-freeze system in action. It is anticipating the need to protect the body from threat or danger. Although this system is critical to our survival when there is actual threat or danger, it's a big problem when there isn’t.

Common areas of anticipatory anxiety include:

  • Applying to college or university
  • Athletic, musical or other performances
  • Going on a date or to a party
  • Joining a club, team or sport
  • Starting a job
  • Starting school
  • Tests, projects and oral reports

 

In addition to specific events or situations, for youth who have panic disorder, anticipatory anxiety is a contributing factor to ongoing panic attacks. Panic attacks result from misinterpreting bodily sensations associated with the “fight-flight-freeze” response, as being dangerous. For example, a youth may believe that an increase in his heart rate means he is having a heart attack. As a result, he is always anxiously anticipating the worst outcome, staying on the “lookout”, and constantly scanning his body for sensations that might signal another attack.

 

Helping your child or teen recognize and address anticipatory anxiety is important. Most of the examples we've mentioned occur throughout life, as do normal fluctuations in bodily sensations, like panic. The following is a list of strategies that can help:

  • For younger children, provide a reasonable amount of notice about upcoming events. Avoid giving weeks of warning so that your child isn't a quivering mess once the event finally arrives. However, avoid springing the news on him an hour before go time.
  • For younger children, remind them about the positive and fun aspects of the event. Help them to see that worry is causing them to focus only on the scary aspects and forget all about the fun ones. Validate that the event might be scary/difficult for him/her, but there are positive aspects as well. Strike a balance!
  • Remind your child or teen that the physical sensations they are feeling are harmless. They are the body’s protective mechanism to managing danger. However, the system has experienced a false alarm, as there is no danger.
  • Direct your child or teen to their personalized My Anxiety Plan (MAP) and encourage them to use tools such as Learning to Relax, Balanced Thinking, Tolerating Uncertainty, Panic Exposures, and others. 
  • For ongoing situations that continue to generate anticipatory anxiety for your child or teen such as tests, clubs, or social events, consider using the strategies outlined in the Facing My Fears worksheet.