What Does Anxiety Look like in a 4.5 Year Old?

Our 8yo has been diagnosed with anxiety, and many of his struggles are similar to what CoCoMom described. He is a perfectionist, and is extremely h*** o* himself. Even when he was younger this was an issue, wanting his drawings and handwriting to be perfect. Now it's centered around every grade needing to be a 100, even when he's working on challenging subjects. That is his expectation, not ours. He has extreme anxiety before tests, causing all sorts of stomach issues, but he usually ends up doing well on the tests. My brother was/is exactly the same way.

He also struggles with time, and has since he was very young, even as young as 3 or 4. He hates birthdays because he worries about getting older, moving out of the house, and eventually getting old and dying. This is extremely stressful for him. He struggles with it for weeks before his birthday, and for a bit afterward too. He also LOVES the holidays, but gets so upset at the thought of them ending that he begins getting anxious about when they will end before we even get to Thanksgiving. I spend a ton of time with him trying to help him learn to appreciate the moment. He has a calendar in his room where he can check off the days, but it's more so that he can see that we still have so many days left to enjoy.

He gets anxious at the end of the school year because he loves school so much that he doesn't want it to end, but then gets upset at the end of the summer because he loves summer so much that he doesn't want that to end either. He just doesn't handle transitions well, but he doesn't have behavioral issues either. He just gets anxious and sad, but he doesn't behave badly.

As for seeking help, his anxiety has always been an issue, and we've discussed it off and on (briefly) with his pediatrician for years, but it didn't become a major concern until this school year. This year his anxiety intensified. We started asking for help from the school counselor. Our son loves her, and feels comfortable with her, so we figured it was a good place to start. I'm not sure how much she has really helped him, but he likes knowing she is there to help him, so that alone may help him some with anxiety at school. His teacher this year is also fabulous. Her daughter has always struggled with anxiety, so she is good about noticing when he is feeling anxious, and she tries to help him feel more at ease.

I also met with his pediatrician who knows our son very well. We discussed having him meet with a psychiatrist or psychologist, but feel that my son would feel even more anxious in that situation. He feels that what we're doing now is working best. Our son is happy and well-adjusted most of the time, and we help him through his anxious times. He did suggest that our son spend some time talking to my brother about how he deals with his anxiety. My son loves his uncle, and it will likely help him to know that he isn't alone in feeling anxious. My husband, oldest son, and I are all extremely laid-back, and this is obvious to our youngest son. He feels like the odd man out sometimes, and has expressed to us that we just don't understand how he feels. It breaks my heart when he says that because he sounds so alone. The doctor suggested that my brother may be able to give our son some tips on how to handle the anxiety, but even more importantly, could offer emotional support.

I'm really sorry this got so long. This has been a long, difficult road for us this semester, not knowing what to do. Like I said, he is so happy most of the time, but then when he's in a bad stretch - it's awful. I hope that you find the help you need.

My daughter was diagnosed with anxiety in the 98%ile at 6yo and in 1st grade (so a bit older than 4.5, but still fairly young) as part of her IEP testing.

She had some fairly severe perfectionist traits. Extreme self-critical behavior if she didn't do something correctly. She would say "I'm not any good" but it wasn't attention seeking, it was more conversational.... which was actually kind of scary and sad.
Once when copying spelling words she was unhappy with how she made one of her letters and she took her pencil and began "slashing" the paper with marks all over it.
She also struggled with "letting things go", so if she spilled her milk or whatever she would mention it DAYS later.

I actually worked with a therapist for ME. Her dad and I divorced when she was 4 and we moved in with my mother. She went to an extremely good Kindergarten, but the focus of that school was on test scores and it wasn't a good fit. I moved her school for 1st grade and she was diagnosed with a learning disability that now (at 12) has sort of evened out. Basically she could READ at a 7th grade level, but her spelling and writing couldn't even be rated on the chart it was so low. She could pass tests if given verbally, but would fail if she had to do the written test.
Her dad is also VERY critical and I'm sure that she "learned" most of her coping behaviors ("it must be me") from watching and listening to me.

She didn't do well in activities (like ballet or soccer) because she would get very frustrated if she couldn't do something quickly. And, if she COULD do it quickly, well, then it wasn't good "enough".

I remember that I set "failure goals" for her. Ok - you will try the step 5 times before you should be able to get it 'right'. or, you have 6 pieces of paper, draw a house 4 times before you color it in. That seemed to help her A LOT with taking the pressure off of her.

I parented her with allowing her to have as much control as possible, without giving her POWER..... for example pretty early all clothing choices were hers (from the clothing I hung in her closet, so it was always seasonally appropriate etc). This also seemed to help.

I also taught her "coping strategies" so "take 3 deep breaths" or when we were going through the divorce i would have her physically go into her closet to "pick a new attitude". Or if she was mad I told her she could go in her room and punch the pillow as many times as she wanted. I found these to be VERY helpful and the more areas I could give her control and something to DO the less anxious she would be.

I focused on fixing mistakes rather than getting angry with her or telling her what she did was wrong. That was a tip from the therapist that I saw.... so, in the spilled milk example instead of saying "you shouldn't have....." I simply said "please clean up the milk".

I found that it was helpful to provide structure around what would be happening. So..... "Today we have errands to run. We are going to start at Target and go to 4 or 5 stores. We will end with the grocery store before we come home. Why don't you pick a piece of fruit that you can take with us and eat in the car".

She still struggles with being very self-critical, and she is now 12. It's MUCH better than it was when she was younger, but this is something we work on consistently and probably will throughout her life.

She has had an on-again off-again relationship with her dad (who lives in another state). I did take her to a therapist because her dad told her he was "done" with her after she didn't return play quick enough during a Words With Friends game (I'm serious) and then didn't talk to her (return texts, calls etc) for 3 months. She went once and during the session scratched her ankles so badly with the end of her shoe laces that 2 days later the marks were still there. She has a return appt next week, and I am hoping it will be beneficial.

Hope that helps.

My daughter is 5 and was diagnosed with a social anxiety disorder at 4. She is getting better but was very focused on what she wore and for all of 4K she would only wear the "ugliest clothes" so "no one will think I am cute". Even though at home she was very into looking pretty and wearing princess dress up stuff. She also has issues with how her socks, shoes, sleeves etc feel on her skin which I think is a indicator of anxiety in kids. I am not sure I buy into sensory integration disorder 100% of the time with these issues. I think a lot of times it's really just anxiety.

She has social anxiety so she can't talk, make eye contact or move around other people if they are trying to interact with her. She has never spoken at school and cannot eat around others in school or use the restroom with them.

She sees a therapist who specializes in childhood social anxiety issues and he works with her teachers. We don't pressure her at this point. She is only 5.5.

My daughter was diagnosed with anxiety recently but had exhibited symptoms since 10th grade two years ago. Like CoMoMom's daughter, she has some OCD and wants to be perfect; but most of all, she wants to please me! She also has anxiety during transitions and esp. going to new places, traveling and doing things other than the routines.

She would find faults in others, talk incessantly, won't listen and won't let go to the point of wearing our patience. When finally she realizes that she was over bearing, she would apologize profusely and say she is no good, etc. and need us to soothe her to calm her down.

After two years of struggling with that numerous times daily, we decided to see a psychiatrist who prescribed some SSRI medication. It does not eliminate anxiety but it decreases its intensity from her obsessing with the
problem for days or weeks to being able to be reasoned in a matter of minutes. This is such an improvement that calms everybody down quicker
and makes us all much happier. She is able to feel better about herself and we are able to talk things over. In the long run, we hope that she will learn to be able to control her own anxiety and does not need medication.

I am not advocating to relying on medication for children because it does not eliminate anxiety; it only lessens its reaction. Cognitive Behavioral Therapy (CBT) is also recommended !