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The Anxious Child: 3 Strategies to Reroute the Brain

For emergency help with a mental health crisis, call or text 988 or cal 911.

Interrupt and Reroute Anxiety

I explain to my patients that anxiety is like always looking behind your back for danger, always assuming that danger will happen the next moment. And this is good. For survival. Thousands of years ago. When saber-tooth tigers were still in existence. While there are no more saber-tooth tigers today, anxious brains have not caught up and do not realize this. The good news is that awareness of this and intentional practice to interrupt and to reroute the anxious thoughts can decrease the brain’s doom-inclined pathways. Here are three strategies to do that.

1. Breathing

What happens to our heart rate, breathing, and blood pressure when we are anxious or worried or see something dangerous or scary? Everything goes up! The opposite effect happens when we slow down our breathing. Being more focused on our breathing and slowing down the breathing pace slows down our heart rate and blood pressure. As a result, our brain is tricked into thinking that everything is fine and calm, and relaxes the anxious thoughts, leaving room for thoughts of safety.

Here are three ways to focus on breathing.

  1. Pizza breathing. Here is a >>>video demonstration<<< of it. Basically, hold your hands up with your palms facing you, and overlap the your finger tips so that your hands make the shape of a triangle aka a pizza! Bring that pizza up to your nose. And smell the most delicious pizza ever! Mmmm, so good right? Oh, but it is STEAMING HOT! So we can’t eat it yet. Let’s blow off the steam – foooooooooo. Wow, it smells so good, let’s smell (inhale) it again! Oh, still too hot, so let’s blow off the steam (exhale) again. Anyone hungry now?
  2. Starfish breathing. Start your pointer finger at the outside base of the other hand’s pinky. Inhale as you trace the pinky up and then pause at the finger tip. Exhale as you trace down the pinky and pause in the space between the pinky and 4th finger. Continue this to the rest of the fingers.
  3. Infinity breathing. I made this one up to try to get at a 1:2 inhale to exhale ratio with a nice pause in between. Inhale as you trace half the infinity sign. Then pause and you trace the other half of the infinity sign. Lastly, exhale for a whole infinity sign. Repeat as many times as you need.

2. Likely or Unlikely Game

A kid’s therapist once taught me the likely or unlikely game. The therapist said that if my kid had repetitive worries, I could review them with my kid and ask if that worry is likely or unlikely. When I did this with my kid, I would offer her information and let her choose likely or unlikely. For example, she had a recurring fear that our home would get broken into. I reviewed several safeguards in place for that not to happen – such as having locks and an alarm system. She would choose likely or unlikely. When she had trouble falling asleep for a few days because she was worried she wouldn’t be able to fall asleep, I gave her several facts. She has been able to fall asleep before, eventually she always falls asleep, and we have a plan in place if she can’t – rain/waterfall sounds, and then melatonin. She would then choose likely or unlikely. Same thing with fires in our house when she learned about fire safety at school – fire alarms at home, double checked stoves.

Therapist said that it is VERY important that my child makes the choice. In order to reroute the brain pathway away from the anxiety, she would have to take the initiative. I can lead her to it, but she has to complete the task on her own. Me as a parent telling her the choice to make – likely or unlikely – won’t be as powerful in creating a new, stronger, longer lasting neural pathway in her brain. Now, I might give her a look when she responds that her worry is likely, and, over time, I see that while her mouth and vocal cords make the sound “likely”, her facial expressions tell me she is believing that less and believing that it is unlikely more

3. Using the Senses 5-4-3-2-1

This technique engages all five senses. It helps the brain exit the worry thoughts loop and reroutes it back into the present. It shifts the brain away from the worries and grounds the brain into the physical environment. Use your hand as a guide.

  • Try to find 5 things you can touch.
  • Try to find 4 things you can see.
  • Try to find 3 things you hear.
  • Try to find 2 things you can smell.
  • Try to find 1 thing you can taste.

There are various versions of this to help our brains reroute back to the safety and ground into the present. For example, one of my patients chews gum so that she can really focus on the taste, touch, and feel of her gum in her mouth when she gets anxious thoughts. Another patient told me they will wear thick, soft socks on bad anxiety days because being able to feel the squishiness of the socks around her toes anytime.

Anxiety Busting Tips

These tips take practice. Imperfect practice. Any little bit that nudges thoughts even just a little off the anxious route counts and makes a big difference! Imagine being off by a tiny fraction of an angle off for a spaceship – the trajectory would land it in a very different location. Overtime, a small nudge, could result in a very big transformation! And practice practice practice! Don’t just practice in the anxious, panic attack moments. Practice often and in calm moments so you can be focused. The more practice someone has with these strategies, the more prepared they will be to use them in moments of despair. Also, it’s best to use these strategies under the guidance of a therapist. Don’t try to DIY these things, if possible (and I know poor access to mental health care is a really terrible problem). You wouldn’t try to control diabetes without the help with an endocrinologist and dietician, so try to work with a medical doctor (pediatrician or psychiatrist) and a therapist to best control the anxiety.

If you found these tips helpful, please subscribe to the blog and follow along on Instagram @betamomma to learn more tips about helping kids with mental health struggles. The writing in his blog and any writing by Joannie Yeh is to be used for general info only, not medical advice. Please contact your child’s doctor or your own doctor for your personal concerns. I am not it. Unless I am… in that case… uh… call the office 😋.