The Parents Guide to Death, Grief, and Child Anxiety

griefguideOne child may scream in agony. Another may start kicking her toys. A third may hide under his bed, refusing to come out for a week. Each of these behaviors can be an anxious child’s reaction to grief.

There are no rules on the “right way” anxious children should grieve. There are no rules how anyone should grieve, for that matter. The important thing for parents is to be there for your child to offer support and a sounding board for the emotions following a death or loss – regardless of how your child may express them.

Explaining Death to Your Anxious Child 

Whether your child is going through the death of grandma, a playmate, a parent or even the family dog, being honest is a must. Trying to shield your child from death can actually make anxiety worse, according to the National Center for Education in Maternal and Child Health. 

“Many adults think they are protecting children by leaving them out of the discussions and rituals associated with the loss,” the Center says. “However, when the normal grief process is denied them, children often feel more anxious, bewildered, or alone.”

Your child’s imagination can fill in the blanks on what happened if straightforward answers don’t come. And imagination can actually be far more horrific and scary than the truth.

Honesty is the best bet at any age, as is answering and encouraging questions. Reinforcing that all feelings your child may have about death are perfectly OK is another good move. While children vary in maturity, KidsHealth offers a general overview of development.

Up to age 5 or 6: Children this age see everything on literal terms, so using euphemisms like “passed away” doesn’t work all that well. What may work instead is noting that a person’s body stopped working, either from old age or from an accident, and the body is going to the cemetery. Also discuss any spiritual beliefs you may have or want to share. This age group may also not grasp the finality of death.

Ages 6 to 10: More detailed explanations may be appropriate, although children may still not understand that death is a part of life for everyone. For instance, they may think making promises to do something like behave better in school can be used as a trade-off to stop grandma from dying. This age is also prone to personifying death as the boogeyman or monster in the closet.

Ages 11 to teens:  This age group is beginning to understand that death happens to everyone. Older children may start asking about their own mortality. Honest explanations remain the best answers.

Grief and Reaction to Death

Exactly how your child grieves or reacts to death depends on numerous factors, according to the National Association of School Psychologists and bereavement psychologist Robin Goodman.

Death can signify loss on many levels, and those levels play a role in the grieving process. The loss of the actual person in your child’s life has the greatest impact, but that loss can also signify additional losses and changes. These include a loss or change of security, identity, a certain lifestyle or in the meaning of life.

Other factors include the type of death experienced, how family members are responding to the death and the level of support your child receives from family, friends or at school. Your child’s personality, maturity level and the quality of the relationship your child had with the deceased play a part. If he just fought with grandma and grandma then dies, for example, your child may be riddled with guilt.

Overall life stressors play a role in reactions to death, as do high levels of anxiety. A stressed-out child who is already warped with worry is likely to have a tougher time getting through the grieving process than others.

The Five Stages of Grief

Anxiety, sadness and confusion may be part of a grief at any stage, and recognizing the five stages of grief can further help you understand what your child is experiencing.

Denial: Grief often kicks off with a wholesale unwillingness to even talk about the death or loss.

Anger or guilt: This stage involves blaming other people – or themselves, for the death or loss, even if there is no possible way anyone could have played a part in it.

Depression or sorrow: The sorrow stage of grief is often accompanied by distinct changes in behavior that exhibit signs of depression. These include lack or loss of appetite, fatigue and disinterest in things that used to excite them.

Bargaining: Here’s where children may make promises to change their behavior in an attempt to regain control of the situation. 

Acceptance: The final stage is an overall admission that the death is, in fact, for real. This stage can easily be the most painful, as the truth hits home that the child is suffering from a significant loss that is real and often agonizing.

When to Get Help

While a child’s reaction to death and grieving process can take many forms, psychologist Robin Goodman points out several red flags that can indicate a child needs additional help with his or her feelings. These include:

  • Excessive denial
  • Extended symptoms of depression
  • Vague and generalized feelings of depression and guilt not connected to the death
  • Loss of ability to express joy
  • Withdrawal from friends, family and support or lack of comfort from support network
  • Extended and extensive physical ailments
  • Becoming prone to accidents
  • School refusal or decline in grades
  • Destructive outbursts or inappropriate euphoria
  • Illegal or inappropriate behaviors
  • Chronic anxieties about own mortality
  • Acting like the person who died
  • Repeatedly pining to join the deceased in a manner that suggest self-harm 

How to Get Help 

A number of groups offer support for people of all ages going through a difficult grieving period. Check with your child’s school or doctor for possible suggestions. Opting for short-term family therapy may also help.

The positive effects of family therapy can stick around long after the grieving has decreased, especially for younger children, according to a study published in the Journal of Child Psychology and Psychiatry. The study looked at 83 children under the age of 16 who lost one of their parents.

The 45 families involved in the study were divided into two groups, with one of the groups assigned to six family therapy sessions within three to five months of bereavement. After one-year and two-year follow-ups, the group that received family therapy treatment showed benefits that included higher levels of mental and physical health in the parents as well as more positive health and behavior in the children.

Grieving is a process, but that process should not be a permanent one. Knowing when to seek outside help can alleviate some of the pain, just as can knowing when to listen and offer a hug.


Study Info:

  • Black, D. and Urbanowicz, M. A. (1987), “Family Intervention with Bereaved Children.” Journal of Child Psychology and Psychiatry, 28: 467–476. doi: 10.1111/j.1469-7610.1987.tb01767