Client Background
An 8-year-old boy is experiencing significant anxiety, particularly around school and bedtime. His mother reported that the symptoms began a few years ago, following the family's move to a new country and a change in schools. At the time, she believed he would adjust naturally to their new environment.
The child exhibits signs of anxiety including shallow breathing, racing thoughts and digestive upset, symptoms that appear to be closely linked to moments of stress or worry. He also struggles with sleep, often unable to fall asleep until the early hours of the morning, despite a consistent bedtime routine and getting into bed around 8:00 p.m.
Although the boy has made some good friends at his new school, he still expresses reluctance to attend, citing feelings of worry and anxiousness while there.
Dietary History
- Diet includes a variety of fruits, vegetables, grains and lean proteins. Meals are generally home-cooked and well-balanced.
- Occasionally skips breakfast or eats very little on school mornings due to anxiety.
- Often experiences reduced appetite and digestive discomfort (stomach aches, nausea) during periods of heightened anxiety.
- Eats a packed lunch at school but doesn’t always finish it. Appetite improves in the afternoon and evening.
- Regularly consumes dairy products, including milk, yogurt, and cheese.
- Drinks mainly water and milk, with occasional diluted juice. No caffeine or soda.
The child’s eating patterns suggest a link between anxiety and disrupted appetite, particularly during school-related stress. Anxiety-induced digestive symptoms may impact nutrient intake and absorption. While his overall diet is varied and balanced, inconsistent eating during anxious periods may contribute to nutritional vulnerability or energy imbalance.
Naturopathic considerations
Anxiety and HPA axis dysregulation: The child's symptoms including racing thoughts, shallow breathing and difficulty falling asleep suggest dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Ongoing school-related stress and unresolved emotional adjustment following relocation may be contributing to a heightened sympathetic nervous system response, leading to chronic activation of stress pathways and poor sleep.
Gut-Brain axis imbalance: Digestive symptoms such as stomach aches, nausea and reduced appetite during stress episodes indicate dysregulation of the gut-brain axis. This may be compounded by anxiety-induced changes in gut motility and secretions. A disrupted microbiome or low microbial diversity could be exacerbating his anxiety and digestive reactivity, suggesting benefit from probiotic support and fermented foods.
Nutrient depletion and nervous system: Periods of stress and poor appetite may reduce intake or increase demand for key nutrients involved in neurotransmitter synthesis and nervous system regulation. Nutrients of concern include magnesium, B6, B12 and zinc. Ensuring adequate intake of these nutrients may improve resilience to stress and reduce anxiety symptoms.
Sleep disruption and Melatonin dysregulation: Difficulty falling asleep despite a consistent bedtime routine may reflect elevated evening cortisol or insufficient melatonin production. Nervous system hyperarousal and poor emotional processing before bed could be interfering with circadian signalling.
Emotional adjustment and environmental stress: The child's reluctance to attend school despite having friends suggests unresolved emotional stress tied to previous life transitions. Environmental and emotional instability may be perpetuating feelings of insecurity and anxiety
Herbal Support
Chamomile (Matricaria chamomila): Acts as a natural antihistamine by inhibiting histamine release.
Oats (Avena sativa): Adaptogen that modulates immune response and reduces inflammation. May help balance histamine levels and calm stress-induced allergic flare-ups.
Ginger (Zingiber officinale): Anti-inflammatory, circulatory stimulant and digestion supporting.
Herbal Formula:
Chamomile (Matricaria chamomilla): 50mL
Oats (Avena sativa): 45mL
Ginger (Zingiber officinale): 5mL
Total: 100 mL
Dosage: 2.5 mL twice daily
Additional Recommendations:
Dietary Modifications
- Encourage a small, protein-rich snack in the morning even if appetite is low
- Include fermented foods like yogurt, kefir, sauerkraut to support gut microbiota
- Reduce excess dairy if digestive discomfort persists; trial 2-week dairy-light period
- Increase sources of magnesium such as leafy greens, pumpkin seeds and oatmeal
- Increase intake of omega-3s via fatty fish and flaxseed oil
Supplement Support
- Children’s multivitamin with adequate B6, B12, zinc, magnesium
- Magnesium glycinate: 100–150 mg in the evening to support sleep and nervous system calm
- Probiotic: Broad-spectrum children’s probiotic, ideally with strains like Lactobacillus rhamnosus GG and Bifidobacterium longum
Lifestyle Recommendations
- Breathing exercises: Introduce guided breathing in the morning and before bed
- Mindfulness tools: Short meditations or kids' yoga apps before sleep
- Create a calm-down box with sensory or comforting items such as a lavender sachet, stress ball and journal
- Maintain consistent bedtime routine but incorporate a wind-down period with no screens, soft lighting, story time, or gentle music
Follow-Up
The child has shown an improved appetite, particularly in the mornings, with less resistance to eating breakfast. His school-related anxiety has decreased reporting feeling less worried about attending school and exhibits fewer signs of anticipatory stress. He described himself as feeling “generally less anxious,” with a noticeable reduction in racing thoughts and digestive upset.
Despite the improvements in daytime anxiety, he continues to struggle with falling asleep, often taking more than an hour to settle, although there has been a slight improvement in his overall sleep onset time.
Next Steps
Update herbal formula to incorporate sleep-specific nervine and mild sedative herbs to address persistent sleep-onset insomnia.