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By Gabrielle Dworkin, LMHC, RPT, GC-C, Child & Family Clinician at JCS

Do the words Back-to-School make you feel excited? I picture sharpened pencils, new boxes of crayons, plus a new backpack and planning a first-day outfit. Most children and teens will have some back-to-school jitters about new routines, separating from parents, schoolwork, new teachers, or social interactions, but they will subside over a few weeks. This is especially true for students who are in a transition year, like starting preschool, kindergarten, middle school, high school, college, or a new school.

Parents may notice some red flags that indicate a child’s anxiety is causing significant distress, including:

  • Continually seeking reassurance or asking repeated, worried questions despite already receiving an answer;
  • Tantrums when separating from caregivers to attend school;
  • Difficulty getting along or withdrawing from family members or friends;
  • Avoidance of normal activities in and out of school;
  • Fatigue, taking longer to fall asleep, waking parents during the night;
  • Loss of appetite or changes in eating habits;
  • Difficulty concentrating;
  • Extreme mood swings or expressing feelings of hopelessness, despair, and worthlessness;
  • Use of drugs or alcohol;
  • Frequent somatic complaints of headaches, upset stomach, or even vomiting.

I always encourage parents to check with their pediatrician for any somatic complaints, such as headaches, upset stomach, frequent vomiting, changes in eating habits, and bed wetting. It is important to rule out any medical conditions before treating any mental health concerns.

Anxiety disorders are the most common mental health disorder in children and adolescents. Children and teens can also suffer from social anxiety that impacts their ability to function at school.  Social anxiety occurs when a person is overcome with fear and worry in social settings, along with deep feelings of embarrassment and fear of being judged by others. Some symptoms of this include feeling nauseous, sweating, nervous shaking, unexpected blushing, and fear of having to talk or perform in front of a group.

The emotional distress that goes unresolved can sometimes lead to school avoidance when students want to go in late, leave early, or skip school altogether. School refusal is an extreme pattern of avoiding school due to emotional distress and is distinguished from normal avoidance by how long the child has been avoiding school, how much distress they associate with attending school, how strongly they resist, and how much their resistance is interfering with themself and their family’s life. The longer a child is absent from school, the harder it is to get back to the routine. Reasons a child or teen may refuse to go to school are:

  • Being bullied
  • Not understanding or failing a subject
  • Rejection from peers
  • Other mental health disorders present
  • Family conflicts or problems at home
  • Physical illness

School refusal is different from truancy which is not typically a result of anxiety. Instead, a teen may not care about school or feel that they do not have a good reason to attend.

Before getting into how caregivers can help their children and when to seek mental health advice, let’s not forget about college students! Anxiety disorders are one of the most common mental health problems on college campuses, according to the Anxiety and Depression Association of America. The increase in antisemitism on college campuses can also contribute to feelings of anxiety. Here are some statistics:

  • 30% of college students reported that stress negatively impacts their academic performance.
  • 85% of college students reported feeling overwhelmed by everything they must do.
  • 6% listed anxiety as their top concern.
  • 5% of college students reported taking medication for anxiety or depression.

Here are some ways you can best help your child of any age with back-to-school anxiety:

  • A week or two before school starts, start preparing children for upcoming transitions by resuming school-year routines, such as setting up bedtime, preparing tomorrow’s clothes, and packing their bags. This means going to bed earlier and putting screens away 30 minutes-1 hour before bedtime.
  • Arrange play dates and meetups with friends before school starts. The presence of a friend during transitions has been shown to improve a child’s academic and emotional adjustment.
  • Visit the school before the first day. Take a tour, meet the teachers, learn how to use a locker (those combination locks were tricky to learn in 7th grade!), and see where classrooms and bathrooms are located. You can also rehearse the drop-off routine and practice walking to the classroom. Inform staff of your child’s anxiety and perhaps develop a go-to person who they can check in with upon arrival (Aide, Counselor, Nurse) as well as who they can go to when they need a break during the day (Aide, Counselor, Nurse, Principal, another teacher).
  • Validate and listen to your child’s worries to help them feel secure. Don’t dismiss or avoid it with “everything will be ok”. Highlight the good and fun times your child has had in the past. Role model stress management.
  • Encourage journaling, yoga, meditation, mindfulness, and calm coloring.
  • Connect with your family. Everyone’s afterschool schedule is busy with sports, clubs, and lessons. Try to eat together at least one or two nights during the week. Turn off all devices while you are eating, so you can focus on the food and each other. There are some question card games that you can use to foster conversation over dinner time.
  • Get out in nature. It has been shown to reduce levels of stress, depression, and anxiety. Smell the roses, head to the beach, take a hike, and look up at the clouds!
  • The best advice is… ask your child what would support them in transitioning back to school. It might be a new outfit or an after-school plan to be more relaxed the first few days. It can be a relaxing family activity or a get-together with a close friend.

If problems persist or increase in frequency and intensity, as well as interfere with their ability to attend and participate in school, you may need to seek professional mental health services. This can include Play Therapy, Cognitive Behavior Therapy, Dialectical Behavior Therapy, referrals for medication from a psychiatrist, or referral for assessment/testing for psychological, neurological, or learning disorders. Please reach out to the Counseling Center at JCS if you would like to see if our services could benefit you or your child at 401-331-1244.

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