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Spotlight
Anxiety and School
As summer comes to a close, many children are likely to experience a case of the jitters about the upcoming school year. Nervousness and anxiety are normal, common reactions to a new situation, and most children find something to look forward to about starting school. But some experience persistent and excessive anxiety that interferes with their academic, behavioral, emotional, and social development. These symptoms may point to an anxiety disorder.
The idea of returning to school or starting a new school may bring some symptoms to the surface in your child. If that’s the case, be assured that although anxiety disorders are serious medical conditions, they are treatable. Read on to learn more.
What is an anxiety disorder?
Anxiety disorders are a unique group of illnesses that fill people’s lives with persistent, excessive, and unreasonable anxiety, worry, and fear. They include generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder (SAD), and specific phobias. Click here to read a more detailed overview.
What kinds of anxiety disorders do children have?
Some anxiety disorders are more common in children, and some tend to be specific to age development. Separation anxiety and specific phobias are more likely to occur from about 6 to 9 years old. Generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are more common in middle childhood and adolescence; panic disorder can also occur in adolescence. As with adults, children with anxiety disorders—and especially teenagers—may have depression as well.
WATCH FOR CHANGES
Further investigation may be necessary when a child seems out of step with peers or exhibits changes or problems in these areas:
- appetite or eating habits
- sleeping habits
- general mood
- schoolwork and grades
- energy and activity levels
- relationships with family and friends
- aggressive behavior
- regression to behavior typical of a younger child
- developmental milestones such as speech and language
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When is it time to consult
a doctor?
Any emotional or physical problem that is particularly bothersome warrants a call to the pediatrician. If your child’s fears persist, consult a qualified mental health professional.
Dr. Daniel Pine, a psychiatrist at the National Institute of Mental Health and a member of the ADAA Scientific Advisory Board, offers this advice: “Parents of a child not making it to school, or even missing just one day, because of anxiety should speak with their child’s pediatrician or consider getting an evaluation by a mental health professional.”
Where can I find professional treatment for my child?
ADAA offers helpful information and checklists for parents to find professional help for their children. To find a therapist who treats anxiety disorders in your area, click here.
Is medication a preferred treatment?
The use of medication is one of many treatment options available to manage the symptoms of anxiety disorders. Click here for answers to frequently asked questions about treating anxiety disorders in children with medication.
What about college students?
While much of the stress and anxiety that college students experience is normal and even healthy, some will experience chronic, relentless anxiety that may be a sign of an anxiety disorder. Visit Got Anxiety? for more information, including an analysis of counseling and mental health services available at America's top colleges and universities. Find helpful Tips for Parents on the final page.
Is there a specific anxiety related to school?
School refusal describes the disorder of a child who refuses to go to school on a regular basis or has problems staying in school. It should not be confused with truant children, who go to school but demonstrate antisocial behavior or delinquency. Parents should be concerned if their children regularly complain about feeling sick or ask to stay home from school with minor physical complaints.
What are the symptoms of school refusal?
Although children experience the symptoms of anxiety in much the same way as adults, they display and react to them differently. This can lead to difficulties in diagnosis. It can also be difficult to determine whether a child’s behavior is “just a phase” or a disorder.
School refusal may show up in the form of physical symptoms shortly before it is time to leave for school. Then symptoms subside after the child is allowed to stay home or is in school, reappearing the next morning. In some cases a child may refuse to leave the house.
These symptoms are common:
- headaches
- stomachaches
- nausea
- diarrhea
Behavior symptoms may also show up:
- tantrums
- inflexibility
- separation anxiety
- avoidance
- defiance
Children in the higher grades have added academic pressure, and stresses may manifest themselves in these ways:
- extreme preoccupation with appearance
- sleeplessness
- rebellion
What are the reasons for school refusal?
Starting school, moving, and other stressful life events may trigger the onset of an anxiety disorder. Often a symptom of a deeper problem, anxiety-based school refusal affects 2 to 5 percent of school-age children. It commonly takes place between the ages of five and six and between ten and eleven, and at times of transition, such as graduating from elementary school and middle school.
Children who suffer from school refusal tend to have average or above-average intelligence. But they may develop serious educational or social problems if their fears and anxiety keep them away from school and friends for an extended period of time.
Anxieties differ among age groups, but these are the most common stressors:
- separation anxiety
- concerns about academic performance
- anxieties about making friends
- fear of a teacher or bully
Children may also have common fears concerning school:
- riding the bus
- eating in the cafeteria
- using the school bathroom
- being called on in class
- changing for gym class
- interacting with other children or teachers
- being picked on by peers or older children
School refusal may adversely affect not just a child’s education, but socialization and coping skills and self-confidence, too. Research has shown that if untreated, children with anxiety disorders are also at higher risk to be more vulnerable to substance abuse.
What else can parents do?
It’s important to keep your children in school. Missing school reinforces anxiety, rather than alleviating it. Here are some other things you can do to help your child develop coping strategies for school anxieties as well as other stressful situations.
- Expose children to school in small degrees, increasing exposure slowly over time. Eventually this will help them realize there is nothing to fear and that nothing bad will happen.
- Talk with your child about feelings and fears, which helps reduce them.
- Emphasize the positive aspects of going to school: being with friends, learning a favorite subject, and playing at recess.
- Arrange an informal meeting with your child’s teacher away from the classroom.
- Meet with the school guidance counselor for extra support and direction.
- Try self-help methods with your child. In addition to a therapist’s recommendations, a good self-help book will provide relaxation techniques. Be open to new ideas so that your child is, too.
- Encourage hobbies and interests. Fun is relaxation, and hobbies are good distractions that help build self-confidence.
- Help your child establish a support system. A variety of people should be in your child’s life—other children as well as family members or teachers who are willing to talk with your child should the occasion arise.
- Learn about your child’s anxiety disorder and treatment options. For more information about school refusal and children’s anxiety disorders, click on the resources listed below.
Resources
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