Don't Worry, Mom

Coping with anxiety in families

Back to School and Back to Anxiety Part I

Child anxiety and how to recognize it

Every year when the air starts to turn crisp and colder and I start seeing back to school commercials on TV, I have the same nightmare. I arrive at school only to realize that I forgot to study for an exam. I wake up with my heart beating out of my chest and covered in sweat.  It doesn’t matter that I haven’t been in school for years—I still have that dream every year and it still instills terror in me.

As a kid, I worried a lot about school. I had nightmares. I sleep walked. I cried a lot. I was an anxious kid who was very achievement-oriented and terrified of failure.

So at this time of year, I always think about how many kids may be going through what I used to go through—the many kids having school-related nightmares and so terror-stricken over the idea of returning to school that they are unable to function.

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So how do we recognize kids’ anxiety? And how do we know if our child’s anxiety level is typical or problematic?

Recognizing anxiety

Typical anxiety

Some anxiety about returning to school is typical in kids. Most kids have a little anxiety about who their teacher will be and what the new year will bring. Kids may have some difficulty falling asleep or some nightmares at the very beginning of the school year. The child may cry and initially refuse to go to school, but the child is able to calm himself/herself down and successfully make it to school.  Some children may even experience some anxiety for a short period of time upon arriving at school, but this anxiety dissipated within a short period of being at school and the child is able to participate in classroom activities. The child may continue to have anxiety for the first week or two of school, but as time wears on, the child’s anxiety diminishes and soon the child is going to school with little to no anxiety.

When anxiety starts to get in the way

For some children the anxiety continues. These are often kids who are suffering from an anxiety disorder. Signs that a child is experiencing an anxiety disorder include frequent headaches, stomach aches, difficulty sleeping, nightmares, and avoidance of anxiety-provoking situations, such as giving a book report at school or asking questions in school. Some children may refuse to go to school and throw a tantrum when it comes time to leave for school.  If this continues beyond the first few weeks of school, your child may be experiencing a level of anxiety that is causing him/her significant distress and getting in the way of his functioning. 

Many children experience school-related anxiety, but this anxiety may be for different reasons.  Below are some brief descriptions of common childhood anxiety and related disorders.

Separation Anxiety Disorder

Children who suffer from this disorder have difficulty separating from their parent or guardian. They may have difficulty going to school, going on a play date, or sleeping in their own bed. At a young age, most children experience some anxiety about separating from their parent for the first week or two of going to school, but if it continues, the child may be experiencing separation anxiety.

Generalized Anxiety Disorder (GAD)

Children with Generalized Anxiety Disorder are worriers. They worry about all kinds of things but often cannot express exactly what their worries concern. Children with GAD often experience restlessness, difficulty sleeping, physical complaints like stomach aches, and irritability.

Social Anxiety Disorder

Children with social anxiety disorder fear social situations. The particular types of social situations that are feared vary by child. For some, they fear speaking in class, asking the teacher for help, or reading in front of the class. For other children, the fears focus more on peer relationships and making friends. 

Obsessive-Compulsive Disorder (OCD)

Children with OCD experience repetitive anxiety-provoking thoughts about particular topics and engage in repetitive behaviors to reduce their anxiety. Common topics are concerns about germs, order, and doubting (such as doubting whether doors are locked, the stove is turned off, etc).  Common compulsions are repeating behaviors (flipping a light switch off and on), counting, washing, checking things, and asking for reassurance.

Selective Mutism

Children with selective mutism do not speak in specific situations—often at school—but speak freely in other situations, such as at home and in places where they are comfortable. Some believe that this is a severe variant of social anxiety disorder.

 

Seeking help

There are obviously many other reasons why children may not want to go to school, such as learning disorders, ADHD, issues such as wetting his/her pants, or even being bullied; therefore, it is extremely important to talk with a child about what their school-related anxiety is stemming from. 

If a child’s anxiety is lasting for a long time (such as months) and seems to be causing him/her significant distress or getting in the way of the child school performance, social abilities, or functioning at home, that is when it is time to see a psychologist for an evaluation. Often your pediatrician can make a referral to a psychologist in your area; however, below are some resources that may also be helpful:

Information about diagnoses:

http://psychology.case.edu/research/fear_lab/diagnoses.html

Information about common types of treatment:

http://psychology.case.edu/research/fear_lab/treatment.html

Finding help:

http://psychology.case.edu/research/fear_lab/links.html

 

Next time: Back to School and Back to Anxiety Part II: Reducing back to school stress

Copyright Amy Przeworski

Follow me on Twitter @AmyPrzeworski https://twitter.com/AmyPrzeworski

 

Amy Przeworski, Ph.D., is an assistant professor of psychology at Case Western Reserve University and specializes in anxiety disorders in children, adolescents, and adults.

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