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Samantha C. Sweeney, Ph.D.
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Back to School Series: Childhood Anxiety

8/28/2014

1 Comment

 
Going back to school stirs up all kinds of feelings and emotions for children. For some children, those emotions are quite mild, while others struggle significantly with the change of returning to routine. For many children, these feelings will subside, but others will continue to struggle with their emotions. One emotion that can be overpowering is anxiety. Anxiety is a feeling of dread; overwhelming emotion that something bad is going to happen. This feeling is often especially powerful when returning to school. It is not that school itself is always the major issue, although it can be. It is just that school has requirements and demands, whereas summer is relaxed and there is not as much pressure on kids. So how do you as a parent know when general worry has crossed the line and become a significant problem? The following article can help you figure that out.

http://www.psychologytoday.com/collections/201208/back-school/back-anxiety

This article talks about the different types of anxiety that we typically see in children and adolescents. One of the things I like about this article is that it points out that some anxiety is normal. In fact, small amounts of anxiety are helpful. In limited doses, anxiety helps motivate us. Without anxiety, we wouldn't feel that small tinge of discomfort that drives us to stretch ourselves and try to accomplish a new task. And school can be stressful. Your child is bound to encounter things that are hard for him or her (and children should-or else they are not learning anything). So some anxiety is normal, but what happens when it builds to unbearable levels and doesn't subside?

Anxiety becomes a problem when it starts to interfere with everyday life. This may manifest as physical, or somatic, symptoms such as headaches or stomachaches. It may also mean school refusal or school avoidance (this may mean some other things as well-check out my blog from this series on bullying). It may also mean that your child or adolescent is unable to complete their homework, concentrate in school, or relax enough to interact with peers and make friends. 

The article talks about the most common anxiety disorders found in children and adolescents. These are Separation Anxiety Disorder, Generalized Anxiety Disorder, Social Anxiety Disorder, Obsessive-Compulsive Disorder, and Selective Mutism. You may have heard of some of these, but not all. I will describe each briefly below. 

The first is Separation Anxiety Disorder. This is when a child has excessive fears about being away from a caregiver. The child may feel that if they are not with their loved one that something terrible will happen to that person. In this case, the anxiety does not have to do with school specifically, but rather being away from a caregiver in general. If a child has Separation Anxiety Disorder, they are distressed when they are away from a parent or caregiver no matter where they are going. It could be something that they would normally enjoy and take a lot of pleasure in, such as going to the zoo, the park, or grandma's house. If the parent or caregiver is not with them, it causes overwhelming distress. 


Another common anxiety disorder in children is Generalized Anxiety Disorder (GAD). Children with GAD worry about everything. Some children may be able to communicate their worries, but others will be unable to verbalize their fears. These children can sometimes develop physical symptoms that are cannot be medically explained. 


Social Anxiety Disorder is another disorder that occurs in childhood. This is when children fear social situations. As you can imagine, school is full of social interactions and for the child who suffers from Social Anxiety, it can be a very stressful place for them to be. School is not just about what you learn in a textbook. It involves playing with friends at recess, talking about the weekend in the hallway, eating lunch with peers in the cafeteria, and working together on group projects. All of these situations are social and therefore extremely stressful for a child or adolescent with Social Anxiety Disorder.


Obsessive-Compulsive Disorder (OCD) has two components-obsessions or ruminative, anxiety-provoking thoughts and compulsions-repetitive behaviors that briefly relieve those thoughts. Most people have heard of this disorder, but may not understand it fully. A child with this disorder must carry out his or her compulsions or the obsessive thoughts will become overpowering. As one can imagine, this would be difficult in school. 


Selective Mutism is the last common anxiety disorder and I have seen it surprisingly often in my work in the schools. Identifying this disorder requires communication with teachers (so build that relationship-see my previous Back to School post!) so that they can tell you about what they see-or don't see-in the classroom. Selective Mutism is exactly what it sounds like, when a child refuses to speak in certain environments (often school) but will speak fluently in other places (such as home). 


There you have a brief overview of each disorder. I want to reiterate that for most kids, a little bit of anxiety in the first few weeks is to be expected. If that anxiety persists, take a look back at this post and try to determine if it is interfering with your child's functioning. I know that I suggest it often, but this is definitely an area where you should contact your school psychologist. He or she is the person in the school trained in assessment and diagnosis of these issues in particular. You can and should work with your child's teacher to see if some informal strategies might work, but the school psychologist should also be aware of these concerns. You should also seek out a psychologist or psychiatrist to officially diagnose and help treat your child. It is better be to proactive (there that goes again!) than wait until the end of the year when your child is at risk of not passing for the year and then expecting a psychologist or psychiatrist to move mountains. I have seen this happen many times in schools. It is frustrating for everyone involved-parents, teachers, the child-and much of it could have been avoided with an earlier visit for treatment.


I would love to hear your thoughts about this article and blogpost. Comment below, tweet @fpschDrSweeney or contact me directly. Don't forget to check back tomorrow for more Back to School blog posts! We are more than halfway through the series, but there is still more to come. Enjoy!
1 Comment
Carol
8/28/2014 12:24:07 pm

I like the way you describe childhood anxiety in clear, concise terms and provide an article to read as well.

Reply



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