How to Cope When School Anxiety Lingers

US News

Back in August, those jitters seemed normal. Sure, your kid was worried about who she'd sit with at lunch, how he'd handle the workload or what her friends would think about her first-day outfit. It wouldn't be the start of a new school year without some nerves, right?

But now we're a month in, and the anxiety still hasn't tempered. And that, experts say, is worrisome. Anxiety disorders affect at least one in eight children, according to the Anxiety and Depression Association of America, and though it's unclear how many experience school anxiety, experts say rates appear to be rising. The National Institute of Mental Health estimates that 25 percent of 13- to 18-year olds will experience an anxiety disorder - an increase of twentyfold over the past 30 years. If left untreated, these kids are more likely to perform poorly at school, miss out on important social experiences and engage in substance abuse.

"For some kids, it's so severe that they can't even get themselves into the school building each day," says Ann Lagges, a child psychologist and co-chief of the Mood Disorders Clinic at Riley Hospital for Children at Indiana University Health. "Their anxiety is so intense that I've seen some high school students have to drop out. They usually end up getting their GEDs, but they do need to figure out a way to address the anxiety."

[Read: Can Your Mental Health Affect Your Longevity?]

Though symptoms vary by age, kids with school anxiety may complain of physical symptoms before it's time to head to class, or repeatedly ask to visit the school nurse. If it's not a headache, it's a stomachache or nausea. Sometimes these ailments are made up to prove they shouldn't go to school; other times they're real, brought on by nerves.

If the child is allowed to stay home, these symptoms tend to quickly disappear - only to return the next morning. Younger kids will likely express their fears and request reassurance from mom and dad: "Can you stay at school with me today?" Anxious students may also appear overly clingy, experience sleep problems, show signs of low self-confidence and avoid social situations.

As kids get older, school anxiety materializes in different ways. High school students, for example, often respond to stress by developing eating disorders or experimenting with drugs. Teens may appear withdrawn or show a lack of responsiveness in the classroom.

[Read: Binge Eating Disorder: A Diagnosis for Healing.]

About 2 to 5 percent of kids experience anxiety-based school refusal, which means they refuse to go to school or have problems staying in school. This is often triggered by moving or other stressful life events, like bullying or parents getting divorced. These kids clock prolonged absences and then expect the worst: "I can't go back. People will give me a hard time about being away." It most commonly affects kids who are 5 to 6 or 10 to 11, and these children tend to be of average or above average intelligence. When school refusal is the issue, parents need to make sure they send clear messages about attendance: Instead of "Are you going to school today?" opt for "It's time to get up for school. We can't allow you to stay home."

In general, there are other ways parents can help sooth school anxiety, Lagges says. Mom and dad should encourage kids to focus on the positive aspects of school (this year's field trip; the school musical; the science fair). It's important not to discount a child's fears or tell him not to feel anxious - but at the same time, parents shouldn't indulge those concerns and allow kids to stay home. It's not smart to make comments like, "I know this is terrible. The rest of the week is going to be very hard." That's going to intensify the anxiety, Lagges says.

Parents ought to pay attention to their own disposition, too: Research suggests emotions are contagious. "If a parent is anxious, their child will be, too," says family psychologist Don MacMannis, who's based in Santa Barbara, Calif. "The brain is a social organ, and it's mirroring people around us. Without being conscious of it, we're reading and experiencing the feelings of others in the family."

[Read: 8 Ways to Become an Optimist.]

If students haven't settled into their daily routine by this point in the school year, that's a sign they need professional help - the anxiety has become too intense and lasted for too long. This typically means cognitive behavioral therapy - a technique that teaches skills for handling life challenges or overcoming negative thoughts - or medication; sometimes, a combination of both. "What this therapy involves is helping kids learn the difference between a situation where there's a real danger - meaning that it makes sense to feel fear - and a situation in which they're getting a false alarm," Lagges says. "Once they can tell the difference, we start working on ways to deal with those false alarms."

The school and teachers play a role, too. They have a responsibility to understand anxiety and school refusal, to provide support and to help promote whatever coping strategy has been decided upon. It's often helpful if teachers stay in touch with parents, alerting them to any red flags. Some schools also set up quiet rooms for recess and lunch and even modify the curriculum.

[Read: How Your Personality Affects Your Health.]

But what it typically comes down to is getting anxious students to change their thought process, MacMannis says. "There are techniques that teach kids to become the boss of their thoughts," he says. "It's the tale in their head that's the problem, rather than real fears. You have to help kids sort through that."

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