Dr. Ritu Chandra, MD, FAAP, Preferred Medical Group
Kids have had exciting experiences over the summer; they’ve grown both physically and intellectually, and now it’s time to return to an environment they haven’t seen for several months. That can be stressful. Kids may be unable to sleep, act hyper in excitement or express reluctance at the idea of going back to school. This is normal. Parents should offer calm reassurances to their children, affirming their feelings and helping redirect their fears into positive opportunities for growth.
You could say, “You’re right that there will be new kids in your class this year, and that can be a little intimidating at first, but just imagine how many new friends you’ll make!”
Sometimes though, a child’s worry about going back to school may reflect a deeper condition that should be treated, especially if their distress starts to impair their day-to-day functioning. For a clinical diagnosis of anxiety, the child’s fear or worry will be out of proportion to virtually any new situation over a period of several months, making the child hyper-vigilant, so that they feel as if any change in their routine represents a looming threat.
Some of the common symptoms of clinical anxiety in children might include headache, tightness of the throat or chest, heart fluttering, difficulty breathing, tummy aches or frequent urination. They may also have problems with falling asleep or eating, have poor performance at school, explosive outbursts, excessive need for reassurance or feel dizzy. Kids with clinical anxiety also tend to be excessively shy and avoid things that other kids enjoy.
Often times these children get labeled as having “behavior problems.” I have diagnosed and treated several children like this, and it is very rewarding to see that soon after the medication for anxiety is started, the child’s “behavior problems” get better.
Symptoms of clinical anxiety may not be present all the time, nor in all situations. Anxiety is a triggered-affective illness, which means that if the child is in his/her ‘bubble’ they may do just fine. However, when the child gets out of their safety zone, the anxiety may be triggered.
Sadly, many children who have clinical anxiety go undiagnosed and untreated. This happens most commonly because the adults in the child’s life might see the symptoms, but they fail to recognize them as anxiety. In my practice, I have found that when I ask a parent if their child has anxiety, they say “no.” However, when I ask if their child is a “worry wart,” “shy,” “self-conscious,” frequently gets “home sick” or has “apprehension” or “dread,” they say “yes.” All of these could be symptoms of clinical anxiety.
Along with the lack of awareness, frequently there is also an element of denial. Sometimes parents just do not want to accept that their child has anxiety. Yet, clinical anxiety is a relatively common childhood disorder. It is estimated that approximately 25% of 13-18-year-old children have some form of clinical anxiety. The onset is commonest between 6-12 years of age, though clinical anxiety can be seen in children as young as 3-4 years old.
Chances are that your kid is just having some normal butterflies before school starts. If so, being sensitive and listening to their concerns is the best way to help them negotiate this stressful time. If their resistance to new situations has been going on for a few months though, you may want to check with your pediatrician to see if there’s more you can do to help them out.
Dr. Ritu Chandra is the founder and lead pediatrician at Preferred Medical Group with locations in Phenix City, Fort Mitchell, and Opelika.