Recognizing back-to-school anxiety

By Debra L. Wentz, N.J. Association of Mental Health Agencies
   While small groups of children are talking, laughing and playing games on the playground before the first bell rings at school, Emily sits alone on a bench far away from the activity. She hugs her backpack and looks down at her lap.
   Any of the other children, as well as teachers and other adults, may suppose that Emily is shy. However, the true reason for her timidity could be anxiety. As she avoids her peers and social activities, Emily could be overwhelmed with anxiety about school, friendships, changes at home—or any combination of these issues. Her parents and teachers need to recognize this possibility, support Emily and get her professional treatment if they determine that is necessary.
   Emily’s anxiety and withdrawal represent a common occurrence for many students, not only in elementary schools, but also middle and high schools and colleges. For some students, a certain level of anxiety is normal. A new school environment, the pressure to succeed, concerns about fitting in and fear of bullying could be significant causes of anxiety.
   However, for some others, anxiety could be a sign of a mental disorder, a biologically based illness that is just as real as any physical disease. In either case, parents and teachers must be supportive, by listening and comforting youth to help them work through their anxiety, and by remaining alert to a potentially more serious condition that needs professional help.
   When anxiety — excessive, unrealistic worrying about everyday activities or for no apparent reason — lasts for six months or longer, the student should see a mental health professional. Such anxiety affects academic performance and relationships and may cause a student’s reluctance or refusal to go to school. Anxiety can be accompanied by physical symptoms, such as headaches, dizziness, stomach aches, fatigue and muscle tension. Other non-physical symptoms include self-doubt and self-criticism, excessive concern about gaining others’ approval, inflexibility in conforming to rules and not enjoying hobbies or recreational activities.
   Before and during treatment from a mental health professional, parents and teachers can help by:
   • Listening to the student’s feelings without giving advice.
   • Remaining calm when the student is anxious.
   • Offering reassurance, particularly if the student has previously experienced and survived anxiety.
   • Teaching relaxation techniques, such as deep breathing, counting to 10 and visualizing a peaceful place.
   • Planning for transitions and allowing for extra time.
   • Encouraging participation in activities.
   • Praising all efforts the student makes to control symptoms of anxiety.
   • In school, encouraging and assisting with small group interactions and providing a safe place where the student can reduce symptoms of anxiety.
   Parents and teachers must be vigilant in recognizing signs of anxiety, as well as depression — both of which could be due to drug abuse or could indicate a risk of suicide. In 2005, the most recent report from the National Center for Health Statistics, 272 children aged 5 to 14 years nationwide committed suicide; this equates to 0.7 percent of this population. In the same year, 4,212 youth (10 percent) aged 15 to 24 years took their own lives, with suicide the third leading cause of death among 15- to 24-year-olds.
   Warning signs of suicidal tendencies include long-term anxiety or depression, alcohol or drug use, unexpected anger, withdrawal from activities that used to be enjoyable, difficulty sleeping and thinking and talking about death. To help someone who exhibits any of these signs:
   • Take it seriously.
   • Listen.
   • Do not try to argue the individual out of suicide. Instead, show that you care and understand and offer to immediately take him for help.
   • In an acute crisis, take the individual to a walk-in clinic at a psychiatric hospital or an emergency room and stay until help is available. If these options are not available, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
   With the appropriate treatment and services, most individuals can lead healthy, productive and fulfilling lives. By contrast, without treatment, students are more likely to experience worsened health symptoms, both mental and physical, which could interfere with their relationships and academic performance.
   It is equally important to not stigmatize or feel stigmatized by mental illness, which presents a harmful barrier to seeking treatment. Depression, addictions, anxiety and other mental disorders must be attended to just as physical illnesses are treated.
   We must tear down barriers—not only stigma, but also lack of insurance coverage and insufficient funding—to ensure that children, adolescents and college students can access the treatment and support services they need. In addition, for older students, we need to demonstrate that they must not hesitate to ask for help and inform them of resources available to them.
   Many colleges have good mental health service programs and students must not hesitate to seek assistance when they feel overwhelmed. Parents who have concerns about students in elementary and secondary schools can contact their school counselors or their community based mental health programs.
   The New Jersey Association of Mental Health Agencies, Inc. (NJAMHA), which represents 125 nonprofit mental health organizations in every community statewide, provides information about local mental health providers on its website (www.njamha.org). NJAMHA is also available to provide this information over the phone (609-838-5488) between 8:30 a.m. and 5 p.m. during normal business days.
   Debra L. Wentz, Ph.D., is Chief Executive Officer of The New Jersey Association of Mental Health Agencies, Inc, which represents 125 nonprofit mental health organizations and provides information about local mental health providers online at www.njamha.org. For more information, call (609) 838-5488).