Anxious Child

Between high expectations from teachers and complex peer interactions, a child’s school day can be stressful. Your children may not know how to deal with school anxiety, or they may not share what they’re going through or feeling. It’s important to know how to spot signs of anxiety and take action to help your child thrive in school and life.

Child Stress Symptoms

Signs of stress vary in children and teens, but typical symptoms include:

  • Fear and worry
  • Anger, irritability, or inability to control emotions
  • Fatigue
  • Sleep issues
  • Headaches
  • Stomachaches
  • Changes in appetite
  • Bed-wetting
  • Social withdrawal
  • Refusing to go to school

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Prioritizing Mental Health

School situations can exacerbate an existing anxiety disorder, something that affects 7.1 percent of children ages 3 to 17, according to the Centers for Disease Control and Prevention. Common anxiety disorders in children include:

  • Generalized Anxiety Disorder (GAD): Children with GAD worry excessively over a variety of things, such as grades, friendships, and sports performance.
  • Separation Anxiety Disorder: Separation anxiety affects about 4 percent of children, usually those ages 7 to 9. They experience extreme homesickness and worry when separated from family or caregivers and may refuse to go to school altogether.
  • Social Anxiety Disorder: Being called on in class or working with a classmate on a school project can be highly distressing for children with social anxiety disorder. The condition is also known as social phobia. Children with social anxiety disorder have an intense fear of social and performance situations.

Children with untreated anxiety disorders are more likely to struggle academically and socially and engage in substance abuse, according to the Anxiety and Depression Association of America. Child stress symptoms can even include self-harm as a coping mechanism. To prevent these consequences of anxiety and stress, there are a few options for teaching your child how to deal with school anxiety.

Tips on stress relief for kids

Here are seven ways you can help your child relieve stress:

1. Talk to your child

It’s important to listen to your child, empathize with them, and strive to understand their feelings. Reassurance can go a long way toward reducing stress.

2. Maintain a low-stress environment

Make sure your child isn’t over-scheduled. Allow for downtime during the busy school week.

3. Develop positive coping skills

Stress can cause bad coping habits, such as unhealthy eating, avoiding exercise, or social withdrawal. Provide a good example by coping with your own stress in positive ways. Provide kids with healthy snacks and meals. Encourage exercise through family activities, such as bike rides or walking the dog.

4. Talk to the school counselor

School counselors can offer insights on dealing with school anxiety. They can provide school-based interventions, such as tutoring or test prep strategies, to help your child reduce stress. If your child has a diagnosed psychiatric disorder, he or she may qualify for an individualized educational program (IEP). An IEP will let you work with your child’s teachers and school administrators to develop strategies that help manage child stress symptoms.

5. Prioritize sleep

Not getting enough sleep exacerbates stress and anxiety, according to the National Sleep Foundation. It recommends that children ages 6 to 13 sleep for 9 to 11 hours per night. Teens aged 14 to 17 will need 8 to 10 hours nightly. To help children sleep well, establish bedtime rituals and avoid electronics before bed.

6. Incorporate relaxation skills

Meditation, yoga, breathing exercises, drawing, and journaling can proactively manage stress. Students who received school-based mindfulness training, a practice focused on being in the moment and eliminating distractions, reported feeling less stressed, according to an MIT study. Practicing mindfulness for six months or longer resulted in fewer suspensions and greater academic performance.

7. Get professional help

Your child’s doctor can refer you to a therapist, psychologist, or psychiatrist who can evaluate what’s going on. Depending on your child’s diagnosis, their treatment plan may include traditional psychotherapy and/or medication.

How to Find a Counselor for Your Child: Connecting with Resources

The first step in finding a counselor who’s a good fit is to check in with your child’s pediatrician, who understands both your child and your family history. Your child’s doctor may want to do a complete physical as well to ensure that your child doesn’t have sleep, vision, hearing, or learning problems that are causing behavioral issues.

At UPMC Children’s Hospital of Pittsburgh, we provide evidence-based behavioral health treatments to children/adolescents and their families. We work closely with community pediatricians, medical specialties, schools, and families to provide family-centered behavioral treatments, teaching children and families skills to minimize distress and maximize wellness. To begin therapy services, no referral is needed. For additional information on our embedded behavioral health programs and developmental medicine, please call 412-692-5100. For all other UPMC Pediatric Behavioral Health services please call 412-246-6668.

Behavioral health counselors at UPMC Family Medicine Health Centers have professional training in different counseling methods to help manage many behavioral health diagnoses. To find a counselor, please call 412-647-8762 or 800-533-8762.

UPMC Western Behavioral Health Child Services is a continuum of behavioral health programs designed to offer prevention, early intervention, and incremental intensity of treatment through multiple levels of care. Services are provided on-site in UPMC facilities, in the home, community, and schools. All sites are currently located within Allegheny County. Most services are available through telehealth. If you need resources, support, or would like to find services for your child, please call 412-246-6668.

Editor's Note: This article was originally published on , and was last reviewed on .

Centers for Disease Control and Prevention, Anxiety and Depression in Children. https://www.cdc.gov/childrensmentalhealth/depression.html

Centers for Disease Control and Prevention, Data and Statistics on Children's Mental Health. https://www.cdc.gov/childrensmentalhealth/data.html

Anxiety and Depression Association of America, Childhood Anxiety Disorders. https://adaa.org/living-with-anxiety/children/childhood-anxiety-disorders

Science Daily, Mindfulness for Middle-School Students.https://www.sciencedaily.com/releases/2019/08/190826153630.htm

National Sleep Foundation, Children's Stress and Sleep. https://www.sleepfoundation.org/articles/childrens-stress-sleep; and

National Sleep Foundation, How Much Sleep Do We Really Need? https://www.sleepfoundation.org/articles/how-much-sleep-do-we-really-need

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.