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The New Back-to-School Anxiety

Father walks his young son to class on the first day of school. Wearing a blue backpack, the unsure boy holds onto his dad. Rear view. Elementary school building in background.

Back-to-school season can always feel a bit uncertain, but this year, kids and teens are facing a unique set of circumstances as many return to in-person learning for the first time since March 2020. “The majority of children have been expressing concerns about returning to school, whether it’s minor worry or more significant and impairing,” says Willough Jenkins, MD, inpatient medical director of Child and Adolescent Psychiatry Services and clinical lead of the pediatric consultation liaison service at Rady Children’s Hospital-San Diego and an assistant professor for the Department of Psychiatry at University of California San Diego School of Medicine. “The rates of depression and anxiety have [also] increased in youth during the pandemic. It is important to recognize that for some children, they have not only fallen behind in terms of academics, but also social and emotional development. Returning to school needs to equally prioritize the academic and social/emotional catchup. Over the last year-and-a-half, children have changed significantly, as opposed to the standard two months away over the summer. There is concern about where they might fit in and how their peers might react to those changes.”

More pandemic-specific fears include worrying about whether in-person classes and new schedules will stay in place and concerns about whether oneself, friends or loved ones will get sick. “Some children are returning to school having lost loved ones to the pandemic and have the added anxiety of explaining their loss,” notes Dr. Jenkins. And, particularly for younger children, a transition from significant time with family and caregivers to significant time without them has the potential to amplify separation anxiety. However, although the pandemic looms large in our minds, if a child is facing stress or anxiety, don’t automatically assume it’s COVID-related, Dr. Jenkins adds. “In addition to the pandemic, there has been focus on social justice issues, racism and politics, which certainly has affected older children and youth.”

As your child prepares to head back to the classroom, keep watch for signs of anxiety. Sleep changes, whether sleeping much more or less than typical, can indicate anxiety for children and teens of all ages, as can repeatedly seeking reassurance or asking the same questions in spite of getting consistent responses. “Avoidance of triggers is [also] a key sign,” says Dr. Jenkins. “Are they not looking at communication from the school? Do they change the topic every time school is brought up? Not reaching out to friends? Putting off back-to-school shopping or preparations?” Younger children are especially prone to physical manifestations of anxiety, such as stomachaches or headaches. Irritability and difficulty focusing can also point to concerns across all age groups.

So, how can you help? If you notice something, say something. Dr. Jenkins offers the following tips for getting the conversation going:

  • Pick an appropriate time to start a discussion, ideally when it’s just the two of you with limited distractions and you both are in stable emotional states. The age-old trick of going for a car ride is always a good one!
  • Be aware of your own anxiety and conversations you are having around your children. They are always listening!
  • Resist the urge to only focus on the positive.
  • Use an article as a reference point or ask how their friends are handling the transition for a less direct way to begin your discussion.
  • Provide honest and accurate information, and refer to the Centers for Disease Control and Prevention for the most up-to-date recommendations.
  • Try to speak in a matter-of-fact manner as opposed to emotionally laden language. For example, “they will check your temperature at school” versus “some kids might be sick and coming to school, but they will check temperatures … but I sure hope they have good thermometers.”

Dr. Jenkins says talking openly about concerns and providing validation is a huge part of helping kids and teens cope with back-to-school anxiety, and suggests helping them try to identify any specific concerns, such as worrying about fitting in or catching up with schoolwork. She also recommends getting connected with friends before the school year begins, whether setting play dates for younger children or encouraging teens to plan a fun outing or activity. Children may also benefit from going to school and practicing walking up to the front door — known as “graduated exposure approach” — or meeting their teacher and seeing their classroom in advance, if possible.

If your child is still struggling once they return to school, Dr. Jenkins notes meeting with a school counselor or their pediatrician may be a great next step. They can help refer to additional mental health support, if necessary, and you can also find a mental health provider through websites such as Psychology Today. For more urgent concerns, experts at Rady Children’s Behavioral Health Urgent Care or our Copley Psychiatric Emergency Department, the first pediatric option of its kind in the San Diego region, are ready and waiting to help. She also emphasizes that parents and caregivers can “consider all the possibilities. If your family risk for COVID-19 is higher or your child has been thriving in online school, do remember there are options for education, including continuing online schooling.”

Even if you’re looking forward to getting back to vacations and dinners out, or your child is excited to go back to school, “any change, even good change, can cause anxiety,” says Dr. Jenkins. As our world begins to reset, take some extra time to check in with yourself and your children about fears, feelings and thoughts so you can stay connected and provide support.