A primer
Facts about anxiety and depression in children and teens:
Anxiety disorders affect one in eight children.
Anxiety and depression are treatable, but 80 percent of kids with a diagnosable anxiety disorder and 60 percent of kids with diagnosable depression are not getting treatment,
Research shows that untreated children with anxiety disorders are at higher risk to perform poorly in school, miss out on important social experiences, and engage in substance abuse.
Anxiety disorders often co-occur with depression as well as eating disorders and attention-deficit/hyperactivity disorder (ADHD).
SOURCE: tthe Anxiety and Depression Association of America
The blaring early morning alarm … a backpack jam-packed with homework … nerve-racking quizzes and exams. It’s enough to make any student pull the covers over their head.
But what if it’s more than that?
For some children and adolescents, returning to school is more than a nuisance; it’s anxiety inducing. School refusal goes beyond simply not wanting to go to school. It occurs at all ages and affects between 2 and 5 percent of school-age children.
“School can be stressful. Children are expected to learn at a fast pace, even early on,” said Zach Woessner, Dayton Children’s Hospital child psychologist. “And there’s the onset of testing, overscheduling and, sometimes, bullying or peer problems. It can be tough.”
And school refusal can impact more than just the student.
“It can be overwhelming for the entire family.”
What causes school refusal and what can be done to turn it around?
Anxiety vs. anxiety disorders
From a young child who gets nervous when she stays with a baby sitter for the first time to a teen whose stomach is in knots at the prospect of asking someone to the homecoming dance, anxiety is a part of life from childhood into adulthood.
“Anything that is out of routine, a change of some sort, can cause stress,” said Richele Shepard, executive director of WellSpring, a Springfield-area nonprofit counseling organization that offers support and programs for adults and children. “Knowing how to manage it is what’s important.”
A University of Michigan survey of 8,000 young people, found that two-thirds of the respondents felt stressed out at least once a week and one-third reported being on edge at least once a day.
According to the American Academy of Pediatrics, anxiety is a normal reaction to the stresses of life. A case of the jitters, however, isn’t necessarily harmful. It can, in fact, spur us to be at our best. Ordinarily stressful situations prompt a flurry of brain and hormonal activities known as the fight-or-flight response. Body systems mobilize to meet the challenge and a person feels more alert, focused and energetic.
But, in contrast, an anxiety disorder can be incapacitating. The anxiety may be overwhelming, even terrifying. And a young person has nearly a one-in-seven chance of developing an anxiety disorder — the most common mental health condition among all age groups.
Causes and symptoms
There is no single cause for school refusal. For some students, it’s separation anxiety while others experience social or performance anxiety. Depression or bullying can also trigger school refusal behaviors.
The symptoms can manifest themselves physically including nausea, vomiting, diarrhea or headaches.
“You feel anxiety in the body,” Shepard said. “And that means very physical symptoms.”
And those symptoms may well disappear while the student is at home.
“That’s the hard thing, especially for parents, because by avoiding school, their child’s anxiety decreases and they feel better. And what parent doesn’t want their child to feel better?” Woessner said. “But don’t give into the anxiety, you need to work on coping skills.”
Strategies and solutions
Anxiety and depression are treatable, but the 2015 Child Mind Institute Children’s Mental Health Report indicates that 80 percent of kids with a diagnosable anxiety disorder and 60 percent of kids with diagnosable depression are not getting treatment.
Treatment can include consulting with a professional, like a child psychologist or licensed professional counselor, but Woessner suggests starting at the school.
“Work with the school, the school counselor, a teacher or, maybe, the principal, to help identify stressors and come up with a plan,” Woessner said. “And identify some allies for the student, it helps make school more fun.”
Creating a partnership with school staff can be a positive first step.
“Counselors, administrators and teachers all work together to build relationships quickly with students who are anxious about coming to school,” said Amy Moorman, a guidance counselor at Adena Elementary in the Lakota Local School District. “Those relationships help demonstrate that school is a safe place for them and that they have people who support and care for them there.”
Parents can also do things at home to help improve the chances for success.
“I always encourage parents to maintain a regular routine in the morning,” Moorman said. “The consistency can be comforting and also helps avoid tardiness, which can increase anxiety. Some parents find it helpful to have a ‘goodbye’ routine, such as saying the same phrase every day, having one final hug or using a special handshake right before their child gets on the bus or enters the school.”
If school anxiety continues to be a struggle, the school counselor can be a good resource for providing families with additional strategies. Parents may also want to obtain a referral from their pediatrician or family doctor for a specialist.
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