Mental Health Matters

By RONNIE KOENIG

With the start of a new school year comes excitement and anticipation for some kids, but for others the thought of going back is a cause for worry and anxiety. Given the many changes and ups and downs during the pandemic, it’s no surprise school-age kids may continue to feel uneasy about heading back to the classroom. “Transitions are a normal time for anyone to become anxious,” says psychologist Nicole Lacherza-Drew, Psy.D., also known as Dr. Nikki. Anxious and depressive symptoms can manifest differently in different kids. “Typically, you might notice avoidance of certain anxiety-provoking things (such as certain people or places), increased emotionality (including irritability and crying) and difficulties concentrating,” she says. “For younger kids especially, somatic symptoms such as headaches and stomachaches are also common symptoms.” Changes in routine can be jarring for kids, so it’s best to stick to a schedule as much as possible. “Our brains like routine and even if our kids don’t like the routine, it’s predictable and something they can depend on,” she says.

If your kids are anxious, Dr. Nikki suggests talking about the upcoming school year and all the exciting things they can look forward to. “Remind your child what’s in and out of their control,” she says. For example, kids might not have a say in the fact that they are attending a new school, but they can feel a sense of control by going on the school tour.

“Get them excited by picking out new school supplies,” she says. Dr. Nikki also encourages parents to help kids use coping skills to deal with anxiety. “These can include listening to music, going for a walk or deep breathing.” The key is to practice these skills before your child needs to use them so that they are routine. “Model using them,” she says. “Kids are sponges and are more likely to do something if they see an adult doing it.”

All kids experience a case of the butterflies or anxiousness from time to time, but how can you tell if your child is dealing with more intense worries or depression? Jeremy Fox, Ph.D, associate professor of psychology and director of clinical training at Montclair

©ISTOCKPHOTO.COM / AARONAMAT

©ISTOCKPHOTO.COM / MONKEYBUSINESSIMAGES State University, says rates of anxiety and worry in children have been increasing in recent years.

“We know that the COVID pandemic has had a negative impact on child and adolescent mental health in general, as young people have been experiencing greater social isolation and loneliness that has contributed to worry and social anxiety,” Fox says. “Even before the pandemic, anxiety symptoms, along with diagnoses of anxiety disorders, were becoming more common. Findings from the National Survey of Children’s Health, recently published in JAMA Pediatrics, showed a 27 percent increase in anxiety symptoms from 2016 to 2019.”

While occasional anxiety is a normal and healthy part of development, Fox says it’s important for parents to notice when it’s becoming a problem. “One of the most common signs of problematic anxiety in children is a persistent pattern of avoidance of triggers or situations associated with their anxiety,” he says. “For example, a child who has social anxiety may refuse to participate in class, speak with their teachers or even go to school. Children may also frequently exhibit significant distress, such as heart palpitations or sweating, around triggers of their anxiety or have anxiety-related interference with peers and school, such as lower grades.”

“Parents can take several steps to help their children overcome anxiety and worry such as rewarding brave behavior,” Fox says. “This means encouraging your child to gradually face their fears and engage in situations that make them somewhat anxious or nervous, such as asking their teacher a question,” he says. “The more that children practice these situations, the easier they will find it to tackle even more stressful situations.” Parents should also try to model brave behavior themselves. “When children see their parents are able to cope with situations that make them anxious or stressed, they may emulate it.”

Kids should be encouraged to express when they’re feeling anxious or worried and to work with their parents to come up with strategies for coping and facing their fears, says Fox. “If parents help their children to develop a mindset that they can gradually face their fears, their children will learn that they can do more and more on their own.” But Fox says parents should avoid providing too much reassurance to their children around anxiety-provoking situations such as reminding them there’s nothing to be afraid of.

“Reassurance is often important to a child, but anxious children may come to depend on reassurance too much and not face their fears without it,” he says. “Parents should also normalize working with a mental health professional. If kids know that it’s healthy and natural to receive help for anxiety, they will be more likely to be open to and benefit from it.”

While the stigma surrounding mental health has lessened, it’s important for parents to remember there’s nothing wrong with turning to trusted professionals when they need help. Fox reminds parents not to dismiss anxiety as “something they’ll grow out of” and to seek help when necessary.

“If the worries are causing distress and interfering with daily functioning (school refusal, uncontrollable outbursts), it might be time to consult with a pediatrician and mental health provider,” says Dr. Nikki. “Everyone has anxious and depressive symptoms at times. The key is if they are causing distress in our daily functioning. If they are, it’s time to seek out help to decrease the severity and frequency of those symptoms.”

Box breathing is a technique used by many professionals including Navy SEALs to relax the mind and body. The great thing is that it can be done by anyone, anywhere. Try this technique with your kids:

Close your eyes. Breathe in through your nose while counting to four.

Hold your breath while counting slowly to four.

Exhale for four seconds.

Repeat steps 1 to 3 until you feel calm.