A new school year brings excitement — but for many children, it also brings anxiety. And the signs aren’t always easy to recognize.

“Children want to know they are heard without judgment,” says Mandy Stanuszek, a licensed clinical social worker and behavioral health expert at BlueCross BlueShield of Tennessee. “They often want to feel validated and supported.”

Why back-to-school may contribute to anxiety

Mandy Stanuszek: The back-to-school transition can trigger anxiety for several reasons. A child with attention deficit hyperactivity disorder (ADHD) or a learning disorder diagnosis may experience additional school-related stress. A child may have experienced bullying or cyberbullying previously. Children may also feel anxious about school safety due to things they have seen on TV or online.

Common feelings of nervousness are often an occasional worry — an upcoming test or having to speak in front of a class. It may be eased with encouragement from parents.

If a child’s worries start to affect everyday life, it may be an anxiety disorder that warrants attention from a health care or behavioral health professional. It may impact eating habits, school performance and relationships with others. In a post-pandemic world, parents should know that the issue is not always only regular childhood fears.

Signs that may be easy to overlook

Mandy Stanuszek: Many signs of childhood anxiety may resemble a physical illness or may be mistaken for a phase the child will get over. Here are things to watch for:

Physical signs:

• Frequent stomachaches or headaches with no known medical cause
• Excessive sleepiness or fatigue
• Increased nervousness or restlessness

Behavioral signs:

• Increased sadness or crying
• Emotional outbursts out of the norm
• Fidgeting or panic attacks
• Withdrawal from activities they used to enjoy
• Avoiding people or places
• Changes in appetite

Sleep disruptions may include difficulty falling asleep, waking frequently throughout the night, or having nightmares. Poor sleep may disrupt the brain’s ability to tolerate stress and manage emotions.

Irritability may appear to be short-tempered, becoming easily frustrated or inability to cope. Emotional withdrawal happens when children stop communicating or lose interest in activities they once enjoyed.

Grounding techniques to practice together

Mandy Stanuszek: These techniques may help children manage anxiety before and during school. But they are not a substitute for professional evaluation or treatment when symptoms are persistent or severe

5-4-3-2-1 Technique: Have them name five things they can see around them. Then, name four things they can hear, three things they can smell, two things they can touch, and one thing they can taste. This brings the mind into the present moment.

Belly Breathing: Have the child take a deep breath through the nose as the belly expands. Hold for a few seconds, then blow the air out — while they imagine anxious thoughts leaving with the breath.

Remind children, these techniques can be used at school, too. Encourage them to let their teacher know if they may need a break. Communicating with your child’s teacher, guidance counselor or school administrators can help provide an extra layer of support.

At home, set up consistent routines and practice and model healthy anxiety management. Most importantly, let the child know they are supported.

When to seek professional help

Mandy Stanuszek: Seek help by talking to your child’s doctor when anxiety interferes with everyday functioning. They can assess and make a referral to behavioral health professionals if needed. Warning signs include:

• Frequent emotional outbursts
• Significant behavioral changes
• Isolation
• Severe mood swings
• Self-harm or substance use (get guidance or assistance from resources listed below)

“Take action if your child’s symptoms are affecting daily functioning,” Mandy says.  “Contact your child’s health care professional or other qualified behavioral health professional for guidance.”

Helpful resources:

• childmind.org
• crisistextline.org
• Call or text 988 for mental health emergencies

If you’re worried that your child is in immediate danger, call 911 or go to the nearest emergency room. For immediate emotional support during a mental health crisis, call or text 988, to reach the Suicide and Crisis Lifeline. It’s free, confidential, and available 24-7. Or you can text TALK to the Crisis Text Line at 741741.

WellTuned: How to cope with back-to-school stress

Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.