By Amelia Sponseller, FNP-C, Menopause Society Certified Practitioner
It happens every year. As kids return to school after summer break, I start hearing stories – stomachaches that happen daily before school but not on weekends; visits to the school nurse with vague reports of feeling ill; school-night insomnia; teens overwhelmed by stress over grades. Are these normal back-to-school jitters or signs of something more serious? According to the American Academy of Pediatrics and the CDC, mental health concerns among youth have risen in recent years, with school transitions being a common trigger.
Signs of Anxiety in Kids and Teens
Anxiety can manifest in various ways and is often mistaken for physical illness or behavioral issues. Younger children may report stomachaches, headaches, or fatigue without a clear medical explanation. They may appear overly clingy, irritable, or have sudden tantrums. In school-age children, anxiety may look like reluctance to participate, avoidance of social interactions, excessive worry, or difficulty concentrating. Children may also refuse to go to school. All of these can cause distress or impair day-to-day functioning.
In teens, anxiety may show up as excessive worry about grades, social acceptance, or future plans. They may appear restless, constantly seek reassurance, or isolate themselves. Sleep issues, perfectionism, school refusal, and physical complaints like muscle tension or racing heart are also common.
Signs of Depression in Kids and Teens
Depression in youth often differs from the classic signs seen in adults. Children may become withdrawn, lose interest in play, or show sudden changes in appetite or sleep. Irritability is often more prominent than sadness. In teens, signs may include persistent low mood, loss of interest in hobbies, academic decline, social withdrawal, and expressions of hopelessness or worthlessness.
Why It’s More Prevalent During Back-to-School Season
The return to school brings multiple stressors: new teachers, social dynamics, academic expectations, and changes in daily routine. For some kids, especially those with prior mental health struggles, these changes can trigger or worsen symptoms. A 2021 JAMA Pediatrics study found that youth mental health symptoms tend to increase during periods of transition, especially during school-related changes. Social media use, pandemic-related disruptions, and heightened academic pressures have contributed to an increase in mental health challenges among children and adolescents in recent years.
What Parents and Caregivers Can Do
1. Stay Connected: Regular check-ins with your child create a safe space for them to share feelings. Encourage them to express their feelings, and listen actively without judgement. Ask open-ended questions like, “What was the hardest part of your day?” or “Has anything at school been bothering you?”
2. Observe Behavior Over Time: Tough moments or days may happen here or there, but it’s important to watch for consistent changes in mood, energy, or behavior lasting more than two weeks. Keep track of sleep patterns, appetite, school performance, and social interactions.
3. Normalize Mental Health Conversations: Let your child know it’s okay to feel anxious or sad, and that seeking help is a sign of strength – not weakness.
4. Seek Professional Help: If symptoms persist or interfere with daily life despite reassurance and support, consult your child’s primary care provider or a licensed mental health clinician. When parents call me with concerns about their kids’ mental health, I make sure to see them promptly. Therapy, school support services, lifestyle changes, or medications may be part of their treatment plan.
Amelia Sponseller is a Scarborough resident, Family Nurse Practitioner, Menopause Society Certified Practitioner, and owner of Marshview Direct Primary Care.
Photo: Jordan Whitt
