Anxiety in the School

By Jessica Pian, B.S., Kaitlin Gallo, M.A., and Donna Pincus, Ph.D.

Anxiety is a normal part of life. Adults experience anxiety when moving or finishing a project with an upcoming deadline. Similarly, children might experience anxious feelings around grades, school presentations, or sports. However, when children experience too much anxiety, it can be distressing and interfere with their everyday functioning. In fact, clinical anxiety is the most prevalent emotional disorder in childhood.     

Parents are often unsure whether their children’s fears and anxieties are a normal part of development, or if they are cause for concern. If anxiety prevents a child from engaging in developmentally appropriate activities, or starts to interfere with events the child used to enjoy, the child may benefit from treatment. Children with anxiety may experience difficulty going to school because they are worried that something will happen to their parents or that they will be teased by other kids. These difficulties often are exacerbated at the start of the new school year. Children with anxiety may also worry excessively about their homework or exams to the point they miss out on playing with friends. 

Children can experience a number of different anxiety disorders, including generalized anxiety, separation anxiety, social phobia, specific phobia, obsessive compulsive disorder, and panic disorder. Children with generalized anxiety disorder (GAD) worry excessively about a variety of events. Children’s worries can focus on school, their health and others’ health, competence in sports or academics, world events, or other topics. Separation anxiety disorder (SAD) is common in younger children who are extremely unwilling to separate from one or more people, like parents or other family members. Children with SAD often are afraid that something bad might happen to them or their families when they are apart, and often cry and beg for someone to stay with them. 

Children with social phobia experience intense fear of being embarrassed in social situations. They might appear to be excessively shy and fear talking to authority figures like teachers, writing on the board in school, or giving oral presentations. Children with social phobia avoid situations that make them feel uncomfortable and experience interference in school or social relationships.

Specific phobias are intense and excessive fears of objects or situations like dogs, bees, injections, the dark, or elevators.  Many children alter their lives to avoid contact with these objects and situations. For example, a child may take a different route to school to avoid walking by a dog. 

Another anxiety disorder that occurs in children is obsessive compulsive disorder (OCD). Individuals with OCD experience recurrent obsessions and compulsions that cause marked distress or significant impairment in daily functioning. Obsessions are unwanted and intrusive thoughts or images and compulsions are repeated thoughts or behaviors that are completed to reduce the stress brought on by the obsessions. 

Panic disorder can occur in children and adolescents. Individuals with panic disorder experience recurring panic attacks and constantly worry about the next attack. A panic attack is an episode of intense fear and unease, made up of physical symptoms and fearful thoughts. Children and teenagers who experience panic disorder often avoid going places, including school, because they are scared a panic attack might occur while there.

 Symptoms of anxiety are often difficult to detect and go untreated. However, if left untreated, anxiety can continue into adulthood and lead to other psychological problems. The Center for Anxiety and Related Disorders at Boston University offers treatment for children ages 4-17 with anxiety. In addition, the Center is offering free treatment for children 12-17 with panic disorder who qualify for a study funded by the National Institute of Mental Health. For more information about services, visit www.bu.edu/card/ or call 617-353-9610.