Beyond Butterflies: When to Worry About Your Worrier

Experts offer advice about how to alleviate some of the pressure for back-to-school and beyond

As summer winds to a close, a fourth grader develops frequent stomachaches, seems irritable and restless, and regularly refuses play dates. A second grader starts putting up a fight every morning about going to school. A toddler, newly installed in day care, is waking up at odd  hours after two years of sleeping soundly through the night, needing what seems like excessive calming to settle back into sleep.

“Transitioning to the new school year is one of the most anxiety-producing moments kids experience,” says psychologist Tamar Chansky, author of Freeing Your Child from Anxiety

For preschoolers, the combination of going into the classroom and being away from a parent or a regular caregiver for the first time is a lot to get used to. Returning students often have concerns about whether they’ll be able to handle the more advanced assignments or still be pals with kids they haven’t seen for a while. Kids moving from one school to the next may feel exceedingly nervous about how they’ll navigate a new cafeteria or how their locker will work. “The anxiety comes around things they don’t have experience with,” she explains.

View expert advice on how to alleviate stress infographic (PDF)

The difference between having ordinary worries—the ones that are temporary and easily forgotten—and having more extreme, inexplicable, intractable anxiety is a tendency to worry about lot of different things and often all at the same time, Zack explains. These are the kids who, as Chansky puts it, “leave no worry stone unturned.”

GAD sufferers are often very high functioning at school while falling apart at home

And mostly they come into the world that way. Sometimes anxiety is triggered by a stressful life event—a death, a divorce, a move—or a developmental phase. But more often it’s innate. These are the kids that invent far-fetched scenarios to worry about in situations that most people would find completely non-threatening. Reassurance from their parents or other authority figures doesn’t help. “Generalized anxiety disorder (GAD) occurs in both boys and girls equally at younger ages, though in adolescence it’s about two times more likely in girls,” says Zack. “Whereas a child with a phobia is fearful of something specific, like dogs or needles, kids suffering from GAD are often afraid they might not be perfect or that things—bad things—are going to happen in life that they can’t control,” Zack says. Their perfectionist tendencies mean GAD sufferers are often very high-functioning at school while falling apart at home (not sleeping, having emotional outbursts, picking fights, questioning parents excessively), so there may be a big difference between what parents are seeing and what the teachers observe.

Silver Lining Playbook

If you suspect your child has generalized anxiety disorder (GAD), the best first step is to consult a child psychologist, pediatric anxiety specialist, or cognitive behavior
therapist. He’ll evaluate the child by asking questions about what you’re noticing and by engaging the child in activities to get a full picture of her feeling and coping strategies, says Zack. If the therapist does diagnose GAD, he will outline a plan for how to treat it, including specific exercises that help kids reframe their anxious feelings and work through their fears.

“The good news,” says Zack, “is that GAD is very treatable,” even for kids who’ve been through trauma, and in many cases, relatively quickly. “The vast majority of children who engage in treatment improve with cognitive behavioral therapy or other approaches in as few as 12 to 20 weekly sessions,” she says. Best of all, the treatment typically has a lasting positive effect, leaving kids feeling more empowered and self-confident and setting them up with lifelong skills for managing life’s stressors.