Back-to-school jitters or something more serious? How to tell — and how to help your child

CATHY WURZER: Glad you're with us here on Minnesota Now from MPR News. I'm Cathy Wurzer. As kids and young adults head back to school, they may be feeling a little nervous. For caregivers, it can be tricky knowing when it's just routine jitters or a more serious case of anxiety. You may have heard the number of children struggling with depression and anxiety doubled during the pandemic.

Dr. Sara Gonzalez is a psychologist at Children's Minnesota. She's with us right now to help us walk through how to tell if your child is moving through something just fine or if you need a little more help to get through it. Dr. Gonzalez, welcome to the program.

SARA GONZALEZ: Thank you for having me.

CATHY WURZER: Big feelings are normal this time of the year, right? And going back to school, given all the disruptions of the past few years feels big. So what do you expect to see from a child who might be a little nervous about going back to school?

SARA GONZALEZ: Absolutely. I think it's fantastic for parents to recognize that, right? There has been a lot of disruption, both direct and indirectly with the COVID-19 pandemic and different social factors that have been impacting our community. So I think it's normal for kids to feel nervous going into this school year, for parents to normalize that.

And what we want to do is be proactive about recognizing when it steps away from just traditional school jitters and then it starts becoming something maybe a little bit more problematic, leading into maybe some mental health concerns. And I think that's where parents can really step in to try to tease those things apart.

CATHY WURZER: I'm curious. What are the signs that a child might be a little anxious about going back to school?

SARA GONZALEZ: Some of the telltale signs is when we see disruptions in routine or start seeing difference in patterns of functioning. So parents are the experts on their child. They know their child best.

So if they're talking with their child or really noticing changes in eating patterns, sleeping patterns, different behaviors, not wanting to go to school or connect with friends, all those things are things to be kind of keying into and looking out for so that we can make sure to get children the supports that they need.

CATHY WURZER: So you can watch for the signs. Are there questions parents can ask to suss out some emotions?

SARA GONZALEZ: Absolutely, yeah. So I think open communication is the name of the game, but also for parents to recognize that if they're talking to their child or their adolescents, particularly adolescents here, also thinking about those conversations enders, right? Parent asks a question and the kid's like, yeah, yeah, you need to do this now.

It's important to look at those behaviors too. If we're expecting for a child to come to us, the adult, in the situation and say, I'm so stressed, or this is really bothering me, we might miss on a whole bunch of information.

So what we really want to be doing is cuing into those manifestations of stress, physical ones like talking about having stomachaches or headaches and just different aches and pains or changes in sleep or eating. Behaviors like withdrawing, not really wanting to engage in things that they really used to like. Saying, I am really zoning out or having trouble focusing or paying attention.

And then emotionally, which is the one that we most often look for, which are those more unhappy feelings or feeling overwhelmed or angry. All those things are things that we want to be looking out for.

CATHY WURZER: What's the line then when it really starts to tip over into serious anxiety, depression, mental illness?

SARA GONZALEZ: When it impacts functioning is when we start talking about it really teetering that line where we really want parents to be seeking out that support. If it's changing sleep patterns, your child's not sleeping or sleeping too much, not wanting to eat or eating too much and withdrawing, anything that deviates from the norm of what your child typically does or in the way that your child typically behaves are signs that we would want parents to be proactive about connecting with school personnel, school psychologists, counselors, social workers, connecting with your pediatricians, and linking into, we have these concerns as parents. This is not normal. How can we find support for my child?

CATHY WURZER: When in your opinion is it time to consider medication perhaps?

SARA GONZALEZ: That's a great question. I think it needs to happen in discussion with a pediatrician. What research demonstrates is that oftentimes the combination of medication and therapeutic support leads to best outcomes.

Families talking to pediatricians, leaning into trying to figure out what's going to be best for their child, maybe trying to get some social supports or some kind of therapeutic intervention going. See if that can help improve supports that school. And if not, kind of carrying on to have that discussion about medication with their pediatrician.

CATHY WURZER: So we're talking about signs between kind of, I would say, garden variety nervousness and something a little more serious. We've talked a lot on the air about this global mental health crisis that was clearly made worse by the pandemic, right?

But children's anxiety and depression rates and other rates of mental illness have been going up for quite some time. Why is this happening? What's going on in our world that it's affecting the kids?

SARA GONZALEZ: Absolutely. That's such a large question, right? But during the pandemic, we saw that seven in 10 adolescents were reporting that they've been experiencing mental health difficulties, and we've continued to see this number escalate.

I think there's a lot to say about what's happening socially, and now too the broader ability that we have to link into what's happening in other places of the world. That can make us question our safety or anything that can really have parents start thinking about their children in different ways.

So social unrest, social struggles like a medical crisis like a pandemic. All of that put together really led to disruptions into the consistency of children's routines, and it was all over, right? All over the news, all over social media. It was all that we were talking about.

How could we have escaped that? And so I think it's fair to say that it's been harder to kind of digest everything that's going on and stay focused on well-being.

CATHY WURZER: And as a parent, many of us have experienced the exact same things, right? So how does a parent help the child navigate these waters that are still pretty rough?

SARA GONZALEZ: Great question. I think it's important for parents to validate their own stressors and struggles, right? Nothing is more important than children having an appropriate display of emotional health and well-being. And so a lot of times there's this misconception that if we don't talk about it or don't point it out, it'll pass.

With mental health and emotional health, we don't see that. We want for kids to have appropriate models of, hey, I am struggling right now. Acknowledging your own difficulties within the circumstances that we are in as a family, as a parent will have the child question less of what they are trying to read into the situation, read into the family dynamics, and give them perhaps a voice to also say, hey, this is some way that I can help with the stress, or this is impacting me too.

CATHY WURZER: Say, before you go, I'm curious. I know you've been so busy over the past few years in what you're doing. How are you doing?

SARA GONZALEZ: [LAUGHS] Thank you for asking. I think we have established, at least as Children's Minnesota-- I can speak for the institution that I'm in-- there's been a good support system of us all checking in together to make sure that that burnout, which is very real, remains being talked about and that we're finding healthy strategies to kind of work through that.

But with that said, I'll link it back to the community because parents are also feeling that, and I want to acknowledge that. It's really hard to even be able to, if you see that your child is struggling, find the appropriate supports for your child.

So I would say start with the schools to kind of alleviate. You're not operating alone as parents and caregivers. Use the school community as part of your village.

And then a little bit of more information or tools that we can offer at Children's Minnesota. Parents, on an online browser go to Children's Minnesota Behavior Checker. They put that in. That's a tool that can get parents the support that they need, simple solutions and encouragement to over 150 common behavior or mental health problems that they might be noticing in their child.

So link it back to them because I think we're all in this state of operating with little resources. And the more that we can get those out there for the community, I think the better that we'll all be together.

CATHY WURZER: All right. Dr. Gonzalez, I appreciate the conversation. Thank you so much.

SARA GONZALEZ: Absolutely. Thanks for your time.

CATHY WURZER: Dr. Sara Gonzalez is a psychologist at Children's Minnesota. She says if you are worried that your child's nervousness is tipping into a more serious anxiety or depression, you should connect with your school psychologist or your pediatrician.