Overcoming School Anxiety:
How to Help Your Child Deal With Separation,
Tests, Homework, Bullies, Math Phobia, and
Other Worries by Diane Peters Mayer, M.S.W.,
L.S.W.
Chapter 2: Anxiety Is
a Mind-Body Experience
Most
elementary school children with school anxiety
cannot make sense of their anxious symptoms;
they just know that they feel nervous, get physically
sick, or just don't want
to go to school. Many children are outwardly
anxious and panicky on school mornings, like
Sean, who can't stop himself from screaming
to stay home and shaking all the way to school.
Some children may not feel consciously anxious,
but they still try to avoid school, like Tiara,
who denies being anxious, but complains of a
stomachache on most school mornings and sometimes
throws up on test days. Other children fear
their symptoms are caused by a disease, like
Jaime, who believes that the heart palpitations
he has in school are due to a bad heart and
that he might die. No matter the reason for
school anxiety or how it manifests, children
who have it do suffer.
When children become anxious,
they are not just feeling nervous; in fact every
aspect of their physical, mental, and emotional
functioning is affected. Symptoms can vary from
feeling out of control and scared when walking
through the school doors every morning to being
unable to remember what was studied for a test
to shaking and being unable to answer when called
on in class.
School is a tension-filled
environment with stressors that include leaving
the safety of home to go to school, being judged
and evaluated by teachers, fitting in with peers,
or being bullied. Stressors are events, circumstances,
or situations that create physical or emotional
strain, frustration, and pressure. Some stressors
are considered negative, for example, if a child
has trouble reading and is failing second grade.
However, stress is also felt around positive
situations, such as a student soloing in the
spring concert and feeling the pressure to play
perfectly.
Anxiety is one type of a response
to stress. The way children react to stress
is determined by a number of factors, such as
heredity, learned behaviors, life experiences,
physical and mental health, and the number of
stressors that are occurring all at once. Positive
ways to handle stress can be learned, so teaching
your school-anxious child how to cope with and
adapt to stressful situations will reduce anxiety
and make for a more positive school experience.
As a parent of a child with
school anxiety, you know how difficult it can
sometimes be to understand your child's behaviors,
and how upsetting it is to watch her struggle.
If you had school anxiety yourself, you can
probably understand your child's experience.
Parents often ask, "Why
does my child feel that going to school is a
jail sentence?" "Why are my child's
symptoms so intense?" "Why can't my
child think anxiety away?" These are important
questions to have answered, and the first step
in helping your child is to understand why and
how the disturbing symptoms are created and
how chronic school anxiety develops.
What Is the Nervous System? The symptoms of anxiety are created by a primitive
defense mechanism called the fight-or-flight
response. This response is the body's way of
protecting itself in situations that could result
in injury or death. Every living thing on earth
has a fight-or-flight response, from the one-cell
amoeba to the human body, which is made up of
trillions of cells. This defense is a function
of the nervous system, which includes the brain,
spinal cord, and other structures. The nervous
system coordinates all life functions, including
breathing, limb movement, organ action, thinking,
feelings, and emotions. It is really a communication
system, and one of its main jobs is to alert
the body to external situations and events and
then to prepare an appropriate response to them.
For example, you want to hug your child. Your
brain sends this message to the nerve cells
and chemicals that control your limbs, allowing
you to put your arms around your child. Or,
your child's ball rolls into the street and
without thinking she starts to run after it.
In a split second, stress hormones course throughout
your body, you yell at her to stop, but she
doesn't hear you. Your respiration revs up,
and nerve cells send messages to your legs enabling
you to run like an Olympian to stop her. Whether
it is giving your child a hug or running after
her, all of this activity occurs in seconds
without conscious thought.
The Fight-or-Flight Response The fight-or-flight
response is an alarm system located in a nervous
system called the sympathetic nervous system.
It jump-starts when real physical danger is present,
but it will also activate if a situation is perceived
or thought of as being threatening. For an example
of a real danger, let's say your child is in the
school yard playing with his friends when the
school bully comes over with a group of followers.
The bully begins to taunt your child and make
threatening movements that he is going to hit
him. Your child's fight-or-flight response kicks
in to help him defend himself by either running
away or trying to fight back.
For an example of a perceived
danger situation, let's say your child has test
anxiety. The night before a test she tries to
study but feels sick to her stomach and later
can't fall asleep. On the day of the test, her
heart beats fast and she is irritable with a
feeling of dread. Her anxiety spikes when the
test is passed out to the children and the fight-or-flight
response revs up to defend her from what she
believes to be a dangerous situation. She has
panic symptoms that make it hard for her to
concentrate and do well. Of course, a test is
not really dangerous, but when your child sees
it as a threat, then the brain cannot distinguish
between real or perceived danger and will protect
her in either case.
What Happens to My Child During
the Fight-or-Flight Response? When danger is sensed,
the brain immediately sends messages to the sympathetic
nervous system to begin the defense, and powerful
physiological changes take place all at once.
These changes, which create the symptoms associated
with anxiety, can be disturbing and frightening.
Your child might experience the following physical
symptoms from school anxiety:
Pounding, rapid heartbeat or
palpitations from the increase in blood pressure
when stress hormones, such as adrenaline and
cortisol, are released into the bloodstream,
thereby pumping more blood into the brain, muscles,
and other organs. At the same time, blood flow
decreases to extremities, so hands and feet
feel cold.
Rapid breathing, which increases
oxygen levels. However, shallow breathing may
occur too, causing shortness of breath, gasping,
and hyperventilation, often associated with
feeling trapped and leads to sensations of being
smothered. Hyperventilation is abnormal deep
breathing that reduces levels of carbon dioxide
in the blood, causing tingling in fingers, dizziness,
and fainting.
Tension in muscles as they
ready themselves for action, which may create
body and chest pain, leading to fears of a disease
or heart attack, and numbness in the face, head,
and limbs.
Sweating as the body cools
itself to prepare for physically demanding activity,
either battle or flight. Sometimes a hot flush,
blush, or chills are felt, too.
Vision changes when pupils
dilate to let in more light to increase awareness
of the environment and the danger, sometimes
creating hypersensitivity to light and other
visual stimuli, or distorted vision, such as
tunnel vision.
Other physiological changes
include a decrease in saliva production to stop
digestion, creating dry mouth; voiding of bowel
and bladder to empty the body for action, leading
to frequent urination and diarrhea; headaches
because of muscle tension in the head, neck,
and shoulders; hypersensitive nerve endings
affecting the delicate skin, causing feelings
of numbness, rashes, hives, and other skin conditions.
However, the physical symptoms are only the
beginning; the emotional manifestations of anxiety
pack a wallop, too.
Mental
Symptoms of the Fight-or-Flight Response
The mental signs of anxiety play havoc with
cognitive functions. Thought processes become
distorted, making it extremely difficult to
think clearly and rationally. The ability to
focus and concentrate decreases, which makes
learning new material difficult. Other common
emotions include feeling:
Overwhelmed and out of control
Helpless, hopeless, and wanting
to flee the situation
Irritable and angry
Embarrassed and ashamed
Some children feel mild electrical
shocks throughout their bodies when anxiety
is high, due to sensitized nerve impulses. They
may feel disconnected or dissociated from their
own mind and body or may be jittery and unable
to sit still. Others feel physically off balance,
and even think they are going crazy. Anxiety
and its distressing symptoms generally do not
remain at high levels for more than ten minutes
at a time, although symptoms can spike up and
down for hours. Fortunately, the body also has
a cool-down phase.
The
Relaxation Response After the threat or
danger has passed, the parasympathetic nervous
system is set in motion, decreasing stress hormones,
returning blood pressure and respiration to normal,
ramping up digestion, and relaxing major muscle
groups. This a time of rest and renewal for the
body. This branch of the nervous system is not
an opposing force of the sympathetic nervous system;
rather the two are complementary systems that
work to ensure survival by trying to maintain
a perfect balance in the body, called homeostasis.
Anxiety affects every aspect of the mind and the
body. It runs on a continuum, from mild to severe.
However, even moderate symptoms can throw a child
into a tizzy, making school the last place on
earth a child wants to go to five days a week
for most of the year.
For children who have school
anxiety, it is very difficult to turn off the
sympathetic response and turn on the parasympathetic
state of calm because the majority of their
lives is spent trying to navigate their fears
about school. Long weekends and summer vacation
can't erase having to cope with nine months
of feeling distressed and nervous. For these
children, school anxiety becomes a recurrent
condition, but the good news is that it is possible
to consciously create the relaxation response
and decrease anxiety symptoms.
How Does School Anxiety Become
Chronic? School anxiety can easily
become a chronic state unless some kind of intervention
or treatment is provided. The cycle into a persistent
state of anxiety looks like this:
Tiara, a nine-year-old fourth
grader, generally liked school, but by second
grade she began to experience panic. When she
was called on to answer an arithmetic question
or go to the board to work on a problem, she
would get very nervous and not be able to think.
Since second grade, after many
experiences of not knowing the answer or being
stumped at the board and having classmates tease
her about it, Tiara feels stupid and is nervous
about going to school. Now, when she is called
on for a math answer, the fight-or-flight response
kicks in immediately. Her heart pounds, her
whole body tenses, she feels unable to catch
her breath, and if her anxiety spikes higher,
she may experience that scary feeling she's
told her parents about, when she feels distanced
from the class and can't hear the teacher. This
severe anxious reaction makes it impossible
for Tiara to think clearly and come up with
the correct response to a math problem she does
know the answer to or to learn how to work out
problems she doesn't understand.
When math class is over or
when she's on her way home from school, the
parasympathetic nervous system activates to
return Tiara's body into a less aroused state
and a more relaxed one. However, her relaxed
state never reaches its normal resting condition
because tomorrow school looms and the worry
about math is never more than a few days away.
The cycle of Tiara's chronic anxiety is caused
by her thoughts about past classroom experiences
where she felt humiliated, and the worry that
these same situations and her feelings about
them will occur again in the future.
The fight-or-flight reaction
is a wonderful defense system; after all it
has allowed humans to survive to this day. However,
its intended purpose is to act as a short-term
solution to a physical threat, not as a continuous
state of mind and body. A chronically anxious
child, whose fight-or-flight reaction is always
just below the surface, will not be able to
decrease stress hormones or other anxiety symptoms
to normal healthy levels, interfering with the
body's balance and functioning. If not treated,
a child may develop an anxiety disorder, such
as a panic disorder or phobias. Along with anxiety,
other ailments can develop such as depression,
avoidance of challenging situations, eating
and sleeping problems, or a depressed immune
system.