Deborah Howell (Host): Well, whether they're starting daycare for the first time, moving up to a new grade or heading off to college, that first day of school can be stressful for kids and parents. Joining us is Dr. Brittany Peters, a psychiatrist here at PRISMA Health, to offer some advice on how to make the back to school transition easier.

Host: This is Flourish, a podcast brought to you by PRISMA Health. I'm Deborah Howell. Welcome, Dr. Peters.

Dr Brittany Peters: Hi. Thank you so much for having me.

Host: Oh, our pleasure. So, this is a big subject, so let's just go ahead and dive right in. First off, how do you know if your child is just jittery about going back to school or if they might be dealing with anxiety?

Dr Brittany Peters: I think first I'd just like to point out that anxiety in new situations is completely normal. So, we all have anxiety when we aren't quite sure what to expect next or what's coming around the bend. So when kids are headed off back to school, it's a good idea to just kind of check in with them. How are you feeling? Are you feeling nervous? Are you feeling excited? And help them understand that anything that they're feeling is completely normal. I would say don't be surprised if you get some moans and groans or some anxious responses. But if your kid's really having trouble doing their usual activities like eating or sleeping, if they're complaining of having frequent nightmares, if they're not able to turn their attention to activities that they would typically enjoy or have fun doing, those are things that we might want to look at a little more closely and consider, you know, are they having more anxiety as opposed to just kind of back-to-school jitters.

Host: Sure. Now, how can we make the transition of going back to school easier?

Dr Brittany Peters: I think it's important to focus on getting back into that routine. So, summertime is really kind of a much needed break from the rigors of school and our usual after-school activities and all of those kinds of things. And so, transitioning back to school should really kind of focus on getting back to the basics, so things like sleeping at a usual routine, eating on a schedule, moving our bodies. So, I usually will advise parents to start moving back bedtimes, because we all know those bedtimes can creep later and later during the summertime. and starting to schedule earlier wake up times really a couple weeks before school starts, 15 minutes at a time every few days.

Also, getting back on a regular meal schedule. Kids tend to spend the day kind of grazing through snacks, whatever they can find in the pantry, and getting back on a regular meal schedule like they're going to be on when they're in school will help them fuel their brains appropriately and kind of get their bodies back on track. And then also, trying to get in some exercise and movement. Kids tend to be working in bursts during the summertime, you know, getting out and playing, but then also spending a lot of time laying around, especially with more electronics available. So, we want to make sure that kids are up and moving and using their brains and bodies, so that they're kind of used to that when they get back into the school day.

Host: Great idea. Now, any tips for parents of toddlers who are going to daycare for the first time?

Dr Brittany Peters: Yes, absolutely. So again, I think we're all anxious of the unexpected, what we don't know is going to happen next. But for older people, you know, we've been through things that are not expected and we know, "Hey, I'm going to be okay. I've done this before and it turned out fine." Toddlers, on the other hand, have a very limited amount of life experience. So when something new or novel comes up, that can be pretty scary for them. So, the more that you can do to help them understand what's coming next is going to be helpful. So if they have the opportunity to go meet their teachers or tour their classrooms or to sort of learn what their schedule is going to be like in school, any of those things could be helpful. Even practicing the schedule for the day at home, like "Hey, at this time, you're going to be meeting your teacher. At this time, you're going to be doing playtime. At this time, you're going to be having snack," that kind of thing, just to sort of take the edge off that novelty and make it something that they can expect and have gone through the routine to an extent, that can really take the edge off.

Host: Okay. Now, this is a multiple kind of question. What is separation anxiety? Does it only happen to little kids and what can parents do about it?

Dr Brittany Peters: So, separation anxiety is essentially an excessive amount of distress, experienced by-- it can be anyone, so it doesn't necessarily have to be a little kid. It's more common in little kids, but anyone who's separated from a caregiver or a strong attachment figure, so that could be any loved one that someone has a strong attachment to. Like I said, it's most commonly experienced in young children. However, elementary school-aged children, middle school, high school-aged can also experience separation anxiety. And this is typically a problem when trying to drop kids off at school, drop them in their classroom or drop them in car line. And it can be helpful to have kind of a transition plan in place. So, these are the things that we're going to say to each other on the way out the door or we're going to hug and say goodbye and then I'm going to leave. Again, it's that knowing what to expect, what's the routine going to be can be helpful.

Also, I always recommend not prolonging that drop off period. So if you're taking your little one into their classroom, we're not going to do one more hug and one more hug because then the child will then say, "Oh, if I keep asking for one more hug, I can keep mommy or daddy or, you know, whoever in the room with me." So, that's important also.

The other thing that I recommend sometimes with kids that are struggling with separation anxiety is allowing them to have a transitional object. So, what that is, is something that they can keep with them or hold with them that reminds them, "Hey, mom and dad are coming back," or "Grandma's coming back," or whoever the caregiver is. And so, it's something that their caregiver gives to them at drop off and then they give back to the caregiver when they get back home. So for young children, that could be something like a blanket or a stuffed animal. That obviously doesn't work as well in older kids. So, things like a bracelet or a small picture or something like that can be helpful for separation anxiety as well.

Host: Okay. And what are some common struggles you see among elementary school children, and what advice do you have for those?

Dr Brittany Peters: So, kids in elementary school, they kind of experience a broad spectrum of anxiety symptoms with return to school. So, some kids start to have more social anxiety in elementary school where they kind of worry about, "What are others thinking of me? How do I fit into my friends?" Some kids are having performance anxiety about their academics or still that separation anxiety. And I think one thing that's important to remember is anxiety is very, very common. And so, this isn't something that we should feel ashamed of or take as a problem with our parenting or something like that. And so, I think it's important to feel open that you can talk to teachers and administrators and school personnel, you know, "My child's struggling with X, Y, or Z. What has been helpful for other kids in the past? Can we work together to manage this?" Because those teachers and administrators have seen this a hundred million times and they can sort of help to arrange plans depending on the specific situation.

Also, I think it's important to point out sometimes kids start to really resist wanting to go to school or saying, you know, "Can I be homeschooled? Can you keep me home from school?" And I think it's really important in those cases to reach out to the school personnel, the guidance counselor, the administrators, to work on a plan for helping your child feel more comfortable in school and staying in school, because pulling the children out of school kind of teaches them that their fears are correct and they can't handle that tough situation, and we just need to avoid it. And I think an important lesson for everyone regarding anxiety is that we can also experience anxiety, but also learn to manage it and deal with it in a way that's healthy and appropriate.

Host: Sure. And now, maybe the most challenging, why is middle school such a stressful time for kids?

Dr Brittany Peters: Oh, man. Yeah, I think we've all been there. So, middle schoolers are developing all kind of at different rates. So, kids are just physically, socially, emotionally, they're all over the place, they're all at different levels. And at the same time, they're kind of trying to figure out how do I fit in with everybody and everybody is so different from me. And so, that can be very stressful. And then again, logistically, middle school things are different. They might be changing classes for the first time. They might be put into different academic tiers for the first time. And all of those things can create stress. And so, I always recommend in middle school, don't be afraid to ask your kids how things are going. Let them know it's okay to talk. Again, you might get some eye rolls, leave me alone. A lot of that is very normal. However, it does plant the seed, "Hey, I'm available. I'm here. I'm open to hearing anything that you need."

Host: Okay. And you know, I'm going to have to ask you, how can parents help their teens manage the pressures of high school?

Dr Brittany Peters: Yeah. So again, I think I would stress the importance of open communication. What I hear the most from teens is that when they're trying to talk to their parents, the parents are constantly trying to give advice. And I think as a parent it's tough to hold back on giving advice because you want to help your teenager, you want to give them your experience and try to help them navigate the world in the best way possible. But sometimes, kids just kind of wanna talk and be heard. So, letting them talk and getting curious about how they're feeling and why. And if you want to give some suggestions saying, "Would it be okay for me to give you some suggestions from my experience?" That can go a long way in keeping kids kind of shutting down. That's not to say it's not important to have rules, boundaries, consequences, for risky behaviors, which can certainly come up in those high school years. But, you know, as far as that's concerned, I think it's also best to discuss expectations around behavior ahead of time. And kind of work together collaboratively on, "What's going to happen if I engage in this behavior? What can I expect as a consequence on the front end?" So, everybody's kind of on the same page.

Host: Okay. Here it is. Finally, your student is heading off to college. How can we help them? Because you know they need help during this very difficult transition.

Dr Brittany Peters: Yeah, that's a big transition for sure. And I think acknowledging to your student that it's okay to have mixed feelings. Like this is an exciting time and there's lots of graduation parties and there's lots of, "Oh, congratulations. We're so excited for you. We're so proud of you," that sometimes you can feel like, "Oh, maybe I shouldn't be feeling anxious. Maybe I shouldn't be concerned about this." So, putting up front, like it's normal to feel both excited and nervous at the same time, or all nervous or any of those things.

So, I usually tell parents, you know, if you have a student who's already had some level of anxiety or depression in high school or even earlier, help them recognize what their warning signs are. These are signs that stress might be becoming a lot for you or the anxiety might be coming a lot for you and help them understand what they can do. So, most colleges and universities do have student mental health centers, so identifying those ahead of time. So, if you do get in a tough spot, this is what you can do and you can access that pretty easily. And then also, I think it's important to remember that if your student had any kind of accommodations for learning or anxiety or depression or anything like that as they were going through school, those accommodations still hold true in college and university settings. And I think it's important for kids to feel comfortable knowing that those things will still be in place, reaching out to the student help centers, to make sure that those accommodations are still going to be carried on throughout college as well.

Host: I'm sure they had them when we were going through college, but it's so wonderful, all the resources that students have these days.

Dr Brittany Peters: Yes, it is definitely wonderful. And I think it's important people just have to remember they exist and so they have to ask for them.

Host: Yeah. Like it would never have occurred to me in college to seek help if I were anxious, you know. Now, it's kind of more normalized, right?

Dr Brittany Peters: Exactly. And I think that's wonderful that people feel more empowered and encouraged to reach out when they need help, as opposed to feeling kind of ashamed and it's something they aren't supposed to talk about.

Host: Dr. Peters, is there anything else you'd like to add to our conversation?

Dr Brittany Peters: I just really appreciate you giving me the opportunity to come here and talk and this being an open forum for us to discuss these important issues.

Host: Wonderful. Well, it was a pleasure to have you. Thank you so much for this great information. We really appreciate how you've shined a light on back-to-school stress today.

Dr Brittany Peters: Yes, ma'am. Good talking to you.

Host: Dr. Brittany Peters is a psychiatrist here at PRISMA Health. For more information and other podcasts like this one, head on over to prismahealth.org/flourish. This has been Flourish, a podcast brought to you by PRISMA Health. I'm Deborah Howell. Have yourself a terrific day.