Back to School Anxiety: Helping your child

Jennifer Hanes MS, RDN, LD

Gosh, it’s that time of year again!  And while anxiety surrounding the return to school after summer break is common; we’ve got extra reason to be nervous this year.

Here in Texas, we’re experiencing another COVID surge with a variant that seems to be affecting younger people more than earlier variants. And since masks are about off the table, RSV cases are on the rise again as well.

Causes of back to school anxiety

But anxiety surrounding back to school is not new, and there are many causes.

For instance, this morning, my son today said he was worried because he hasn’t seen any of his school friends since the end of last year.  He doesn’t know if they’ll be different, if they’ve dropped out of their dual language program, or if there will be new students he’s not familiar with.  He is also a bit worried about who will be wearing masks and if people will be mean because he will be wearing his.

In the past,  he’s alternated between excitement and nervousness about his lunches, despite always having input on those meals.

Other reasons often cited for anxiety about school include:

  • Bullies
  • Body image/confidence concerns
  • New physical appearance (glasses, acne, puberty)
  • New school
  • New teacher
  • Pressure to excel
  • Difficulty during the previous school year
  • Fear that new lessons will be too hard
  • Friends moved away
  • Separation from parents or siblings
  • More

Signs of Anxiety in Kids

It is important to note, that I am not a therapist. However, there are some common themes in how anxiety presents in kids.

  • Chronic, consistent dodging of school – beyond the occasional “I don’t wanna’s”
  • Frequent headaches or GI distress (nausea, diarrhea, cramps)
  • Increase in tantrums, fits, or bad moods
  • Difficulty sleeping
  • Expresses fear or concern over school, curriculum, friends, or being in public
  • More

There are great resources for how to manage anxiety in kids online. But often in boils down to giving them a space to talk and process.  Breathing exercises, practice runs, and modeling comfort/ease. 

However, I would like to focus on lifestyle and nutrition factors that can help.

Can nutrition and lifestyle really help back to school anxiety?

Absolutely! Granted, there are frequently times when lifestyle modifications are not enough.

Mild anxiety that centers around a particular, transient event is normal. However anxiety that does not resolve or is affecting your child’s quality of life needs to be addressed with their doctor and a therapist.

So what can help?

Many things can help with a child’s ability to cope with stress and anxiety. Consistency is very important here. So is following your doctor’s advice.

Nutrition

There isn’t any research yet that shows a direct link between a particular food or nutrient and anxiety symptoms. However, a well-balanced diet seems to help.

Offer fruits, veggies, whole grains, and lean proteins that your child is willing to eat.  Resist the urge to force or fight over these foods, or you’ll counteract your intentions.

Mix new and familiar enjoyable foods with each meal. Introduce new foods with nonchalance. Let your kiddo see you enjoy a wide variety of fruits and vegetables.

Basically, keep the stress out of food to avoid making food itself an anxiety trigger.

Consider sending your child to school with a lunch that they helped prepare. Sliced cucumbers, baby carrots, and fruit are generally well accepted. Include a whole grain and a protein source (maybe a chicken or turkey sandwich) so that they maintain energy throughout the rest of the day. If possible, prepare this the night before, so they aren’t feeling rushed or under pressure about this in the morning.

Low blood sugar can cause them to feel anxious. 

Having control over their meal can be empowering, especially for the younger guys. And they won’t have to worry about a negative suprise in the cafeteria or from a lunch bag you prepared without their input. *Bonus: sneak an occasional encouraging note or treat into their lunch box when they’re not looking.

Caffeine is a major anxiety trigger for many people. Consider their drink options accordingly.

Activity

Exercise is one of the most proactive anxiety management techniques I can offer you. My patients find walking outside (particularly on a hiking trail) the most effective.

However, any exercise shows improvement in anxiety in various studies.

If your child is already involved in a sport or physical activity keep it up! If not, consider gentle encouragement such as inviting them on a walk with you, asking them to walk the dog, visiting a zoo or museum, etc. 

Exercise does not have to be strenous to be effective at managing health and anxiety. In fact, if the 2 of you can hit on something enjoyable, they will be more likely to be consistent and turn to that activity when feeling stressed or anxious.

Other lifestyle factors

Adequate sleep – Set a bed time and be consistent with it.  Keep in mind as they approach the teenage years, their natural sleep schedule will  likely skew later!

Screen time – Try to cut off screens about an hour before bed. Use this time for calming activities such as reading, coloring, quiet hobbies, etc, as well as prepping for bed.

While you’re at it, keep track of what their watching, reading, listening too. Make sure it’s appropriate for your child’s age AND development!

When to seek profesional help

The short answer? If you’re worried, you should bring it up to their doctor. Early intervention from a doc and therapist is invaluable.

Specific signs to look out for:

  • Avoiding activities or situations they previously enjoyed
  • Inability to enjoy daily activities
  • Significant time spent worrying
  • Symptoms of illness with no apparent cause
  • Anxiety for a prolonged period of time (weeks to months)

Take-away

There are a multitude of techniques to help your child (or yourself) with anxiety. 

Because I am not a therapist, I cannot make specific recommendations on how to manage an individual’s anxiety. However, we can use diet and lifestyle techniques to supplement any medications or techniques that your doctor or therapist recommend.

Remember that some amount of stress or anxiety surrounding a particular event may be normal, but it should NOT interfere with daily life and activities.

Provide a calming environment and look out for signs that your child’s anxiety may be more than general nervousness surrounding the unknown.

More stress management tips

Why are carbs comfort foods?

Jennifer Hanes MS, RDN, LD

Carbohydrates are famous in comfort food circles. But why? In this article, I discuss many reasons that carbs are comforting.

Low carbohydrate diets have been frustratingly popular since the 90s.  I can remember when popular fad diets skewed from low fat to low carbohydrate in high school. It was revolutionary! Everyone was finally going to be skinny!

I can also remember grumpy moods, stories of “gym bro” freakouts at the gym, and complaints of hair loss from male relatives.

In essence, chronic dieters went from constant grumpiness caused by excessive hunger and cardio in the 80s to constant grumpiness caused by low intake of the brain’s preferred fuel.

Carbs provide fuel to our brain and muscles

Our brains consume a LOT of glucose. An organ that contributes only ~2% of our weight consumes ~20% of our daily glucose intake (in a well-balanced diet).  In fact, our brains use approximately 5.6mg of glucose (from carbohydrates) per 100g of brain tissue every minute!  

So you can imagine, severely restricting your carbohydrate intake could lead to reduced brain performance. People often report feeling grumpy, tired, and foggy-headed, or confused on a low carbohydrate diet.

In addition to giving us energy, steady moods, and clear thinking, the brain utilizes carbohydrates to make various neurotransmitters that enable us to perform many functions, including learning and long-term memory formation.

 

Glycogen is stored carbohydrates that are found in the brain, muscles, and liver. When exercising, your muscles have a rapid energy source readily available. They do eventually switch to other sources of fuel when glycogen sources are depleted. Unfortunately, fat is an inadequate source for muscle training, and they will turn to protein first!  This means that when you don’t eat enough carbohydrates to fuel your muscles you run the risk of muscle breakdown. 

*Side note: this is why low-carb diets initially appear so effective.  When you don’t eat enough carbohydrates, your body releases glycogen stores to maintain your ideal blood glucose range.  Glycogen is stored with water, so you are losing water and glycogen weight, but not necessarily fat! This effect is temporary. The weight gain people see when stopping a low-carb diet is partially a result of restoring glycogen stores.

Carbs help make “feel good” hormones

In fact, low-carb diets are often associated with fatigue and grumpy moods, sometimes even abnormal aggression.

This all makes sense with a quick biology lesson!   Tryptophan (widely known in turkey, but actually present in a wide variety of food) is crucial for many of our feel-good hormones, including serotonin and melatonin.  To make these hormones, however, tryptophan has to make it into the brain. And the only way it does this is by using carbohydrates as a carrier. So when our carb intake is too low, they are used for their most vital functions only. And unfortunately, a good mood is not vital to survival. (side note, getting enough carbs also prevents muscle breakdown – so they do play a role in keeping you strong as well!)

But… there is value in other carb sources for a quick boost. Refined carbs can give us a quick burst of energy

While not ideal for overall health, a refined carb source (such as potato chips, cookies, crackers, etc) will provide you a fast, but short-acting energy and mood boost.  The need for this boost at 3 pm every day may indicate your lunch isn’t as balanced as it could be, or that you simply need to plan a snack into your routine!

Fiber and other complex carbs keep us full and our guts happy

By now, everyone’s heard of probiotics. Some have even heard of prebiotics, which are the foods the probiotics “eat.”

The probiotic fauna in our gut loves them some fiber and complex carbs! Along with unsaturated fat (from fish, nuts/seeds, olives, and avocado), complex carbohydrates are their preferred source of fuel.  A happy gut colony can then indirectly lead to benefits in your mood and energy, though scientists are still determining how large this effect is and how it works.

Fiber also has this awesome ability to “gel up” and take up more space in our stomachs. It then moves more slowly through our GI tract than simple carbs. So we fill up, and stay full longer!

Low carbohydrate intake increases cortisol, the “stress hormone”

Our body perceives low carbohydrate intake as a stressor.  Any type of stress can raise our cortisol levels and sour our mood. And this “perceived starvation” can definitely be stressful to our poor confused bodies.

This rise in cortisol is for a reason. When we don’t eat enough carbs, our body tries to “make” glucose from other sources, namely protein stores.  Cortisol helps it achieve this. Along with increased appetite and reduced energy levels – meaning, we get tired and pissy.

So what does this all mean?

So we should eat carbs, right? So eating pizza, pasta, and bread all day will fix our mood. Then tack on cake, soda, and candy and we’re golden, right?

Not so much…

We need a balance so that we also make sure we get plenty of protein, healthy fats, and non-starchy vegetables.

Additionally, the quality of our carbohydrate intake matters just as much as the quantity.  Carb sources should come primarily from starchy vegetables (yes – even potatoes), fruit, and whole grains.  

Those lovely, lovely probiotics don’t love sugar as much as you do!  Have your simply carb snacks when the occasional craving strikes. But focus on the sources listed above. 

You’ll have more stable energy and carb distribution throughout the day as a result.

For those of you that are more visual, I’m a big fan of Harvard’s Healthy Plate.

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