We have all experienced trepidation before a life-changing event, or a small anxiety-provoking experience. The feelings of butterflies in your stomach, your heart pounding in your chest, or the need to run to the bathroom several times in an hour, is a familiar sensation to most everybody. Regardless of whether you are worried about an upcoming flight, an important business meeting or a life-altering phone call, the physical sensation is the same.  Many children experience this on a yearly basis, prior to the start of a new school year.

What differentiates common anxiety from debilitating anxiety, which can immobilize a child and lead to school refusal? Where does excitement turn to crippling fear? The answer is multifaceted. Nervousness can be adaptive and productive. Anxiety before a test or a big business meeting is important, as it can lead one to study harder and work to his or her full potential. Alternatively, it can be maladaptive, leading to avoidance or refusal.

New Beginnings

A new school year encompasses many changes: a new teacher, harder academic assignments, a change in classroom, and of friends, and at times, a new school. This may occur concomitantly with the loss of a peer group, which can be viewed as a type of death, necessitating time to grieve. For a teenager, this is especially difficult, as they are working towards individuating from their parents, gravitating towards peers, and searching for their own, separate identity. For those with a learning disability, or a developmental delay, a new school year may be fraught with the further peril of increasing frustration if the child is unable to absorb knowledge at the pace expected. For those gifted with superior intelligence and higher expectations, there may be fear of not living up to one’s potential.

Each child also brings with them the residual feelings from the prior school year. If it was a happy, productive year, excitement and enthusiasm may predominate. Alternatively, if there is a history of bullying, depression, or G-d forbid tragedy, apprehension and fear may be foremost.

Easing the Transition

How can parents and healthcare providers ease this yearly transition? Open communication is of utmost importance. Children need to feel comfortable enough to express their feelings openly, without fear of repercussion. They should be encouraged to show anxiety and apprehension, as well as enthusiasm and excitement. These feelings should be normalized, and reassurances given. Fear of the unknown is usually worse than reality, and so different scenarios, whether imagined or realistic, can and should be discussed. Role playing may be a helpful tool as well.

Parents and siblings play an integral role in making the school a comfortable and non-threatening space. Eating dinner as a family allows for continued involvement in the day to day activities of the household, and problems can be addressed before they become catastrophic.

If the child experienced difficulties the previous year, a meeting with the school social worker, teacher or guidance counselor may alleviate trepidation, and allow a contingency plan to be formulated to aid in the transition. If anxieties and fears begin to become overwhelming and impede functioning, it may be appropriate to seek mental health treatment. A therapist or psychiatrist may want to collaborate with the school for greater support and transparency.    Each child needs the support of their friends, family, and at times, treatment providers, to reach their fullest potential for academic, social, and emotional success.  


Pamela P. Siller, MD is a Board Certified Child, Adolescent and Adult Psychiatrist who provides medication management as well as individual and family therapy to children and adults. She maintains a private practice in Great Neck, New York. Dr. Siller is also the Director of Child and Adolescent Psychiatry at the Interborough Developmental and Consultation Center in Brooklyn, and an Assistant Professor of Psychiatry at New York Medical College. Dr. Siller can be reached at 917-841-0663.