Child psychiatrist defines anxiety, its symptoms, how to address it, and when it might be time to see a behavioral health specialist.
As of May 9, 2023, there were 19 school shootings across the U.S. that caused injuries or deaths, according to EducationWeek. Last year, there were 51. It’s difficult for any child to learn of these events and not have a certain level of anxiety about them. A 2018 Pew Research Center survey found that 57% of teenagers worry that their school will be next.
So how do parents and caregivers help their kids manage anxiety around school shootings? And what are the signs they might need help from a behavioral health specialist?
The first thing to understand is that anxiety is not bad, said E. Taylor Buckingham, MD, a child and adolescent psychiatrist at Kaiser Permanente in Colorado. “Some degree of anxiety protects us,” he said.
He compares anxiety to a yellow traffic light, which warns us that the light is about to turn red, so we need to slow down. It’s also important to recognize that kids respond differently to an anxiety-inducing event based on their age, interpersonal makeup, closeness to the event, and social environment. “We know that individuals who have more social support tend to respond better than those who don’t,” Dr. Buckingham said.
Anxiety runs along a spectrum, he said. At the low end, a child might feel anxious about going to school, but the anxiety shouldn’t interfere with daily activities. At the midpoint, a child might feel anxious enough to stay home from school for a day, but then resume attendance and other routine activities. At the high end, anxiety interferes with daily functioning — the child adamantly refuses to go to school or stops participating in other activities out of worry something bad will happen.
At that point, a parent or caregiver should enlist the help of a behavioral health specialist, Dr. Buckingham said, adding that a kid at the midpoint of the spectrum can inch toward the high end. “One day away from school turns into 2, then 3, then 4,” he said.
Anxiety is expressed differently by kids based on their age, Dr. Buckingham said. In elementary school children, it often appears as physical symptoms. They might say they can’t go to school because they have a headache, a stomachache, or their muscles are too tired. They might also be more irritable than normal.
Adolescents, teens, and young adults tend to worry about the worst-case scenario, skip school, or constantly look over their shoulder to make sure they’re safe, he said. Sometimes, if they’ve experienced a traumatic event, they might have flashbacks.
“One of the best things we can do is let them know they’re not alone,” Dr. Buckingham said. “The power of anxiety is that it’s really good at making you feel like you’re the only person in the world who ever felt this way.”
Parents and caregivers should acknowledge kids’ feelings and avoid the temptation to tell them that “everything’s going to be fine.” A child might go to school and see a friend bullied or a fight and decide that things aren’t always fine. This undermines their trust in what a parent or caregiver tells them.
For young children, Dr. Buckingham recommends showing the child you can empathize with their anxiety. “You might say, ‘I’ve noticed you’ve had a lot of stomachaches lately. You know, sometimes when I’m really stressed, my tummy bothers me, too.’”
Talking about anxiety with a parent or caregiver might be the last thing an adolescent, teenager, or young adult wants to do, Dr. Buckingham said. And that’s fine. Instead, he recommends doing things with them that are healthy and can help relieve anxiety, like going for a walk, seeing a movie, going on a hike, playing sports, or connecting to community and faith organizations.
Over time, they might open up to a parent or guardian — or a baseball coach, Scout leader, or someone at church. “We have to let kids know that there are lots of ways to get support.”
In honor of victims and to address the public health crisis of gun violence, Kaiser Permanente established the Center for Gun Violence Research in 2022, and pledged to work with other health systems, public health authorities, community organizations, and business leaders to “relentlessly pursue a healthier future.”
Additionally, the Kaiser Permanente Colorado Institute for Health Research is conducting research in partnership with Northwestern University to learn how pediatricians can best conduct firearm safety conversations and share resources with families, including safe storage cable locks. The research is funded by the National Institute of Mental Health. Learn more and find resources on firearms and child safety.
The American Academy of Child and Adolescent Psychiatry offers free educational resources to parents and caregivers addressing anxiety, bullying, depression, substance use, suicide, disaster and trauma, and other topics.