Helping your child cope with anxiety in middle school and high school

By Elena Mikalsen, Ph.D.
Section Chief, Department of Psychology
The Children’s Hospital of San Antonio

Most children will have anxiety about starting middle school or high school. They worry about being good enough for sports or other electives, being smart enough for their pre-advanced placement and advanced placement classes, and fitting in with peers who all seem taller, prettier, smarter, and more socially savvy than they are. Each year brings new anxiety and most children will have some degree of anxiety and worry on their first day of school, even when it’s not their first year of middle or high school or even if they have many friends going with them to the same school. 

How to help your teen feel that she fits in
The most common worry for teens is fitting in with a new, and usually much larger group of peers. Adolescence is the time when teens struggle to find their identity and struggle to figure out which group of peers they wish to fit in with. Schools have multiple groups for teens to try and there will always be a group that will accept your teen. Reassure your child that he will absolutely find peers and acceptance. Encourage him to express his interests but also to try new things. Adolescence is a good time to experiment and try new hobbies. Encourage him to try different extracurricular activities, based on not just abilities but also interests. Especially, encourage children to try something outside of what their group of peers is doing, as often teens get stuck choosing activities based on whether they will grant an automatic acceptance to a clique. 

How to help your child fit in with his looks
Pre-teens and teens become more aware of their looks and what others think of their looks. Hairstyles (and colors), makeup, certain styles of clothing give kids both an individual and group identity. Boys and girls feel pressure to look or dress a certain way to be accepted. Make sure to recognize their need to belong and feel accepted and express understanding of this need. Don’t comment negatively on their clothing/looks/hair. Remember, you were a teen once and also conformed to peer pressure to look a certain way. If you don’t like the way your child dresses or does her hair, explain to her what your concerns are in a calm way and see if you can compromise between your standards and her need to look in such a way to belong to her group.

How to help your child feel she is smart enough
There is tremendous pressure on pre-teens and teens to achieve and take a greater number of standardized tests than ever. Schools focus increasingly on preparing children for college and pushing for higher scores on standardized tests. Psychologists see an increasing number of children with stress-related medical disorders as early as middle school. Many teens spend most of their free time inside studying for hours in order to compete for their top 10 percent rating in high school so they can attend their college of choice.

As academic competition heats up, remind your teen that colleges don’t just accept students with top grades, they also want a well-rounded happy individual who will succeed for four years. College acceptances are based on many factors, not just all As in AP classes. Make sure your child is able to carry the academic load he may have chosen. While many parents desire a top college choice for their child, being a parent also means ensuring your child has good mental and physical health. If your child becomes so overwhelmed and burned out by fighting for college admission, that he is constantly ill and depressed, you are not teaching him important life lessons about coping with stress. 

When to get professional help
Sometimes, stress, anxiety and worry about school become too severe for a teen and family to cope with. If your child’s anxiety is so high that she can’t attend school or can’t get through the day without calling you and reporting anxiety and panic, seek help from a school counselor or a child psychologist.

If your child experiences ongoing depression or anxiety, talk to your pediatrician. Check our website at to find a pediatrician near you.



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