A young boy sits on the floor and rests his head into his knees. He appears upset.
Anxiety can manifest in many ways during the middle school years. It’s essential for parents and caregivers to spot the warning signs. (For Spectrum Health Beat)

Of all the stages of youth, there’s little disputing that middle school is among the toughest.

There’s peer pressure. Awkward social interactions. Infinite moments of embarrassment. Strange physical and mental developments. Unpredictable experiences aplenty.

The middle school years are indeed legendary for the imprint they leave on a child’s psyche.

It’s a lot for kids to process.

A host of factors can influence how a child handles the events of this period—genetics, environment, parenting, societal norms, you name it.

For some, this formative stage leads to problems with anxiety.

And it’s critically important that parents and caregivers learn to spot any signs that suggest a child might be experiencing problems.

“(It) can present in multiple ways, some more common than others,” said Adelle Cadieux, PsyD, a pediatric psychologist with Spectrum Health Helen DeVos Children’s Hospital.

Dr. Cadieux highlighted some of the hallmarks:

Changes in sleep

Anxiety can make it more difficult for your child to fall asleep or stay asleep through the night.

Sometimes, your child will sleep to avoid feelings or activities that trigger the anxiety, Dr. Cadieux said. Consequently, you may also see your child sleeping more.

Sleep changes are sometimes expected by parents and simply dismissed as teenage sleep patterns.

But it would be a mistake to dismiss them out of hand.

“There are some changes in sleep during adolescence, (but) excessive sleep and poor sleep schedules and (poor) hygiene are not helping a student perform at their best,” Dr. Cadieux said. “And these can be a sign of underlying concerns for the student.” 

School refusal

Another area of concern involves how your child responds to school.

This can arise in many forms, Dr. Cadieux said. Students may complain about frequent aches or pains in hopes of avoiding school, or they might find it difficult to get up or get ready on time.

Their irritability might also increase in the morning.

And once they arrive at school, they may even complain of physical pain in hopes of leaving the classroom and spending more time in the office, or getting a parent or caregiver to pick them up, Dr. Cadieux said.

Performance changes

Anxiety can sometimes make it harder for students to focus and stay on task, which can lead to lower performance in academics, Dr. Cadieux said.

The anxiety can lead to procrastination, robbing the student of adequate time to study for tests or complete an assignment.

When parents notice a change in their child’s academic performance, further investigation is needed.

Middle school tends to be a significant transition time for many youth, given the increased academic demands and the heightened need for students to become more independent and organized.

“This can be a definite challenge for some students,” Dr. Cadieux said. “And navigating through the additional demands can impact a student’s performance.

“Sometimes anxiety is playing a role in the change in academic functioning, but sometimes other factors are there, such as still developing organizational, planning and study skills.”

Increased behavioral problems

For some students, anxiety can impact behavior.

The behavioral issue might simply affect how the student expresses his or her anxiety, but other times the behavior can have the secondary effect of removing the student from the classroom or avoiding the activity that might be causing the anxiety.

Your child may not say “I’m anxious,” but they may make statements about not wanting to do something or statements about not liking an activity, Dr. Cadieux said.

Parents must watch for such subtleties.

You might also hear more negative statements your child says about himself or herself, or about situations.

Changes in extracurriculars, socializing

If your child says they’re not interested in something, or if they seem more withdrawn and irritable, these could be signs of anxiety.

Watch for increased defiance, too, especially around school and social functions, Dr. Cadieux said.

Anxiety can interfere with the student’s ability to stay involved in extracurriculars and it can keep them from trying new activities or socializing.

Parents or caregivers can learn to spot specific behavioral problems that suggest trouble is afoot.

Some middle schoolers will stop being involved in activities they once enjoyed, such as sports or school clubs.

As sports become increasingly competitive, the pressure to perform increases and creates a level of anxiety that makes the activity too difficult to manage.

For many kids, middle school is rich with opportunities to participate in extracurricular activities—but anxiety can impact their desire and willingness to try those new things.

Negative statements to watch out for: “I don’t like it,” “I heard it’s stupid,” and “Nobody does that.”

If parents suspect their child is battling anxiety, it’s important they take action.


Are some signs easy to miss or mistake for something else?

“Irritability is an easy sign to miss, as many parents expect some irritability during adolescence,” Dr. Cadieux said. “Parents can start watching for triggers of the irritability to see if there are patterns.

When anxiety interferes with your child’s functioning at home, at school or with friends, it’s definitely time to step up your involvement.

“For example, if getting your child to school each day has become a combat zone in your home, it’s time to intervene,” Dr. Cadieux said. “If your child is struggling with school or withdrawing from friends or activities, it’s time to intervene.”

Whenever possible, encourage discussions with your child prior to a big transition. This allows them to prepare and develop some questions.

Dr. Cadieux’s advice:

  • Provide your child with information about what to expect and when to expect it.
  • Listen to your child’s concerns about the transition and answer as truthfully as possible. It’s OK to say, “I don’t know,” or, “We’ll have to look into that.”
  • Remind your child that other questions can come up later and you’re always available to talk again.
  • When you notice something has changed or you have a concern, talk to your child about it—and listen to what they have to say.

The bottom line: As a parent, you need to make time to talk to your child.

“Find a time that you won’t be too distracted, but also a time when you can capture your child’s attention—at the dinner table, before bed, in the car, etc.,” Dr. Cadieux said.

When your child shares feelings or experiences with you, listen to them.

“Try to avoid dismissing the feeling or telling your child they shouldn’t feel that way,” Dr. Cadieux said. “Acknowledge their feelings. Maybe even repeat what you heard them say so that you know you understand and your child knows you understand.”

If you’re not sure what to do, it’s time to look for additional help.

Seek help

Ask your child if they’d like advice or help in solving the problem, Dr. Cadieux said. Talk about next steps and see if they’d like additional help beyond talking to a parent.

“Parents are a model,” Dr. Cadieux said. “Model for your kids strategies to cope with stress and anxiety.

“If, as a parent, you struggle with your own anxiety and stress, seek resources for yourself to learn ways to cope.”

Engage in stress-relieving activities as a family—go for walks, play games, have fun together.

At day’s end, if the anxiety is difficult for your child to manage, seek help for them.

“Connect to a counselor,” Dr. Cadieux said. “Many insurance companies do not require a referral for counseling, but check and see what benefits your insurance has and how to access care.”

You can also talk to your child’s pediatrician.

“Many pediatrician offices are familiar with resources in the area and can provide some guidance to parents,” Dr. Cadieux said.

Finally, take time to talk to teachers and staff at your child’s school.

“Teachers and other staff can be your allies at school,” she said. “And some schools either have support at school or can assist families in connecting to help in the community.”