If you're headed back to school, chances are you've already made at least one checklist. Got your schedule? Check. What about your supplies? Check. Talked with friends about which classes you have together? Bet you checked that one more than once.

But there's something likely missing from your list, and it might be the most important thing you take care of all year: addressing your mental health and well-being.

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Going back to school can be exciting. It can also be terrifying, particularly for teens who've already experienced bullying, anxiety, stress, depression, or trauma. In addition to the nerve-wracking aspects of middle school or high school — crushes, grades, cliques — students today are grappling with intense experiences, including natural disaster anniversaries, school shooting drills, and heightened political and social tensions that disproportionately affect young immigrants, LGBTQ+ youth, and students of color.

If you're feeling a whirlwind of back-to-school stress and anxiety, there are effective ways to respond, says Theresa Nguyen, a licensed clinical social worker and vice president of policy and programs for Mental Health America.

"You can control your anxiety..." Nguyen says. "The worst thing you can do is ignore it."

Here are five of Nguyen's suggestions for making it through the challenging back-to-school period:

1. Gauge the problem

Nguyen says that most students are excited to return to school by the end of summer. But for the nearly one-third of teens who experienced poor mental health in recent years, being at school again may worsen symptoms of anxiety, depression, and post-traumatic stress.

It's important that any student who feels prolonged sadness or nervousness about school pay attention to important signs, such as stomachaches, trouble sleeping, and irritability. Those symptoms could indicate that you're struggling with stress, anxiety, or depression. Other clues might be Google searches for terms like "I hate school," "What is depression?" and "What is anxiety?"

If you want an outside assessment of your feelings and experiences but aren't yet ready to speak to a friend, parent, teacher, counselor, or doctor, you can use Mental Health America's free and anonymous screening tool. About 40 percent of those who take the test are under 18, and use of the tool spikes during the school year. In other words, you're not alone.

If the screening indicates you should seek an evaluation from a medical or mental health professional, Nguyen says you can print the results as a conversation starter with a trusted adult or doctor. If you feel uncomfortable talking to an adult, Nguyen recommends speaking with a friend about how to have that conversation.

2. Identify coping skills

Some students might already have a list of coping skills because they know going back to school can trigger emotional and mental distress. For other students, this is a new experience with a steep learning curve. Either way, Nguyen says it's important to ask yourself a series of questions: What worked before to help you feel better? What made things worse? Can you avoid that?

Asking and answering questions like these will prepare you for the moments when stress and anxiety strike. If you need to learn new skills, Mental Health America's back-to-school toolkit includes practical tips for managing your emotions.

Credit: Mental Health America

One of the organization's most popular resources for young people is its "Stopping Stupid Thoughts" worksheet. This two-page document is designed to help you deal with painful thoughts that can warp a person's mood, relationships, and self-esteem. It offers strategies for telling yourself the things you really need to hear.

3. Get educated

The internet is awash in mental health resources and educational materials. First you might check out stigma-busting websites designed for teens like Seize the Awkward and Mental Health is Health.

Then if you're interested in mental health resources and advocacy, bookmark the sites for National Alliance on Mental Illness, The Jed Foundation, American Foundation for Suicide Prevention, National Eating Disorders Association, Born This Way Foundation, and The Trevor Project.

For health and science research, including details about symptoms and treatment, consult the Centers for Disease Control and Prevention, Substance Abuse and Mental Health Services Administration, and National Institute of Mental Health.

Educating yourself about mental health is a way to empower yourself, says Nguyen.

4. Know where to draw the line with the internet

While social media and other online spaces can connect you to vital information and support, they can just as easily make you feel miserable. Nguyen says it's imperative for students experiencing mental health distress to know where to get guidance, resources, and help.

It's sometimes hard to know where to draw a line when, for example, posting on an anonymous social media platform simultaneously brings you support from new friends as well as attacks from strangers or bullies. Unfortunately, algorithms and misinformation can also muddy your social feeds with harmful suggestions.

"Cleaning up your social feeds so that you see uplifting, and fact-checked, content can have a huge impact on your mental health," says Nguyen. "When seeking information about how you're feeling, look for accounts and organizations led by experts."

5. Reach out

Nguyen says it's normal for people experiencing mental health issues to feel unsure about what to do next. But the longer we wait to open up, the worse we feel. She urges young people to reach out to a friend, parent, counselor, coach, or someone else they trust.

It can also be helpful to join extracurricular activities, which provide opportunities to boost self-esteem, learn new skills, and heighten your sense of belonging. But that's not a simple step for teens who feel alone because they've been bullied, are questioning their sexuality or gender identity, or are undocumented.

"For kids who have anxiety, especially if they're bullied or extra isolated, it's hard for them to think about how to join a group," says Nguyen. "They’ve been strategically isolated at school."

That's when making connections on the internet can help. School groups like gay-straight alliances can also be a welcoming environment for marginalized kids, and the same may be true of community arts organizations and nonprofits.

"There are some situations where if you're struggling, please reach out sooner than later," says Nguyen. That includes if you're experiencing suicidal thoughts or engaging in self-harm. The same holds true if you're not sleeping, you're having strange thoughts, and things don't make sense. Though rare, that could indicate the onset of psychosis or bipolar disorder, which can be effectively managed through early diagnosis and treatment in collaboration with a specifically trained medical provider.

"There are some situations where if you're struggling, please reach out sooner than later."

Nguyen says that by taking action, learning more, and reaching out, teens worried about their mental health can make a big difference in their own lives.

"You got this. You are the expert," she says. "You can get control, so let’s start thinking about it."

If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.

UPDATE: Aug. 6, 2023, 5:00 a.m. EDT Originally published in August 2018, this story was updated in August 2023.

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