By Rebecca Loux, MSN, PMHNP-BC, IEDS
Director of Psychiatric Care
Blue Ridge Eating Disorder Care Center
Back-to-school season can bring a wide range of emotions for both children and parents. A little nervousness is completely normal. New teachers, changing friend groups, more demanding schedules, and the return to a structured routine can make even the most confident child feel anxious.
As a Psychiatric Mental Health Nurse Practitioner (PMHNP) who evaluates and treats children and adolescents with eating disorders, I also know that this time of year can sometimes uncover something deeper than typical first-day jitters.
So, How Do You Know the Difference?
One of the biggest indicators is whether anxiety begins interfering with everyday life.
If your child is refusing to go to school, experiencing frequent emotional meltdowns, struggling to sleep, withdrawing from friends, or their mood seems consistently low, it may be time to take a closer look. These can be early signs of anxiety, depression, obsessive-compulsive disorder (OCD), or another mental health condition.
For adolescents recovering from—or vulnerable to—an eating disorder, the transition back to school can be especially challenging. Lunch periods, busy schedules, social comparison, sports, and comments about appearance can all increase stress.
Sometimes the warning signs are subtle: skipping lunch, becoming more rigid with food choices, increased body checking, or heightened anxiety around meals. These behaviors can easily be dismissed as "just being a teenager," but they deserve attention.
Supporting Your Child Through the Transition
One of the most valuable things parents and caregivers can do is create space for open, judgment-free conversations. Instead of focusing only on academics, ask questions such as:
These simple check-ins often provide a much clearer picture of how a child is coping than simply asking whether they finished their homework.
Remember that listening is often more important than having the "right" answer. Creating a safe space where your child feels heard can encourage them to share concerns before they become larger challenges.
Looking at the Whole Picture
As a PMHNP, my role is to look beyond individual symptoms and understand the whole child. Many mental health conditions overlap, and it's common for anxiety, depression, OCD, ADHD, and eating disorders to influence one another.
Through a comprehensive psychiatric evaluation, we can better understand what's driving a child's symptoms and determine the most appropriate course of treatment. Sometimes therapy alone is enough. Other times, medication can help reduce symptoms so a child is better able to engage in treatment, succeed at school, and participate fully in everyday life.
There is no one-size-fits-all approach to mental health. Every child deserves individualized care that considers their emotional, psychological, medical, and developmental needs.
Trust Your Instincts
If your gut is telling you something isn't quite right, don't ignore it. You know your child better than anyone else.
Seeking an evaluation doesn't mean something is seriously wrong. It simply provides an opportunity to better understand what's happening and connect your child with the right support as early as possible.
Early intervention can make all the difference—helping children return to what they do best: learning, growing, building confidence, and simply being kids.
About Rebecca Loux, MSN, PMHNP-BC, IEDS & Blue Ridge Eating Disorder Care Center
Rebecca Loux, MSN, PMHNP-BC, IEDS, serves as the Director of Psychiatric Care at Blue Ridge Eating Disorder Care Center, where she specializes in the psychiatric assessment and treatment of children and adolescents with eating disorders and co-occurring mental health conditions. As part of Blue Ridge's multidisciplinary team, Rebecca is passionate about early intervention, family-centered care, and helping young people receive the support they need to build lasting recovery.
Blue Ridge Eating Disorder Care Center is a clinician-led residential treatment program serving adolescent girls and adolescents assigned female at birth, ages 11–18, experiencing eating disorders and the emotional, behavioral, and mental health concerns that often accompany them. Through individualized medical, psychiatric, nutritional, therapeutic, and family-centered care, our team helps adolescents and their families build the foundation for lasting recovery.
If you have questions about changes you've noticed in your child, concerns about eating disorder behaviors, or you're wondering whether a higher level of care may be appropriate, our team is here to help. We offer complimentary level-of-care assessments and are always happy to connect with families, healthcare providers, and community partners to provide guidance and discuss treatment options.
You don't have to have all the answers before reaching out. Sometimes, a conversation is the first step toward getting the right support.
Learn more: www.blueridgetreatment.com
Admissions: info@blueridgetreatment.com
