Heading back to class can be exciting for many students, but according to the Center for Mental Health Services, part of the U.S. Department of Health and Human Services, the beginning of a new school year can lead some children toward depression.

Children are experiencing more anxiety than ever, according to mental health experts. While they are worried about issues such as making friends, getting a “good” teacher or starting in a new school, there are other pervasive, more intense issues such as “fitting in,” avoiding bullies or ridicule and combating low self-esteem or body image.

According to the Center for Mental Health Services, as many as one in every 33 children may suffer from depression. Further, untreated cases of back-to-school stress can actually lead to depression.

Depression can be characterized by persistent sadness, withdrawal from family or friends, increased irritability, lack of enthusiasm, feelings of worthlessness or thoughts of suicide and, in some cases, substance abuse.

A report released this year by the Substance Abuse and Mental Health Services Administration stated that one out of every 12 adolescents, aged 12 to 17, has experienced a “major depressive episode,” although the rate was much more prevalent in females.

Some 12.7 percent of females nationwide reported a “major depressive episode” as opposed to 4.6 percent of males. Such an episode is defined as a period of two weeks or longer where an adolescent feels depressed and experiences a change in mood.

Approximately half of those included in the study said that their bouts with depression affected their home life, their ability to perform well in school and relationships with friends and family.

Tara Moser, a licensed clinical social worker who operates Delta Family Counseling in Cape Coral, said stress and anxieties will not necessarily lead to depression, but could lead to depressive symptoms.

“It can cause children to show some depressive symptoms but not necessarily full blown depression,” said Moser.

Of course, if a child internalizes his or her anxiety or stress, he or she is more likely to develop depression or other types of social phobia.

“There is a lot of stress for children to get back to school routines, especially with changing schools or not going to schools they want to go to,” said Moser.

At Delta Family Counseling, Moser said most children she works with experience stress or anxiety over not being assigned to the school that they wanted with their friends. In Lee County all students have to go through the school choice program where they can be assigned to various schools around the district.

Students who switch schools in kindergarten, grades six or nine also experience a lot of stress because they are starting at a brand new school.

Bullying has also been a growing problem and source of anxiety in schools over the last decade, although school officials are hoping the new anti-bullying legislation will curtail cases of school bullying.

“Schools are approaching bullying the correct way. I have heard good feedback from schools from parents,” said Moser.

While every person is unique and responds differently to cases of stress or anxiety, Moser said there are a number of good outlets to eliminate stress, such as participating in an extracurricular activity, being active outside or expressing oneself artistically in drawing or crafting.

Most important is having a good support system which may consist of friends, teachers or parents. She also said spending time with a family pet can reduce stress.

“I always say your dog is a good therapist, too. Animals can reduce stress. They are like your four-legged therapist,” said Moser.