Seeing your child stressed is one of the most difficult things for a parent to go through. And because children may not always know how to express themselves, their stress is manifested through different behaviours. You may think that your child is acting out for no reason, and being stubborn. But it could be that he is stressed.


“When a child is stressed, he may appear overly irritable, defiant, or sad,” explains Dr Alvin Liew, a Consultant Psychiatrist at the Adult & Child Psychological Wellness Clinic in collaboration with Mount Elizabeth Camelia Ward.

For example, routine events, comments or questions may result in the child losing his temper or precipitate crying episodes.

But if you know what signs to look out for (see below), you can help your child cope better, suggests Dr Liew.

• Sleep disturbances (difficulty falling asleep or sleeping excessively)
• Appetite changes (eating much less or eating excessively)
• Poor concentration
• Lack of interest doing activities which the child used to like
• Self-harming behaviour (eg. cutting themselves)
• Self-blaming thoughts of being ‘not good enough’
• Refusing to interact with others (being withdrawn, ‘shut down’)
• Having suicidal thoughts

“Deterioration in the child’s functioning level is another important sign to look out for – the child’s academic results and his ability to interact appropriately (and happily) with peers may be adversely affected,” Dr Liew adds.

Age does Not Matter

Children of all ages can be affected by stress. “As children get older, they tend to have more academic and social pressure,” says Dr Tan Hwee Sim, a Specialist in Psychiatry & Consultant at Raffles Counselling Centre.

“However, children of all age groups can be stressed when the demands placed on them exceed their ability to meet them. For example, children of all ages may be stressed if they have too many activities and too little time to relax or rest. Children can also pick up on parents’ anxieties and start to worry themselves.”

Dr Tan suggests ways in which parents can help their children cope with stress:

• Help your child to be aware of signs of stress and how to communicate it
• Build protective factors eg. self-esteem, supportive family and peer relationship
• Ensure your child has enough rest and sleep, proper nutrition
• Encourage exercise and enjoyable activities and a consistent routine
• Prepare your child for potentially stressful situations
• Have your child learn problem-solving skills, time-management skills, relaxation skills
• Teach them to handle disappointment, criticism or negative emotion
• Model appropriate coping skills
• Get professional help if your child continues to have difficulty coping with stress

There are, of course, certain situations in life that bring out the most stress in children. Dr Tan lists the most common ones as related to academic pressure (over-scheduled, too high expectations), social issues (fitting in, bullying) and family issues (parental marital woes, financial problems).

Coping with Stressful Scenarios

Here are some common scenarios and how best to deal with them:

Being overwhelmed by exams.

Dr Tan: Help your child get organised, for example, by working out a revision timetable together early so that he has enough time to cover all the topics he needs to revise. Breaking up the subjects into manageable topics can help revision seem more manageable.
child stress
You can also help your child to keep things in perspective – that is not to think of exam as the biggest thing in his life. Make sure your child is setting realistic targets. You need to let them know that you will listen to them and give them your support. Avoid criticism or adding on pressure. Also ensure that your child has enough sleep, and rests and eats properly.

Insomnia during exams.

Dr Liew: It’s important to talk to your child in a supportive manner, to understand what the underlying stress(es) which has been troubling him is. If possible, try to reduce the excessive amount of stress(es) on your child.

Relaxation activities (including exercises and other leisure activities), having a fixed, appropriate sleeping schedule, letting your child know that you are around to help him deal with the difficult situation, and having psychological therapy with professionals to help your child manage stress better, can be helpful. Avoid taking caffeine-related food if possible, as it may worsen insomnia.

Obsession with doing well.

Dr Tan: Emphasise to your children that there is more to life than exam results and academic achievements. Talk about the other talents, abilities, and strengths that they possess. Identify and redirect your child’s irrational beliefs if his perception of self lies solely on his academic performance. Helping your child set more accurate standards and be more realistic in evaluating himself will help him have a healthier self-concept.

Bedwetting.

Dr Tan: Bedwetting relating to stress is more likely due to sleep deprivation, drinking too much at night, or forgetting to urinate before bed. It’s important to make sure your child knows that bedwetting is not his fault. Don’t blame or punish him. Go back to methods that previously got your child dry, such as restricting fluids before bed and urinating before bed.

Tummy ache before a test.

Dr Liew: First and foremost, ensure that the tummy ache is not due to a genuine medical condition (eg. gastroenteritis). Stress can lead to excessive gastric juice production, leading to gastric reflux and related gastric discomforts.

Next, if it’s ascertained that it’s mainly due to exam stress, approach your child to gently enquire about the possible worries he might have. Is he worried about being scolded if the results are below expectations? Is he setting too high an expectation for himself or having the wrong idea that only certain grades are acceptable to get promoted? Is he having a significant anxiety or depressive disorder which has resulted in tummy ache as one of the presenting symptoms?

Assure your child that you are not fixated on the results (outcome) but rather on the good efforts put in by him. This can be done via rewards (including praising). Do not be overly critical on your child if the results are below expectations.

In the long run,

• Allow your child to know where and who he can turn to for help. This includes support from school teachers and school counsellors.
• Check-in regularly with your child on his progress in a neutral and supportive manner, without being too intrusive or overbearing.
• Maintain relaxation activities, healthy eating habits and good sleep hygiene can also help the child reduce exam-related stress.

If you suspect that your child has developed a significant anxiety or depressive disorder, see a professional to address the underlying anxiety disorder.