Dr. B. J. C. Perera
MBBS(Ceylon), DCH(Ceylon), DCH(England), MD(Paediatrics), FRCP(Edinburgh), FRCP(London), FRCPCH(United Kingdom), FSLCPaed, FCCP, FCGP(Sri Lanka) Consultant Paediatrician
To most adults, childhood can and does seem like a carefree time without stresses and worries. They believe that stresses and worries are only for adults. In point of fact, it is generally not appreciated universally that children too could be subject to the same problems, emotions, stresses and worries as adults. Things like school and social life, which are taken for granted, can sometimes create pressures that can feel overwhelming for children. Parents could take some steps to protect children from these occurrences and help them to develop healthy ways to cope with stress and solve everyday problems. Some scientific surveys have clearly identified that children do deal with stress in both healthy and unhealthy ways. It has also been established that although they may not initiate a conversation about what is bothering them, children do want their parents to reach out and help them cope with their troubles. However, it must be acknowledged that it is not always easy for parents to know what to do for a child who is feeling stressed.
Children do not have to pay bills, cook food or manage the home situation. However, just like adults, they have their fair share of daily demands and things that do not go smoothly. If frustrations and disappointments pile up, they can get really worried. It is of course quite natural for children to worry at times and because of personality and temperament differences, some may worry more than others. Parents need to and they often do help them manage worry and tackle everyday problems with ease. Children, who are able to do that, develop a sense of confidence and optimism that will help them master life’s challenges, whether they are big or small.
The things very many children worry about are often related to the age and developmental stage that they are in. Younger children and pre-teens typically worry about things like grades, tests, their changing bodies, fitting in with friends, that little mishap in a sporting contest or whether they will make the team. They may also worry about social troubles like cliques, peer pressure or whether they will be bullied, teased or left out. Because they are beginning to feel more a part of the larger world around them, preteens also may worry about world events or issues they hear about on the news or at school. Things like terrorism, war, pollution, global warming, endangered animals and natural disasters can become a source of worry. Things like earthquakes, tsunamis, tornados and storms may worry them as much as these things bother adults.
Pressures often come from outside sources such as the family, friends or from school. However, there are some instances where these also come from within. The pressure many people, including children, place on themselves can be quite significant because there is often a discrepancy between what they think they ought to be doing and what they are actually doing in their lives. Stress can affect anyone who feels overwhelmed and this includes children as well. In preschoolers, separation from parents can cause anxiety. As they get older, academic and social pressures, especially the quest to fit in, create worry, stress and other ensuing problems. In the current social scenario, many children are too busy to have time to play creatively or relax after school. Some of them who complain about the number of activities they are involved in or refuse to go to them may be signalling that they are overburdened.
Stresses of children may be intensified by more than just what is happening in their own lives. If and when they hear about the problems that their parents and loved ones have at work or with their circle of acquaintances or them worrying about a relativeillness or fighting with each other, the children automatically feel the pressure and are exposed to a stressful environment. It is very important for parents to be very careful as to how they discuss such issues when their children are near because children will pick up on their parents’ anxieties and start to worry themselves.
Local and world news too can cause stress. Children who see disturbing images on television or hear talk of natural disasters, war and terrorism may worry about their own safety and that of the people they love. It is advisable to talk to children about what they see and hear and monitor what they watch on the box so that one could help them to understand what is going on.
Also, one needs to be aware of complicating factors, such as an illness, death of a loved one, or a divorce. When these are added to the everyday pressures children face, the stress is magnified. Even the most amicable divorce can be a difficult experience for children because their basic security system, which is their family, is undergoing a drastic change. Separated or divorced parents should never put their children in a position of having to choose sides or expose them to negative comments about the other spouse.
While it is not always easy to recognize when children are stressed out, short-term behavioural changes such as mood swings, acting out, changes in sleep patterns or recent onset bedwetting can be indications. Some of them experience physical effects, including stomach aches and headaches. Others have trouble concentrating or completing schoolwork. Still others become withdrawn or spend a lot of time alone. Younger children may show signs of reacting to stress by picking up new habits like thumb sucking, hair twirling or nose picking while older ones may begin to lie, bully or defy authority. A child who is stressed may also have nightmares, difficulty leaving the parents, over-react to minor problems and show up drastic changes in academic performance. In some children the changes seen may be so subtle as to go almost unnoticed.
There are ways in which parents can help children cope with stress and perhaps even mitigate the effects of it. Proper rest and good nutrition can boost coping skills as much as good parenting. It is essential that the parents make room and time for their children every day. Whether they need to talk or just be in the same room with the parents, it is a very good idea on the part of parents to make themselves available. Even as children get older, quality time is important. It may be really hard for some people to come home after work, get down on the floor and play with their kids or just talk to them about their day, especially if they have had a stressful day themselves. But expressing interest in the children’s day would show them that they are very important for the parents. One must help the child to cope with stress by talking about what may be causing it. Very often, together with each other, it may be possible to arrive at a solution. One could also help by anticipating potentially stressful situations and preparing children for them. For example, it is a good thing to let a child know ahead of time, perhaps not too far ahead of time, that a doctor’s appointment is coming up and talk about what will happen there. One must however remember that younger children probably will not need too much advance preparation. It should also be pointed out that too much of information can cause more stress and that the axiom to follow is that reassurance is the key. One should always realise that some level of stress is normal and it is necessary to let children know that it is sometimes in order to feel angry, scared, lonely or anxious and that other people share those feelings too.
When the parents notice that there is something bothering a child, it is best to tell him or her that they have noticed that something is causing some problems. It may be possible to actually name the feeling or behaviour pattern that has directed the parents to the conclusion. This of course should not sound like an accusation or put a child on the spot. It should come as a casual observation that the parents are interested in hearing more about and it is crucial to show empathy and sympathy to show how much the parents care. It is essential that the parents listen attentively and calmly, with interest, patience, openness and caring. One needs to avoid the urge to judge, blame, lecture or say what the parents think that the child should have done instead. The idea is to let the child’s concerns and feelings be heard. One needs to take time over this entire procedure and let the child take his or her time, too. It is a good idea to have the parents comment on the possible feelings that the child may have as doing shows that they understand what the child felt, why and most importantly, that they care. Feeling understood and listened to help a child feel supported by the parents and this is especially important in times of stress.
Many young children do not yet have words for their feelings. If a child seems angry or frustrated, one needs to use those words to help him or her learn to identify the emotions by name. Putting feelings into words help them to communicate and develop emotional awareness which is the ability to recognize their own emotional states. Children who can do so are less likely to reach the behavioural boiling point where strong emotions get demonstrated through behaviours rather than communications with words.
If there is a specific problem that is causing stress, it is always good to talk together about what to do. The parents and caregivers must encourage the child to think of a couple of ideas. The child’s active participation will build confidence. One should of course support the good ideas and add to them as needed. Sometimes talking and listening and feeling understood is all that is needed to help a child’s frustrations to start melting away. Afterwards, one could try changing the subject and moving on to something more positive and relaxing. The grown-ups can always help the child to think of something to do to feel better. One should not give the problem more attention than it deserves. In addition, if certain situations are causing stress, one needs to see if there are ways to change things. For instance, if too many after-school activities consistently cause homework stress, it may be necessary to limit activities to leave time and energy for homework.
Sometimes children fret about big stuff like terrorism, war or global warming, things that they hear about at school or on the news. Parents can help by discussing these issues, offering accurate information and correcting any misconceptions the children might have. One could always try to reassure children by talking about what adults are doing to tackle the problem to keep them safe. One should be aware that one’s own reactions to global events affect children too. If one expresses anger and stress about a world event that is totally beyond one’s, children too are likely to react that way. But if one expresses concern by taking a proactive approach to make a positive difference, the children too would feel more optimistic and empowered to do the same. One has to look for things that one can do with the children to help and this makes everybody feel as if they are making a positive difference. One may not be able to go stop a war for example but the family can contribute to an organization that works for peace or helps those in war-torn countries. The family might even perform community service to give the children the experience of volunteering.
Sometimes when children are worried, what they need most is a parent’s reassurance and comfort. It might come in the form of a hug, some heartfelt words or time spent together. It helps children to know that, whatever happens, parents will be there with love and support. Sometimes children need parents to show them how to let go of worry rather than dwell on it. It is essential to know when it is time to move on and help them shift gears. The parents could lead the way by introducing a topic that is more upbeat or an activity that will create a lighter mood.
The most powerful lessons people need to teach children are perhaps the ones they themselves are able to demonstrate. A person’s response to his or her own worries can go a long way toward teaching his or her children how to deal with everyday challenges. If one is rattled or angry when dealing with something and show it, a child in the same family may learn it as an appropriate response to stress. Instead, they should look on the bright side and voice optimistic thoughts about their own situations at least as frequently as one talks about what worries them. Setting a good example with the reactions to problems and setbacks is going to pay dividends in the long run. Responding with optimism and confidence teaches children that problems are temporary and tomorrow is another day. Bouncing back with a can-do attitude will help the children to do the same.
When children cannot or will not discuss issues related to stress one could try talking about various concerns that the parents may have. This shows that they are willing to tackle tough topics and are available to talk with when the child is ready. If a child shows symptoms that are of concern and is unwilling to talk, it may be necessary to consult a counsellor or other mental health specialist. Most parents have the skills to deal with their child’s stress. The time to seek professional attention is when any change in behaviour persists, when stress is causing serious anxiety or when certain forms of behaviour are causing significant problems in functioning at school or at home.
As a parent, it undoubtedly hurts a great deal to see a child unhappy or stressed. However, one needs to resist the urge to fix every problem. Instead, focus should be on the child to ensure that he or she would, slowly but surely, grow into a good problem-solver, a child who knows how to roll with life’s ups and downs, put feelings into words, calm down when needed and bounce back to try again. Parents cannot solve every problem that comes on as children go through life. But by teaching healthy coping strategies, they will prepare their children to manage the stresses that come in the future.
= It is a common misconception that children are not subject to stress and worry.
= There are many sources of stress that impact on children.
= Parents play a vital role in teaching and ensuring children handle life’s trials, tribulations and brick bats well.
=Some children may not completely vocalise their problems.
=Gentle discussions on the problems and being good role models on the part of parents always help the children.
= Professional help may be required in some cases.
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