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Cape Coral Living Magazine

Stress in Children: Signs, Symptoms and Strategies

May 07, 2021 09:49AM ● By Sandra Mills
By Sandra Mills, pediatric psychologist for Lee Physician Group Pediatric Behavioral Health

We are all living in a time of increased stress these days. Our world as we know it has undergone a drastic shift, and our children are not immune to the impact. Like adults, many kids are struggling right now. It reflects the current state of the world, not parenting skills.

Children are remarkable “noticers.” They absorb feelings going on around them. Children notice when their parents or caregivers are stressed and may react to our emotional states.

However, children don’t always have the emotional intelligence or vocabulary to express themselves. They also lack an understanding of what is truly happening. To them, it just feels different, uncomfortable, unpredictable, and downright scary. 

Stress is often not a familiar term for children. It could be that they express distress with words like worried, confused, annoyed, or angry. Sometimes, it comes across in what they say about themselves or the situation. This can include negative self-talk such as “I’m dumb,” or “nothing is fun anymore.” When children use negative self-talk, don’t just disagree. Ask them to really think about whether what they say is true or remind them of times they worked hard and improved. Learning to frame things positively will help them develop resilience to stress.

The best we can do is to become “noticers” of them. Tune into their emotional or behavioral cues to provide support and guidance in these turbulent times.  

Stress in children can manifest as changes in their typical behavior. Each age/stage may show this differently. Children ages 4-7 years old under stress might show signs of regression. For instance, children that have been successfully potty-trained may wet the bed again or have toileting accidents. Children may have trouble paying attention to you. They may have temper tantrums and separation anxiety. Battles about eating and bedtime may be reoccurring.

Toddlers and young school-age children often show their emotional stress in physical ways. Complaints of their tummies hurting is a common reaction. This has some truth to it. When we are stressed, our bodies make chemicals that have physical effects. We call this the fight or flight reaction, a surge of hormones such as adrenaline and cortisol. Additionally, stress lowers the pain threshold. A hypersensitive nervous system sends signals up the spine and relays pain signals to the brain when a child is stressed.

Children ages 7-10 years old may be more aware of the unusual times we find ourselves in right now. They may have fears for their own health. They may also fear for their families because developmentally they are gaining the ability to consider another’s perspective. It could present as worries about their grandparents. They may release their fears as anger or irritability. This state of being on edge is part of our hard-wired fight or flight response. 

Tweens ages 10-13 are in that uniquely tenuous stage of late elementary school and middle school, stressful enough without a worldwide pandemic. Adding to this stress are challenges of virtual learning, homework expectations, less access and guidance from teachers, and the requirement to be self-directed. Parents and schools are seeing an increase in avoidance, decreasing grades and resistance to log in or complete their work.

Children in this age group may also be less likely to talk about their worries and fears. This doesn’t mean they aren’t there.

Teenagers ages 13 and up struggle with multiple issues. For example, due to the pandemic, they have lost important rites of passage – prom, graduation, college visits, their last years of sports or other extracurricular activities. High school is a time when peers and their support are often more important than family. 

As a result, the sense of isolation is leading to irritability, sleeping all day and up all night, breaking curfew and social distancing rules, depression, a sense of helplessness and hopelessness, and increased anxiety. In some ways, teens may be feeling trapped by spending more time with the family. Developmentally, they are ready to gain independence to move on.

Many teens are reporting a loss of energy, apathy, losing interest in previously enjoyed activities, and overall low mood. Parents may notice their child withdrawing from the family. Stress may also take the form of abandoning friendships or hostility towards family members.  

Caring adults can make a significant difference for stressed children by providing safety, empathy, structure, age-appropriate information, comfort and guidance. 

If you see that something seems to be bothering a child, say so and name the feeling you think your child may be having in that moment. Make it in the form of an observation rather than an accusation, which suggests that you want to hear more about your child’s concern. 

Ask what is wrong and be patient and open. Avoid the urge to judge, lecture or advise them of what they should be doing. Feeling heard and understood helps the child to feel supported, especially crucial when times are stressful. 

For younger children without a broad emotional vocabulary, teach them to label what they might be feeling, which allows them to learn better how to communicate with you. This emotional awareness can be key to avoiding behavioral meltdowns, where feelings are expressed as behaviors rather than with words.

It’s important to model healthy coping. Caregivers can talk with children about how they’ve thought about and dealt with their own stressful situations.

Let kids be problem-solvers. When parents swoop in to solve every little glitch, their children don’t have a chance to learn healthy coping skills. Let your children try to solve their low-stakes problems on their own, and they’ll gain confidence that they can deal with stressors and setbacks.

Promote media literacy. Today’s kids spend a lot of time online, where they can run into questionable content, cyberbullying, or the peer pressures of social media. Parents can help by teaching their children to be savvy digital consumers and by limiting screen time.

The American Psychological Association American Psychological Association provides the following tips for managing stress: 

  • Experts recommend nine to 12 hours of sleep a night for 6- to 12-year-olds. Teens need eight to 10 hours a night. To protect shut-eye, limit screen use at night and avoid keeping digital devices in the bedroom.

  • The U.S. Department of Health and Human Services recommends at least 60 minutes a day of exercise activity for children ages 6 to 17.

  • Talking about stressful situations with a trusted adult can help kids and teens put things in perspective and find solutions. 

  • Make time for fun — and quiet. Also, while some children thrive bouncing from one activity to the next, others need more down time. Find a healthy balance between favorite activities and free time.

  • Spending time in nature is an effective way to relieve stress and improve overall well-being.

  • Studies find that expressing oneself in writing can help reduce mental distress and improve well-being. For example, writing about positive feelings can ease symptoms of anxiety and depression.

  • A study of a five-week mindfulness training found that teens who learned mindfulness experienced significantly less mental distress than teens who did not.

Some kids might be stressed and struggling with anxiety or depression that seems “too big” to manage on their own. Parents may be overwhelmed as well. Nobody gave out an instructional booklet on parenting during a pandemic. It’s OK to not feel like the expert on children’s mental health. Therapy is an option many families find helpful. Kids are being seen both via telehealth and in person with safety protocols in place. Sometimes having a professional provide the space to discuss what they’re feeling may be the lifeline they need right now. 


About the Author

Sandra Mills is a pediatric psychologist for Lee Physician Group Pediatric Behavioral Health.  Lee Health has a team of dedicated professionals at Pediatric Behavioral Health clinic to help kids navigate their stress and develop tools and coping skills to feel better. We can be reached at (239) 343-6050 to make an appointment.