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How Do Parents Recognize and Reduce Chronic Stress in Children?

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Like adults, children experience stress regularly. Sources may include the expectations of parents, teachers and coaches, interactions with friends and classmates, as well as a child's fears and anxieties about the future and the world in which they live.

Stress is a normal part of growing up. But when it becomes overwhelming for a child and begins to affect their physical and emotional health, it may be time to seek professional help. Dr. Lewis First, chief of pediatrics at University of Vermont Children's Hospital, offers advice for recognizing the signs and symptoms of unhealthy stress in children and what parents can do to alleviate it.

KIDS VT: How common is stress in kids?

LEWIS FIRST: If a parent doesn't think their child is stressed, they need to wake up and smell the coffee. Stress is up across the board in this country, including in kids. According to the American Psychological Association, more than one-third of children ages 8 to 17 reported headaches in a given year that they attributed to stress, and about 44 percent reported sleep difficulties due to stress. But only 13 percent of parents thought that their kids experienced headaches or sleep troubles due to stress.

KVT: Stress isn't always bad for kids, is it?

LF: No. A little stress can be a good thing. For a child who's preparing for a test, who's a little nervous on the first day of school or is about to compete in a sporting event, stress gets their adrenaline up, makes their senses sharper and clearer, and gets them energized to do well. Having these experiences helps a child develop positive coping mechanisms for dealing with stress. But stress can become overwhelming when it involves an unhealthy environment at school, at home or in the big-picture environment, such as what's happening nationally in terms of violence, environmental disasters and other current events.

KVT: Why is stress particularly unhealthy for children?

LF: Stress diverts a child's energy away from normal growth and development, such as growing healthy brain cells and fighting infection, and redirects it to the production of what we call "stress hormones" like cortisol and adrenaline, which rev up the child and can lead to emotional overload, such as feeling constantly worried, scared, angry or frustrated. Those hormones are part of the body's normal fight-or-flight response. But when a child constantly feels these emotions all day from stressors in their environment, and those emotions aren't channeled in a positive direction, a child can get burned out and experience physical or emotional ailments that can be associated with stress.

KVT: What are warning signs that a child is experiencing unhealthy stress?

LF: In toddlers and preschoolers, parents may notice changes in the child's daily behavior. Kids may become more irritable, lose their appetite and have difficulty sleeping. They may seem sad, angry, clingy, withdrawn, or have tantrums or nightmares. Some may start sucking their thumb, chewing their hair or going to the bathroom more frequently. Parents may also hear more physical complaints, such as, "My tummy hurts" or "My head hurts." Some kids may even develop tics, twitches or other abnormal movements.

KVT: And in school-aged kids?

LF: Older children may lose interest in classes and activities that they previously enjoyed. They may stop spending time with longtime friends, and seem more fearful and sad. If there's a family problem, such as a parental separation, a child may incorrectly think that they caused the problem, which can lead to guilt and feelings of depression. As kids enter adolescence, the same signs and symptoms will apply, including withdrawing from friends, losing interest in extracurricular activities, spending more time alone in their room, and disrespecting parents and other family members. Negative behavior in teens isn't necessarily always linked to excessive stress. But many preteens and teens, who find their normal coping mechanisms for stress are not enough, may opt to deal with excessive stress through substance abuse, self-harm and even suicidal thoughts and expressions.

KVT: Anything else?

LF: All kids will be better equipped to deal with stress if they're eating healthy meals, playing outside regularly, getting eight hours of sleep each night, and if they aren't overscheduled. But if a child's symptoms of stress last longer than six weeks, it may be time to consult your health care professional to seek formal counseling that might involve helping your child learn relaxation techniques or behavioral strategies to help them overcome whatever may be causing them undue stress. Less commonly, a medication in addition to counseling and behavioral therapy may be recommended to help an older child or teen deal with anxiety or depression resulting from severe stress.

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