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Is your child feeling stressed? A mental health expert shares four strategies to help them cope. Photo: Alamy

Children and stress: its causes, warning signs, and what parents can do to reduce their kids’ anxiety – advice from a psychiatrist

  • Exams, bullying, a new school – there are many reasons children could be feeling stressed; in Hong Kong, violent street protests are an additional factor now
  • A psychiatrist shares four ways to reduce your children’s stress, from listening to lifestyle habits

June Lim can tell when her son and daughter are stressed – they go from being cheerful and easy-going to moody and irritable, and instead of their usual chatty selves they become sullen and withdrawn. They also tend to have a short fuse.

For Russell, 14, and Sophie, 12, exams and school projects are big stressors. And they are not alone. While it’s hard to tell what percentage of children are affected by stress, it’s safe to say that most experience worry and anxiety over schoolwork and exams.

An Organisation for Economic Cooperation and Development (OECD) study based on a survey of 540,000 students in 72 countries and economies, found that most teenagers are happy with their lives – but that schoolwork was among their biggest sources of stress and anxiety. The students interviewed had completed the main OECD Programme for International Student Assessment (Pisa) 2015 test on science, mathematics and reading.

According to Students’ Well-Being: Pisa 2015 Results released in 2017, an average of 59 per cent of students said they often worry that taking a test will be difficult, while 66 per cent reported feeling stressed about poor grades. Some 55 per cent of students said they get very anxious about a test even if they are well prepared.

June Lim with her children Russell and Sophie in Singapore.

The survey also revealed that bullying was a source of stress for kids, with about four per cent of students reporting that they are hit or pushed at least a few times a month.

In Hong Kong, children have been greatly affected by the ongoing social unrest. Hong Kong-based psychologist Dr Adrian Low Eng-ken was assigned to help children who have experienced stress and trauma resulting from the six months of anti-government protests. He has observed a range of symptoms in these youngsters, from skipping school and defying authority, to wanting to be alone, aggressiveness, moodiness, drug and/or alcohol abuse, and an inability to cope with problems.

Hong Kong-based psychologist Dr Adrian Low Eng-ken was assigned to help children who have experienced stress and trauma as a result of the ongoing anti-government protests.

Many have nightmares about the riots. “They tell me that images of the protests show up in their dreams at night,” Low shares. “They also have flashbacks of these events during the day, while going about their normal activities, and many are afraid that they will be victims of the violence. However, while fearful of these events, the children still want to watch them unfold on TV.”

Problems occurring in the home may also be a source of stress. Children whose parents are going through a divorce or whose home life is challenging often feel overwhelmed with anxiety and worry.

Some children are more susceptible to stress than others, says Dr Lim Boon Leng, a psychiatrist at Dr BL Lim Centre for Psychological Wellness in Singapore. “These include kids who experience persistent abuse or who are chronically stressed, who do not have a stable family structure or who have mental health issues like Attention Deficit Hyperactive Disorder or Autism Spectrum Disorder.”

Dr Lim Boon Leng is a psychiatrist at Dr BL Lim Centre for Psychological Wellness in Singapore.

Most children and teens find it difficult to tell their parents or teachers when they’re stressed. Instead, says Dr Lim, they may complain about having to do schoolwork, become anxious more easily, cry more or throw tantrums more frequently. They may also have difficulty falling asleep, have a poorer appetite and feel lethargic, and suffer from headaches or stomach aches.

You may not know how to help your kids cope with stress – especially if you are experiencing stress yourself and aren’t always emotionally available for your children. But research shows that when parents are supportive of their children, they tend to feel less anxious and are better able to manage stress.

According to the OECD Students’ Well-Being report, students whose parents reported “spending time just talking to my child”, “eating the main meal with my child around a table” or “discussing how well my child is doing at school” regularly were 22 per cent to 39 per cent more likely to report high levels of life satisfaction.

Exams are one of the leading causes of stress among children.

Teachers also had a part to play in helping students maintain their emotional well-being, with happier students tending to report having positive relations with their teachers.

“You should talk to your kids about how to handle stress instead of just telling them to accept it,” Dr Lim advises. “I also encourage families to find ways to de-stress together.

“Many kids don’t open up to their parents because they think they don’t understand what they’re going through, or don’t want to listen to them. But if you make the effort to build a strong relationship with your kids they’re more likely to come to you for advice when they’re under stress. When they talk, be empathetic and listen to them so that they feel heard and understood.”

Stay-at-home mum June Lim knows that stress can lead to severe mental health issues like depression, which is why she makes it a point to communicate with her kids.

You should talk to your kids about how to handle stress instead of just telling them to accept it. I also encourage families to find ways to de-stress together
Dr Lim Boon Leng, psychiatrist

“I check in with them often, especially during the exam period and when they have projects due,” she says. “Since my son started at a new secondary school in 2018, I’ve kept a particularly close eye on him to make sure that he’s coping well.

“No matter how many distractions I’m dealing with in my own life, I always try to spend time with my kids, just initiating conversations with them if they seem to be keeping to themselves, and listening to them when they do open up. If I have a sense of what’s troubling them I’ll try to steer the conversation in that direction.”

Since they were in primary school, Lim has also talked to her kids about the link between academic stress and the increased risk of suicide. “I continue to remind them to do their best and tell them that suicide is not an option.”

Children who have been traumatised by the recent violence in Hong Kong are at risk of developing post-traumatic stress disorder, or PTSD. To help children who have been affected by the political instability, Low says that parents and teachers need to work towards making them feel emotionally safe and secure. He also suggests not talking about politics at home or at school. Instead, focus on building stronger, closer family relationships.

Dr Lim’s four strategies to help kids become more resilient to stress

1. Think long-term Do you want your children to score full marks in their next exam or do you want them to grow into useful and happy adults? If you know your future goal, short-term setbacks will not be seen as permanent failures and your kids will be able to bounce back from them faster.

2. Have realistic expectations Tailor your children’s activities and schedules according to their strengths and weaknesses. Some kids can handle gruelling schedules while others may need more time to finish their work. Unrealistic expectations can stress kids out, while realistic ones can be motivating.

3. Focus on the process, not the result Emphasise the process of achieving rather than the achievement itself. Remind your kids to do their best and praise their efforts to help them feel good about themselves and prevent them from worrying about the final result.

4. Instil good lifestyle habits Adequate sleep, a wholesome diet, regular exercise, hobbies and play keep children mentally healthy and help them manage stress better.