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Children, Stress, Signs, & Solutions
This article was in response to a senseless school tragedy, and is dedicated the families of Littleton, Colorado. We will never forget 1999.
Children, Stress, Signs, & Solutions; Teenagers, like adults, may experience stress everyday and can benefit from learning stress
management skills. Most teens experience more stress when they perceive a situation as dangerous, difficult, or painful and they do not have the resources to cope.
Some sources of stress for teens might include:
- School demands and frustrations
- Negative thoughts and feelings about themselves
- Changes in their bodies
- Problems with friends
- Unsafe living environment/neighborhood
- Separation or divorce of parents
- Chronic illness or severe problems in the family
- Death of a loved one
- Moving or changing schools
- Taking on too many activities or having too high expectations
- Family financial problems.
Some teens become overloaded with stress. When it happens, inadequately managed stress can lead to anxiety, withdrawal, aggression, physical illness, or poor coping skills such as illicit drug use.
When we perceive a situation as difficult or painful, changes occur in our minds and bodies to prepare us to respond to danger. This "fight, flight, or freeze" response includes faster heart and breathing rate, increased blood to muscles of arms and legs, cold or clammy hands and feet, upset stomach and/or a sense of dread.
The same mechanism that turns on the stress response can turn it off. As soon as we decide that a situation is no longer dangerous, changes can occur in our minds and bodies to help us relax and calm down. This "relaxation response" includes decreased heart and breathing rate and a sense of well being. Teens that develop a "relaxation response" and other stress management skills feel less helpless and have more choices when responding to stress.
Helping teens with stress: Parents can help their teen in the following ways:
1. Monitor if stress is affecting their teen's health, behavior, thoughts, or feelings closely.
2. Listen to teens and watch for overloading.
3. Learn and model stress management skills.
4. Support involvement in sports and other prosocial activities.
Helping teens decrease stress: Teens can decrease stress with the following behaviors and techniques:
- Exercise and eat regularly.
- Avoid excess caffeine intake which can increase feelings of anxiety and agitation.
- Avoid illegal drugs and tobacco.
- Learn relaxation exercises. For example, learn abdominal breathing and muscle relaxation techniques.
- Develop assertiveness training skills. For example, state feelings in polite and firm and not overly aggressive or passive ways. "I feel angry when you yell at me. Please stop yelling."
- Rehearse and practice situations which cause stress. One example is taking a speech class if talking in front of a class makes you anxious.
- Learn practical coping skills. For example, break a large task into smaller, more attainable tasks.
- Decrease negative self talk: challenge negative thoughts about yourself with alternative neutral or positive thoughts. "My life will never be better" can be transformed into "I may feel hopeless now, but my life will probably get better if I work at it and get some help."
- Learn to feel good about doing a competent or "good enough" job rather than demanding perfection from yourself and others.
- Take a break from stressful situations. Activities like listening to music, talking to a friend, drawing, writing, or spending time with a pet can reduce stress.
- Build a network of friends who help you cope in a positive way.
By using these and other techniques, teenagers can begin to manage stress. If a teen talks about or shows signs of being overly stressed, a consultation with a child and adolescent psychiatrist or qualified mental health professional may be helpful.
Helping children after a disaster: A catastrophe such as an earthquake, hurricane, tornado, fire, flood, (or tragedy such as a school shooting), is frightening to children and adults alike. It is important to acknowledge the frightening parts of the disaster when talking with a child about it. Falsely minimizing the danger will not end a child's concerns. Several factors affect a child's response to disaster.
The way children see and understand their parents' response is very important. Children are aware of their parents' worries most of the time but they are particularly sensitive during a crisis. Parents should admit their concerns to their children, and also stress their abilities to cope with the situation.
A child's reaction also depends on how much destruction he or she sees during and after the disaster. If a friend or family member has been killed or seriously injured, or if the child's school or home has been severely damaged, there is a greater chance that the child will experience difficulties.
A child's age affects how the child will respond to the disaster. For example, six-year-olds may show their concerns about a catastrophe by refusing to attend school, whereas adolescents may minimize their concerns but argue more with parents and show a decline in school performance. It is important to explain the event in words the child can understand.
Post-traumatic stress disorder: Following a disaster, people may develop Post-Traumatic Stress
Disorder (PTSD), which is psychological damage that can result from experiencing, witnessing or participating in an overwhelmingly traumatic (frightening) event. Children with this disorder have repeated episodes in which they re-experience the traumatic event. Children often relive the trauma through repetitive play. In young children, distressing dreams of the traumatic event may change into nightmares of monsters, of rescuing others or of threats to self or others.
PTSD rarely appears during the trauma itself. Though its symptoms can occur soon after the event, the disorder often surfaces several months or even years later.
Parents should be alert to these changes:
- Refusal to return to school and "clinging" behavior, shadowing the mother or father around the house
- Persistent fears related to the catastrophe (such as fears about being permanently separated from parents)
- Sleep disturbances such as nightmares, screaming during sleep and bedwetting, persisting more than several days after the event
- Loss of concentration and irritability
- Behavior problems - for example, misbehaving in school or at home in ways that are not typical for the child
- Physical complaints (stomachaches, headaches, dizziness) for which a physical cause cannot be found
- Withdrawal from family and friends, listlessness, decreased activity, preoccupation with the events of the disaster
Professional advice or treatment for children affected by a disaster (especially those who have witnessed destruction, injury or death) can help prevent or minimize PTSD. Parents who are concerned about their children can ask their pediatrician or family doctor to refer them to a child and adolescent psychiatrist or other mental health professional.
Survivors of disasters: Most child and adult survivors experience normal stress reactions for several days, such as:
- Emotional reactions: temporary feelings (i.e., for several days to a couple of weeks) of shock, fear, grief, anger, resentment, guilt, shame, helplessness, hopelessness, emotional numbness (difficulty feeling love and intimacy, or in taking interest interest and pleasure ion day-to-day activities)
- Cognitive reactions: confusion, disorientation, indecisiveness, worry, shortened attention span, difficulty concentrating, memory loss, unwanted memories, self-blame
- Physical reactions: tension, fatigue, edginess, difficulty sleeping, bodily aches or pain, being startled easily, racing heartbeat, nausea, change in appetite, change in sex drive
- Interpersonal reactions in relationships at school, work, in friendships, in marriage, or as a parent, such as: distrust, irritability, conflict, withdrawal, isolation, feeling rejected or abandoned, being distant, judgmental, or overcontrolling.
Stress symptoms: Most disaster survivors only experience mild normal stress reactions, and disaster experiences may even promote personal growth and strengthen relationships. However, as many as one in three disaster survivors experience some or all of the following severe stress symptoms, which may lead to lasting post-traumatic stress disorder (PTSD mentioned above), anxiety disorders, or depression:
- Dissociation (feeling completely unreal or outside yourself, like in a dream; having "blank" periods of time you cannot remember)
- Intrusive reexperiencing (terrifying memories, nightmares, or flashbacks)
- Extreme attempts to avoid disturbing memories (such as through substance use)
- Extreme emotional numbing (completely unable to feel emotion, as if utterly empty)
- Hyperarousal (panic attacks; rage; extreme irritability; intense agitation)
- Severe anxiety (paralyzing worry, extreme helplessness, compulsions or obsessions)
- Severe depression (complete loss of hope, self-worth, motivation, or purpose in life)
What factors increase the risk of lasting readjustment problems: Survivors are at greatest risk for severe stress symptoms and lasting readjustment problems if any of the following are either directly experienced or witnessed during or after the disaster:
- Life threatening danger or physical harm (especially to children)
- Exposure to gruesome death, bodily injury, or bodies
- Extreme environmental or human violence or destruction
- Loss of home, valued possessions, neighborhood, or community
- Loss of communication with/support from close relationships
- Intense emotional demands (such as faced by rescue personnel or caregivers)
- Extreme fatigue, weather exposure, hunger, or sleep deprivation
- Extended exposure to danger, loss, emotional/physical strain
- Exposure to toxic contamination (such as gas or fumes, chemicals, radioactivity)
Studies also show that some individuals have a higher than typical risk for severe stress symptoms and lasting PTSD, including those with a history of:
- Exposure to other traumas (such as severe accidents, abuse, assault, combat, rescue work)
- Chronic medical illness or psychological disorders
- Chronic poverty, homelessness, unemployment, or discrimination
- Recent or subsequent major life stressors or emotional strain (such as single parenting)
Disaster stress may revive memories of prior trauma, as well as possibly intensifying pre-existing social, economic, spiritual, psychological, or medical problems.
What can be done to reduce the risk of negative psychological consequences & to best recover from disaster stress: Scientific studies are just beginning to be conducted to answer this question. Observations by disaster mental health specialists who assist survivors in the wake of disaster suggest that the following steps help to reduce stress symptoms and to promote post-disaster readjustment:
- Protect: find a safe haven that provides shelter, food and liquids, sanitation, privacy, and chances to sit quietly, relax, and sleep at least briefly
- Direct: begin setting and working on immediate personal and family priorities to enable you and your significant others to preserve or regain a sense of hope, purpose, and self-esteem
- Connect: maintain or re-establish communication with family, peers, and counselors in order to talk about your experiences - take any chance to "tell your story" and to be a listener to others as they tell theirs, so that you and they can release the stress a little bit at a time in disaster's wake
- Select: identify key resources such as FEMA, the Red Cross, the Salvation Army, or the local and state health departments for clean-up, health, housing, and basic emergency assistance
Taking every day one-at-a-time is essential in disaster's wake. Each day is a new opportunity to FILL-UP:
- Focus Inwardly on what's most important to you and your family today
- Look and Listen to learn what you and your signficant others are experiencing, so you'll remember what is important and let go of what's not
- Understand Personally what these experiences mean to you as a part of your life, so that you will feel able to go on with your life and even grow personally
The following are just a few of the many Internet sites available concerning children & stress:
1. National Center for Victims of Crime: Their mission is to "forge a national commitment to help victims of crime rebuild their lives. They are dedicated to serving individuals, families and communities harmed by crime. Keep up-to-date with news & events; find an attorney; learn safety strategies; join in a discussion forum; & more.
2. Trauma Information Pages: This site by Dr. David Baldwin, provides information for clinicians and researchers in the traumatic-stress field.
3. National Center for PTSD: This governmental site researches post-traumatic stress disorder, and maintains a large searchable database of information.
4. Sidran Foundation & Press: A national non-profit organization devoted to "education, advocacy and research related to the early recognition and treatment of trauma-related stress in children and the understanding and treatment of adults suffering from trauma-generated disorders.
5. Diagnose PTSD Online at the Internet Mental Health Site: Take an online survey to help diagnose post-traumatic stress disorder. Their program is only an aid to diagnosis and is not a substitute for expert clinical judgement by a licenced mental health professional.
6. The American Academy of Experts in Traumatic Stress: Search this multidisciplinary network of professionals, who are committed to the advancement of intervention for survivors of trauma. The mission of the Academy is to "increase awareness of the effects of trauma and, ultimately, to improve the quality of intervention with survivors".
7. Health-Center.com: Information on the nature and treatment of PTSD.
8. The Stress Doc: Mark Gorkin, LICSW, ACSW, President, Stress Doc Enterprises, is a licensed clinical social worker, psychotherapist and media humorist, and Stress Coach for the National Capital YMCA. "A national speaker and trainer with 25 years experience, the Stress Doc specializes in stress and burnout, anger management, communication skills, reorganizational change, team building, creativity and HUMOR."
9. Ricky Greenwald's Child Trauma Home Page: His mission is to "provide an increasingly useful resource for parents, clinicians, and researchers".
10. Support the Littleton, CO Victims: A support page for the Littleton community; you'll find a link for Columbine High School here.
Here are 3 informative books to read that deal with the above topic. Use Amazon.com's secure server to order NOW:
 No Time for Goodbyes: Coping With Sorrow, Anger, and Injustice After a Tragic Death: - Janice Harris Lord, Eugene D. Wheeler. How to come to terms with how you're feeling. Buy it NOW through Amazon.com's secure server!
Click HERE or on the image of the books to give this gift to yourself or someone else!
Post-Traumatic Stress Disorder: The Victim's Guide to Healing and Recovery: - Raymond B. Jr. Flannery. "Learn about the aftermath of violence and what you can do about it." Buy it now through Amazon.com's secure server!
Click HERE or on the image of the books to give this gift to yourself or someone else!
I Can't Get over It: A Handbook for Trauma Survivors: - Aphrodite Matsakis. This is the "first book to guide readers through the healing process of recovering from PTSD one step at a time. It helps survivors cope with memories and emotions; identify triggers that reactivate traumatic stress; relieve secondary wounding and gain a sense of empowerment and hope." Buy it now through Amazon.com's secure server!
Click HERE or on the image of the books to give this gift to yourself or someone else!
Reprinted with permission by the American Academy of Child and Adolescent Psychiatry (AACAP) & The National Center for PTSD-"Survivors of Disasters". The above information is presented for educational purposes only, and it is not a substitute for informed medical advice or training. Please do not use this information to diagnose or treat a mental health problem without consulting a qualified health or mental health care provider.
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