Stress in Children: Signs, Symptoms and Strategies

We are all living in a time of increased stress these days. Our world as we know it has undergone a drastic shift. As a result, 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.” Have you ever experienced your child parroting back something you may have said, thinking they didn’t catch it? Been surprised by them mentioning a topic you thought they didn’t know anything about? They pick up on these verbal exchanges. Even more so, they absorb feelings going on around them. And today, there are a whole lot of feelings going on. 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.

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. Common changes can include:

  • Being moody or irritable
  • Withdrawing from activities they once enjoyed
  • Routinely expressing worry
  • Complaining about school
  • Crying
  • Showing fearful reactions
  • Becoming overly clingy
  • Changing eating and sleeping patterns.

Stress in Children Ages 4-7 Years Old

This age group 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. A child may start sucking his or her thumb again. 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. Our guts also have their own nervous system called the enteric nervous system. These nerves react to the same to stress hormones and neurotransmitters that our brains do. Those hormones can make a stomach feel funny or hurt. 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.

Stress in Children ages 7-10 Years Old

This age group 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. For example, 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.

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.” They may alter their behaviors based upon the setting, seeming fine at home but acting out at school or in their sports activities.

Stress in Tweens Ages 10-13

This age group is in that uniquely tenuous stage of late elementary school and middle school, which are considered stressful without a worldwide pandemic. Adding to this stress are challenges of virtual learning. Homework expectations, less access and guidance from teachers, and requirement to be self-directed can be overwhelming.

Parents and schools are seeing an increase in:

  • Avoidance
  • Decreasing grades
  • 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.

Stress in Teenagers

Teenagers 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
  • Increased anxiety

In some ways, teens are 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. Also, they may want to isolate more. Stress may also take the form of abandoning friendships or hostility towards family members.

How Adults Can Address Stress in Children

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

Be sure to “notice out loud.” 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. Consider the difference between “It seems like you’re still mad about what happened at the park today,” vs. “What happened now? Are you still upset about that?” The observation suggests that you want to hear more about your child’s concern. Also, it allows you the opportunity to show that you care and want to understand.

Use active listening. Ask what is wrong and be patient and open. Avoid the urge to judge, lecture, or advise them of what they should be doing. The goal is to let the child express their concerns and feelings, and be heard. Ask questions to get the big picture such as “And then what happened?” Repeat back what you think your child may have been feeling. “That must have been frustrating,” or “Gosh, that sounds really scary.” 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. That will allow 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.

Tips to Help Children Manage Stress

In an excerpt from an article on stress management for kids and teens, the American Psychological Association provides the following tips for managing stress:

  • Sleep well. Sleep is essential for physical and emotional well-being. Experts recommend nine to 12 hours of sleep a night for 6- to 12-year-olds. Teens need eight to 10 hours a night. Sleep needs to be a priority to keep stress in check. To protect shut-eye, limit screen use at night and avoid keeping digital devices in the bedroom.
  • Exercise. Physical activity is an essential stress reliever for people of all ages. The U.S. Department of Health and Human Services recommends at least 60 minutes a day of activity for children ages 6 to 17.
  • Talk it out. 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. Just like adults, kids and teens need time to do what brings them joy. That can be unstructured time to play with building blocks or uninterrupted hours to practice music or art. 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.
  • Get outside. Spending time in nature is an effective way to relieve stress and improve overall well-being. Researchers have found that people who live in areas with more green space have less depression, anxiety, and stress.
  • Write about it. Studies find that expressing oneself in writing can help reduce mental distress and improve well-being. For example, writing about positive feelings — such as the things you are grateful for or proud of — can ease symptoms of anxiety and depression.
  • Learn mindfulness. In a study of a five-week mindfulness training program for 13- to 18-year-olds, researchers found that teens who learned mindfulness experienced significantly less mental distress than teens who did not.

Promoting Healthy Habits

Parents and other caregivers have an important part to play by adopting their own healthy habits and helping children and teens find stress-managing strategies.

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. It’s natural to want to fix your child’s problems. But 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.

Combat negative thinking. “I’m terrible at math.” “I hate my hair.” “I’ll never make the team. Why try out?” Children and teens can easily fall into the trap of negative thinking. When children use negative self-talk, though, 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.

Coping Specifically with COVID-19 Stress

The Centers for Disease Control has some specific COVID-19 suggestions as well. For example, it is important to talk with your child about the pandemic. Answer questions and share facts about COVID-19 in a way that your child can understand.

Reassure them that they are safe. Let them know it is okay if they feel upset. Share with them how you deal with your own stress so they can learn from you how to cope with stress.

Limit your family’s exposure to news coverage, including social media. Children may misinterpret what they hear and can be frightened about something they do not understand.

Try to keep up with regular routines. If schools are closed, create a schedule for learning activities and relaxing or fun activities. Be a role model for them. Take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members. Spend time with your child in meaningful activities, such as reading together, exercising, and playing board games.

When to Seek Help

Be the “noticer.” The emotional or behavioral cues your child exhibits are important in ascertaining information about potential problems. It’s important to be able to work with them, guide them, and support them to successfully work through their stress and difficult times. Spend time and be available to answer their questions. Keep expectations reasonable. Validate how hard things can seem right now.

Know how to reach out for help if needed. 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.

Lee Health has a team of dedicated professionals at our Pediatric Behavioral Health clinic happy 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.

About the Author

Woman with brown hair and glasses smiling - Dr. Sandra Mills
Sandra Mills is a pediatric psychologist for Lee Physician Group Pediatric Behavioral Health.