Back-to-school time can be nerve-wracking and stressful for children and teens. So how can parents help? The Montreal Children’s Hospital wants caregivers to be aware of the signs of stress and offers advice to support children during this sometimes challenging period.

First, it is essential to know that feeling stressed is normal, even healthy — everyone, from babies to centenarians, experiences stress. This is how our body and brain react when challenged. Any type of challenge — COVID-19, a math exam, trying out for the basketball team, or finding out a friend is moving—can be stressful. Usually, the feeling is short-lived. It becomes a problem when it gets chronic and affects the child’s ability to enjoy life. At this point, stress means distress.

“It is not surprising that research shows children and teens are more stressed than ever since the start of the pandemic,” says Dr. Catherine Serra Poirier, Psychologist at the Children’s. Studies show that 50 per cent of youth are currently reporting elevated levels of psychological distress in the form of anxiety and depressive symptoms. Poirier explains that children and teens are often unaware they are experiencing stress. They know they are upset, but they might not be able to explain why.

While signs of stress vary from one child to another, parents should be on the lookout for any of the four suspect behaviours below.

Change in mood

A talkative child or teen might become withdrawn and quiet; a calm child or teen might be irritable, cry with little provocation or overreact emotionally to a situation.

Feel sick

A child or teen might experience physical ailments like headaches, upset stomach, or general discomfort or uneasiness. They aren’t lying. The symptoms are real, but the child or teen might not realize they are due to stress.

Change in behaviour

The child might suddenly have a hard time falling asleep or might wake up in the middle of the night. They might start having nightmares or restart wetting the bed. Changes in appetite are another clue a child is stressed. They might suddenly start eating a lot less or a lot more – mainly comfort food such as sweets. Also, they could stop playing or doing their favourite activity. They might sit in front of a toy or colouring book but not engage.

Avoidance behaviour

When stressed, a child or teen might try to avoid the people, places or things causing their stress. They might not want to go to school or a particular class. They could avoid going to the store or local pool, or passing by the mean-looking dog next door.

“Chronic stress, left unchecked, can contribute to a variety of physical and mental health problems such as anxiety and depression—disorders that are becoming increasingly common in youth,” Poirier says. It is essential to reassure kids that stress is a normal part of life and then parents can help them manage their emotional and physical reactions, she adds. Poirier offers four tips for parents to help children cope.

Get them talking

It can be difficult for a child to express their feelings. Show interest in their lives and ask some questions to help them pinpoint the cause of their stress, for example: Are you sad your team didn’t make the playoffs? Are you nervous about the start of school? Let them talk about their emotions, and then validate their experience. Explain that stress is something everyone lives from time to time and that eventually, it will pass.

Avoid avoidance

Help the child problem-solve so they can find healthy ways to cope with their stress. For example, many people found it difficult to do everyday activities after Covid-19 restrictions were lifted. In this case, parents could tell kids to start with short outings with a limited number of friends, for example, close to home or at a nearby park.

Maintain a household routine

Children and teens respond well to a structured life. It gives them a sense of control and predictability, which is reassuring. Before going back to school, it is important to re-implement the family’s routine as much as possible. Get up at the same time, eat at the same time, encourage a regular bedtime routine including going to sleep earlier.

Be a role model for stress management

Remember, what parents do is just as important as what they say. They should talk about their feelings when they are stressed, angry, or sad, and encourage children to do the same. Demonstrate how to manage stress and other emotions like frustration or sadness.

What if the child’s stress is out of control?

Poirier says persistent stress becomes problematic when it starts to affect the child’s health and well-being. Then it is time to seek professional help. If a parent is worried about their child, the first step is to make an appointment with their family doctor to discuss the child’s symptoms and see if a referral to a psychologist is necessary.