EtonHouse Parenting Series - Stress and Mental Health (Part 1)

With the spike in the number of children visiting paediatricians with symptoms of stress and mental health disorders recently, mental health becomes an important topic, more so in the last year with the pandemic upending our lives and that of our children. Strong mental health helps to develop a positive mindset and behaviour which helps our children to cope with the challenges in life and reduces the risk of developing mental health illnesses when they are older.

We hear from Dr Gina Dahel, Head of Department at the International Medical Clinic's Children’s department, on the effects of stress on child development and what we can do to help our children monitor and assess their mental health. 

Q: What are the signs of stress in a child and how can parents identify them?

Dr Gina: Everyone has stress, even young babies, and it's a normal part of life. The definition of stress is emotional or physical distress and the feeling that you can't cope with a stressor. Stress is important, it motivates us to complete our tasks. As the stress level increases, your focus, determination, activity, and performance increase. Some level of stress is good, and it is the same for children. 

However, when we talk about stress in children, we usually talk about toxic stress where the stress is too much to cope with. When stress crosses a threshold, it moves from being stressed to being distressed and reduces focus and performance, and negatively impacts mental and physical health in the long run.

Where your child is unable to articulate their feelings or unwilling to express their thoughts, parents should look out for the following cues 

• Change in behaviour (depending on their age)
• Regression - more childlike behaviour
• Increased separation anxiety
• More nightmares
• Breaking boundaries/rules
• Aggressive behaviour
• Physical changes
• Changes in sleeping habits
• Changes in eating habits
• Somatisation (the physical manifestation of stress) including stomachaches or headaches
• Change in social interactions or performance in school
• Unable to focus
• Reluctant to attend school
• Isolation

Q: When should parents seek professional help? Would you recommend seeing a doctor or a psychiatrist?

Dr Gina: Parents should seek professional help when normal stress becomes toxic stress. One way to identify toxic stress is when the stress affects the quality of life, daily activities, or relationships with people. 

Early intervention is paramount; we can provide our children with tools or coping mechanisms to help them change their mindsets and cope with stressors as they grow. Many families reach crisis point before asking for help, and by this time, the family unit is exhausted. It is good to seek out help early if there’s any concern. 

The first choice would be a paediatrician or a specialist in children’s health who reviews the overall health of a child without narrowing it down specifically to mental health or physical health. The paediatrician would carry out a full physical examination which may include a blood test and imaging to rule out any physical or organic causes for mental health symptoms. There will also be mental health evaluation and risk assessment, followed by a treatment plan or medication.

Q: How can parents help their children to cope with stress when they are overwhelmed with life challenges?

Dr Gina: Fostering a supportive, open, and positive environment helps your child to respond better when met with challenges. Here are 9 tips that you can try:

1. Maintaining good physical health is equally important
• Exercise releases endorphins which are “feel good” hormones to cope with stress
• At least 60 minutes of physical activity a day
2. A nutritious and healthy diet ensures the brain and body muscles receive the nutritional requirements as your child or adolescent grows
3. Getting time outdoors helps to release oxytocin which is an anti-stress hormone
4. Good sleep hygiene can reduce frustration, stress, and anxiety
5. Reflecting on your personal coping mechanism to model good behaviours for your children
6. Spending quality time with your child doing an activity they like, be present and engaged during the time without distractions to cultivate an open and safe space where they can speak to you without the fear of repercussions
7. Having a positive approach to discipline as an overly harsh approach will do more harm than good to their mental and physical health
8. A good support system with family, friends, and the school helps to foster a positive environment that encourages your child to communicate their thoughts or troubles 
9. Incorporating activities like yoga, meditation, journaling, and mindfulness builds a positive mindset which helps your child to bounce back from setbacks

In conclusion, maintaining good physical health, a nutritious diet, and good sleep hygiene helps to reduce anxiety and combat stress. Read part 2 of our session with Dr Gina or you can listen to the full webinar recording below for more tips on improving children's mental health. 

Click play to view the full webinar recording