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Published October 16th, 2019
Signs of stress and its management for middle school students
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According to a stress management forum conducted at Joaquin Moraga Intermediate School by Paul Espinas, a practicing pediatrician at the Kaiser Permanente Medical Clinic in Hayward, there are many factors attributed to middle school stress.
On an academic level, good grades, homework and test scores all contribute to anxiety. Other factors involve the transition from elementary school to middle school, sports (competition), friends (peer pressure) and future worries about high school and college.
Stress can also come from at-home situations. Espinas stated, "At-home stress can be the toughest, because we'd like to see the home as a source of rest and strength for the family."
Espinas' wife, Juliana Damon, a practicing pediatrician at East Bay Pediatrics in Orinda/Berkeley said, "A lot of the time, I see kids affected by parental pressure [and] expectations, family dynamics, illness in the family, financial stress, over commitment or hyper focus on one activity."
Some of the immediate health effects of stress include stomachaches, headaches and sleep issues. However, stress can manifest itself in emotional and academic ways by causing anxiety, depression, unhappiness, agitation, frustration, negativity, body language and disrupting cognitive functions. Espinas said, "I see a lot of stressed out kids who present to the clinic with non-specific symptoms, like headache and stomachache. I usually tell families that if we don't do a good job of managing stress it can manifest in many different ways."
When asked whether kids are aware that their symptoms are stress-related, Damon responded, "For kids that come to the office, lots are afraid they have a medical condition, but many have an inkling that they are related." Espinas added, "I think the older kids do have a sense of the link between stress and their overall health, but some definitely need to hear it from a doctor."
Both Damon and Espinas feel that severe cases of anxiety may require medication. "When appropriate, anti-depressants or anti-anxiety medications are used to help treat kids," explained Espinas. "In our system, psychiatrists usually prescribe these."
Sadly, diagnosed cases of stress are increasing. "I refer kids to child psychologists and psychiatrists every day of the week," Damon said, and Espinas agreed, saying, "I feel the number of kids that need referrals is rising. I've heard that from school districts, too. They are seeing the demand for mental health services go up."
Many JM students find ways to cope with stress levels by watching television, spending time with family and pets, listening to music, taking breaks from homework, and finding a quiet place to work, and most importantly, talking to parents about stressful situations
It is important to develop good habits such as getting a good night's sleep, having healthy social connections, eating right, maintaining a sensible schedule, taking a break from social media and learning to have fun.
Damon and Espinas encourage parents and families to play a big part in the stress management process. "Parents should model how to help themselves, practice self-forgiveness, giving yourself time to think things through, talking to kids about their own challenges and modeling resilient behaviors," Damon explained. "We can normalize how we struggle and deal with life's challenges. Everyone assumes that people in our community are doing better than themselves, but mental health issues are unfortunately very common. In this age, it's important to have good connections with kids so that they don't feel detached or alone. There are so many things that we can offer to help . but what all of us need and want, whether anxious or depressed or neither, is connection . with our family and friends and the greater world. This is not something that happens overnight but is a life approach that we all can cultivate together."
Espinas stressed that it's important to recognize when kids need more resources. "I think some parents would hesitate to utilize these out of embarrassment, shame, etc. Part of dealing with these issues is having open honest and vulnerable conversations. Start with your doctor if you have concerns. It's also important for families to put effort into prevention - we all want our kids to be successful, but we should do so in a way that promotes their emotional health and resilience."
Tips Espinas recommends are to get sleep, since it is fundamental to emotional and physical health and definitely helps mitigate stress, have a schedule that includes time for play, downtime, fun and family, limit screen time - "Increasing amounts of screen time and social media have been linked to anxiety and depression," he says - and get outside. "Take advantage of the nature around us! Time spent in green spaces has been shown to decrease stress and build resilience."
Finally, Espinas says to model behavior. "Julie has a great line she tells to her parents: `Your kids deserve to see you happy.'"

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