Surviving Back to School Stress and Burnout

For children and teens these days, going back to school doesn't only mean new, color-coded notebooks and freshly sharpened pencils. It also means increased academic pressures, heightened social anxiety and less free time as extracurricular activities fill up the calendar. It's a recipe that, if left unchecked, can lead to stress and even burnout.

The Cedars-Sinai Newsroomsat down with Sabrina Renteria, MD, a child and adolescent psychiatrist in the Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences, and Romina Kim, MD, a pediatric hospitalist with Cedars-Sinai Guerin Children's, to discuss stress and burnout symptoms and what parents can do to help.

What are some of the main causes of stress and burnout in children and teens?

Renteria: Some of the top causes of stress and burnout for this age group stem from academic pressures with high expectations and heavy workloads. High achievers, in particular, tend to overwhelm themselves with extracurricular activities in addition to their schoolwork, leaving insufficient time for rest and relaxation, which can be exhausting both physically and mentally. Additionally, social stress is often a contributing factor, especially in the age of social media where kids are constantly online. Bullying, peer pressure and difficulties navigating social relationships can all lead to severe emotional distress.

What do stress and burnout look like in this age group?

Renteria: Burnout and stress in children and teens can manifest in various ways. This can look like snappiness or irritability, lack of energy or tearfulness. Depression and withdrawing from friends and family can be common as well. Children might even express frustration or that they feel like giving up.

Kim: Physically, stress can show up as things like headaches, gastrointestinal issues, unintended weight loss due to loss of appetite, tics and other generalized pain. In severe cases, some patients can experience what's known as functional neurologic disorder, which is characterized by physical symptoms that cause distress and impair function without a structural or neurologic abnormality. In these cases, while nothing seems to be physically wrong with the child, they may experience various physical manifestations, including the inability to walk, muscle weakness or even seizures. With proper treatment, along with time and patience, most of these ailments are reversible.

How do doctors determine if a child's physical ailment is stress-related, versus physiological?

Kim: It's our role as doctors to do our due diligence. We always start by obtaining a detailed history from the patient and their family. This subjective information is our first step to piece together the puzzle. We also obtain objective data, such as physical exams, lab work, imaging studies and more to help support a possible diagnosis. Once we narrow things down, we often bring in additional experts, such as our neurology or psychiatry teams to help us confirm the diagnosis and address the problem to get the patient firmly on a path to recovery.

What signs of stress or burnout should parents or guardians look for in their children?

Renteria: Parents know their children best and should look out for significant changes in their behavior and mood. If your child starts to have a drop in grades, is increasingly irritable or constantly in a bad mood, those could all be signs they are under too much stress. Kids may also lose interest in their previously cherished pastimes or hobbies. Another red flag may be sleep issues, like trouble falling or staying asleep, or even sleeping too much.

Kim: When kids are burned out or feeling too much stress, they tend not to be able to cope with their emotions. Often, even the smallest inconvenience can trigger a big reaction. It's important that parents don't automatically dismiss what may be an unusual behavior for their child as them just being a "moody teenager," when there may be much more to it than that.

How can parents or guardians help their kids manage significant stress or burnout?

Renteria: It's OK for kids to be active and busy, but it's all about striking a balance. It is important to find the right amount of organized activity and free time to help promote social and emotional growth and development in your child. Parents can help children combat burnout by encouraging them to engage in physical activity, maintain a healthy diet, get enough sleep, establish a daily routine, set realistic goals, practice relaxation techniques, limit screen time and seek professional help if needed.

Kim: By building an open, communicative relationship with their children early on, parents can create a foundation in which a child feels comfortable being able to talk openly about any stress or anxiety they're experiencing. Another important thing for parents to remember: If they are not modeling good self-care and coping skills themselves, it is that much more difficult for their children to learn these habits. By setting an example of healthy balance for yourself, you can help set your kids up for success as well.

Read more from the Cedars-Sinai Blog: Five Deep Breathing Exercises for Kids and Teens

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