Can schools do more to help teens cope with stress?
Mental resilience training may benefit young people, writes Dr. Peter Nieman.
Not so long ago, I encountered yet another teen who came to see me because she was stressed out by the demands of high school. January in particular seems to be one of the worst months in the academic calendar year. It seems to me that even the most motivated students go through anxieties, fears and pressures. In my patient’s case, she could not sleep, lost some hair, experienced abdominal pains and lost weight due to feeling nauseated. Similar stories seem to have become increasingly common.
Can we blame the fact that it seems to be harder than ever to get into some programs at university? In addition to expecting higher grades for admission, some institutions also demand volunteer work in the community to create “more well-rounded” applicants. Has the pace of teaching and the volume of homework increased over the years? Why are some schools adding home work on weekends and holidays? When did it become “normal” to have so many math tutors? And is it fair to blame today’s youth for being too soft — in some cases labelling them as too entitled and lacking resilience?
These questions are open to debate and perspectives will vary widely, but a report on Education Canada’s website shows almost 50 per cent of high school students report moderate to severe stress levels; 68 per cent reported a high interest in learning about stress and effective stress management; 65 per cent reported a minimal amount of knowledge about stress management, but only 19 per cent reported that they had received formal instruction in stress management or had been shown stress management techniques by a parent, teacher or psychologist.
Sadly, some students — especially those who already struggle with depression and anxiety — may present with self-harm such as cutting themselves, somatic symptoms, and the use of substances such as alcohol or marijuana which provide only a temporary escape. Doctors in primary care and ERs are treading water, helping these students while access to mental health and addiction programs seem to be clogged up like a freeway on a snowy morning commute.
The maladaptive coping skills not only cost society money for acute care, but it also impacts the still-developing teen brain. This may have lifelong consequences and even though society has tried hard to de-stigmatize mental health, teens who struggle feel guilty and inferior.
Pediatric sport medicine experts have raised the legitimate concern of teen athletes who are pushed too hard, but can one make the case that mentally teens are also being pushed too hard and that many are not coping well?
Many changes in the way high schools operate were based on research. For example, mandating daily physical activity was inspired by research showing both the academic and mental health benefits. Knowing that teens are on a different trajectory when it comes to sleep and that their bio-rhythms are different led some jurisdictions to introduce a later school start. Some schools are scheduling math exams to later in the day, rather than the first thing in the morning.
We may not be able to reverse the mental demands of higher learning, but could it be time to revamp the curriculum to include formal education in junior high schools to include classes that will add mental resilience skills? Should stress management become mandatory like physical education? (At the time of this writing, it appears that the revamping of the current curriculum by the Alberta government will include classes which will help students become more mentally resilient).
The Canadian Education Association developed a program named StressOFF, which was delivered to over 2,000 high schools. Because educators and administrators cited lack of time to fit such a project into an already tight schedule, the program was designed to deliver stress management in a singlesession, 45-minute program.
The program involved teaching mindfulness, correcting distorted thinking and helping teens to recognize and manage difficult emotions without becoming overwhelmed by them. The acronym STRESS refers to: Stop; Thought challenge; Relaxation; Self-observer and Support and better choices.
In addition, muscle relaxation and breathing techniques were reported by students to be very useful, simple and practical. Close to 90 per cent indicated that they would use this relaxation strategy, and 91 per cent rated the program as either good or excellent.
The detail of this program can be found by visiting www. cea-ace.ca/education-Canada/ article/teen-stress-our-schools.
In the January 2016 edition of Pediatrics, researchers published a landmark paper showing the benefits of school-based mindfulness instruction. Mindfulness-based stress reduction has been well studied and promoted by experts such as Jon KabatZinn, but more data in children need to be gathered before school boards will implement targeted or mandatory mindfulness programs.
High-stress high schools are just the prelude to more stress at the college level. The rates of depression, anxiety and self-harm for first year university students are on an upward trajectory.
The American Academy of Pediatrics offers some sound advice for parents and teens on how to prepare for the transition from high school to college. (See www.healthychildren.org for more information.)
Even though society has tried hard to de-stigmatize mental health, teens who struggle feel guilty and inferior.