By Bettina McAdoo, M.D., PAMF Pediatrics

Headaches, stomach aches, depression and anxiety are common symptoms of stress seen in the pediatric office. Children experience stress from family disruption such as divorce, as well as pressure from their own and others' expectations of superiority. Whether in academics, sports, other extracurricular activities, or even in their appearance, being "average" is no longer acceptable.

Learning to cope with a certain amount of stress and uncertainty is an important life skill. It is healthy for children to take on challenges, but not to the extent that they begin to lose the sense of fun and relaxation that is essential in childhood.

As children grow up, they internalize the expectations of their environment and put tremendous pressure on themselves for success. The tragic consequences are increased teen suicide rates, eating disorders, substance abuse and depression.

As children mature, they're able to make their own decisions about their activities. But in a child's younger years - especially up through middle school - his or her level of involvement in activities tends to be controlled by a parent or another adult. As adults, we need to make sure that we are not putting excessive pressure on our children to make high grades or excel in sports or other extracurricular activities. In high school, when teens put pressure on themselves, parents must help them find reasonable academic and extracurricular loads.

Even a child who appears very mature and able to handle responsibilities may be pushing himself or herself too hard. If you see the following symptoms, your child may be on overload:

• Physical symptoms, such as headaches and stomach pains
  
• Sadness, depression or withdrawal
  
• Restlessness, fatigue and agitation
  
• Lack of interest in an activity once very important to him or her
  
• Falling grades and lack of interest in schoolwork
  
• Antisocial behavior, such as lying and stealing, forgetting or refusing to do chores
  
• Increased dependence on the parent

Parents can try the following to help relieve a child's stress:

• Be supportive of your child's activities, but not pushy. Offer praise, but allow the child to change interests and activities if he or she wants to.
  
• Observe your child, and help him or her evaluate activities that pose a problem.
  
• Help your child change his or her schedule to make time for relaxation and play.
  
• Spend time together every day, even if it's only 10-15 minutes.
  
• Make family dinners and other family activities a high priority.
  
• Examine your own schedule, since a parent's hectic schedule can cause a child stress.
  
• If you see symptoms of problems, discuss it with your child's pediatrician.

By following these simple tips, you can help create what every parent wants - a happy, healthy child.

Bettina McAdoo, M.D., is a pediatrician at the Palo Alto Medical Foundation. This article was originally published in the Redwood Shores Pilot.

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