It seems like we blinked, and summer was over—and school began.
If you notice that your child seems to have more medical conditions during school, you aren’t imagining things. Many medical issues are frequently triggered by the stress of school, manifesting themselves during the school year more on weekdays than on weekends, holidays, and vacations.
Juggling school workload including extracurricular activities can sometimes be
challenging and stressful
Some of these school-centric problems include:
- Headaches: both chronic daily headaches and migraines.
- Gastrointestinal (GI) complaints, often divided into two main categories:
-Functional GI disorders: These include irritable bowel syndrome (IBS) which can look like any combination of pain, nausea, vomiting, diarrhea, and constipation. Functional abdominal pain (FAP), functional dyspepsia, abdominal migraines, and cyclic vomiting syndrome all fall under this category, too. In functional GI conditions, test results come back normal, yet the symptoms are very real.
-Organic GI disorders: Organic GI disorders all have biopsy-proven causes, the most common of which are Crohn’s disease, ulcerative colitis, and inflammatory bowel disease.
These two groups actually overlap quite a bit. Patients with any type of GI condition experience physical, emotional, psychological, and neurological components.
- Tics (with or without Tourette syndrome): There are two types of tics: motor and phonic (or vocal). Motor tics can be simple, involving a single muscle group; or complex, involving sustained or coordinated movements; whereas phonic tics involve any type of sound, such as grunting, snorting, sniffing, squealing, throat-clearing, or coughing. A hallmark of tics is that they are always absent at night. Sometimes parents report that their child can’t sleep due to the tic, yet when the child eventually does fall asleep, the tic stops.
Anxiety or stress of any kind can trigger these problems, but the stress needn’t be the sole result of school. Other stressors include fatigue, illness, disruption in family life, worrying about a loved one’s health, divorce…the list goes on.
Over time, this can become a vicious circle in which the child or adolescent feels stressed because of a test coming up at school, for example, and the symptom surfaces or worsens (headache, diarrhea, tics). Then the child thinks, “These symptoms will never go away,” and the pain or symptoms intensify…which leads to more stress. And around they go.
The symptoms are usually subconscious, the body’s way of reacting to the stress, which speaks to a strong mind-body connection.
With all of these, it is important to realize that the symptoms are real. The child is not faking a stomachache or headache, and the child may need to be evaluated by his or her primary care clinician. Sometimes, as a result of these doctor’s visits, patients are referred to specialists, such as pediatric gastroenterologists or pediatric neurologists. So take your child seriously and follow through if your child’s primary care clinician recommends this.
A common example of these mind-body symptoms is a girl who has stomachaches Monday through Friday mornings and is fine on the weekends, but every Monday morning, her stomachache comes back. This is typically due to something related to school that is upsetting the child. For example, if she has a learning problem, such as dyslexia or Attention Deficit Hyperactivity Disorder, this can lead to anxiety in the classroom, which then leads to the physical symptoms.
Perhaps he is being bullied by another child at school, or he is struggling with math. Any of these things can manifest in real physical symptoms.
I once worked with an adolescent young woman who was angry at her father. On the night of his birthday, the family planned to go out to dinner at his favorite restaurant. Just before she got into the car, however, she said, “Gee, Dad, I’m sorry. I’m getting a migraine and can’t join you tonight.” Again, this was subconscious—she was not purposely trying to avoid the celebration.
However, once the child recognizes the connection between the stressor and the symptom—the mind-body connection—it can be used to his or her advantage.
For instance, in the example of the girl with stomachaches every Monday through Friday, once she realized that they were related to school, she started to think about what was bothering her in school. As my friend and colleague, Marianne Ault-Riché, LCSW, tells a child, “This is good news. It means that you have a very smart tummy!”
When I treat patients with any of the conditions I’ve mentioned, I typically use a combination of medical hypnosis and cognitive behavioral therapy (CBT) to treat them, both of which have been shown to be effective in treating the corresponding symptoms. Patients who use self-hypnosis to control their headaches report that it works faster and better than medication. A big benefit is that self-hypnosis provides this relief without medication and, therefore, without side effects.
Although medical hypnosis also can be helpful to treat the anxiety that accompanies the physical symptoms of stress, CBT has proven time and again to be the best treatment for anxiety.
When it comes to choosing which problem to treat first—the physical issues or anxiety—I simply ask the child, “Which is getting in the way of your life more: the worrying or the symptom?” And the child always knows. Then we work on that issue first, and once it is under control, we work on the other one.
As this new school year begins, don’t let stress get the better of your children. Discover the root causes of the symptoms and get help today to ensure their best year yet.
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or call Dr. Lazarus at 650-322-5333.