Anxiety, fear, panic, depression and suicidal impulses are just some of the feelings associated with the pressure of writing important examinations.
Exam stress may be the worst stress a child has ever experienced, and parents should be alert, according to experts.
Read: How teens can cope with exam stress
Health24 teen expert and clinical psychologist Dr Neíl McGibbon said stress is essentially anxiety, which is a form of fear.
"What develops from fear are overly negative predictions about the future that we then believe are fact, rather than a perception or possibility."
Fear of failure
He pointed out that what can develop is a belief system that tells the person they are not capable of coping in a stressful situation.
"In adulthood this can develop into a lack of self-belief and not striving for goals because of a fear of failure."
McGibbon explained how stress can manifest as depression and eventually lead to suicide.
"Anxiety is future-based; however studies show that we are not very good at predicting the future accurately, especially from a starting place of high anxiety. Depression can emanate from this lack of self-belief, including loss of hope in the future.
"On-going, untreated depression can lead to a sense of being trapped and nothing will get better. From here, suicidal thoughts can develop. Impulsive, panic-related interpretations of outcomes can also cause suicidality."
Overexposure to stress hormones
He said suicidal thoughts, feelings and actions can come from either a long-suffering place, or from an impulsive panic-related position.
McGibbon recommends that concerned parents contact either a psychiatrist or psychologist who specialises in adolescents.
Educational psychologist Dorrithé Benadé told Health24 the body becomes overexposed to stress hormones when stress is not managed.
"It is necessary for teens and young adults to learn how to cope with stress because chronic stress in your life is keeping your fight or flight system switched on a lot of the time."
Benadé pointed out that stress overload can affect the mental and physical health of teens in a number of ways.
"Stress generates anxiety and can increase the risk of panic disorder, an anxiety disorder problem which causes recurrent panic attacks."
She said for people who tend to worry excessively about things – who may have generalised anxiety disorder – stress can increase anxious thoughts.
"Stress and depression are different conditions but ongoing stress can increase the risk of developing depression."
Teens may resort to drug or alcohol abuse and binge or comfort eating. "All of these can be aggravated by stress."
"There’s still a lot to learn about the links between stress and the immune system but research so far suggests that the ability to fight off infection can be negatively affected by ongoing stress."
Worsening symptoms of Irritable Bowel Syndrome (IBS)
Benadé said that brain chemicals may affect nerves in the bowel causing changes in bowel function. "Some evidence also suggests there are links between IBS and the immune system which in turn can be affected by stress."
Increased risk of type 2 diabetes
Although inactivity and being overweight are the main risk factors for this kind of diabetes, Benadé noted that some evidence suggests that general emotional stress, anxiety and depression are also linked to an increased risk of type 2 diabetes.
She recommended that parents should look out for signs in their child such as:
- Lying awake worrying
- Feeling guilty when they are not working
- Getting easily frustrated
- Complaints about a dry mouth, heavy pounding or "butterfly" feeling in the heart
- Grinding teeth
- Flaring up easily at other people
- Regularly eating in a hurry, or going on binges
- Frequently dropping or break things
- Signs of increased irritability, tearfulness or moodiness
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