Fear of re-experiencing or re-experiencing of a traumatic event, eg. molestation, rape, severe burns, riots that results in decreased responsiveness and avoidance of events connected with original stress. The event in itself may be insignificant and a direct threat. Response to stress is different for each child and depends on his/ her personality.

WHAT COMMONLY CAUSES STRESS?

The causes are different at different ages.

1. Children may get acutely stressed after witnessing natural calamities (earthquakes, floods etc) and the damage there of (building collapses, dead bodies and cattle floating in water). Today with all pervasive Television it can affect even children living on the other side of the world.
2.  Acts of terrorism like the Sept 11 crash of World Trade Centre at New York (October poll on this website shows that of all mothers who voted as high as 76% said that their children were badly affected by seeing it on TV). Religious riots and bombing in Mumbai in 93-94 also had children affected.
3. Witnessing an accident especially in which a friend or relative is involved.
4. Disharmony between parents, acts of violence and divorce do lead to a child being much stressed.
5. A child may get severely stressed if beaten by a teacher and may find it difficult to overcome it.
6. A child who is sexually assaulted may be left with an indelible stressor.
7. Adolescents may get stressed due to physical changes (perceived as not proper) and career prospects.
   

HOW DO CHILDREN REACT TO STRESS?

Just like the causes, even reactions to stress differ. One may be either 
anxious, depressed or may even develop a physical symptom. 

Some children may stop eating, others may start stammering after having spoken normally. Others may (re)start bedwetting or encopresis. 

Grown up kids may even resort to smoking. 

Common psychological symptoms are fear (of facing the stressor again); anger (frustration); guilt or shame (over helplessness) 

Reactions to acute stress may be confusion, lack of sleep, inability to concentrate, nightmares etc

WHAT EXACTLY DO CHILDREN FEEL?

They are generally "hyper" - startle at the slightest stimulus, thoughts intruding the activity going on, sleep problems, nightmares, dreams about the event and hyper alertness (mom! The building is shaking - in the aftermath of an earthquake) or (Mom, look that man with beard) The symptoms are aggravated by events reminding one of the stressor event. Sometime the symptoms arise after a long time like child sexual abuse manifesting after marriage. 

HOW IS IT TREATED?

Treatment is mainly Psychotherapy. Family support matters a lot. In some instance medicines (sedatives etc) may be used. Avoidance or telling a child NOT to watch it on TV or cut out gruesome pictures from newspapers does not help.

Next month:
How to manage a child with stress disorder

Please send in real life accounts of how you handled a situation. The best entry will be given books worth 250/-