Stress and Physical Symptoms: When It's Not Just in Your Head

Most people know that when we have an illness, how we feel physically affects how we feel mentally.  So, it should come as no surprise that mental feelings can have the opposite effect and change our physical state. We commonly accept that sadness can produce tears, anxiety can cause shortness of breath and “butterflies” in our stomach, and love make our hearts race and cheeks flush. Some people may also experience constipation or diarrhea when anxious or have tension-related headaches when under stress.

These physical symptoms can be frustrating for parents due to school and work absences to provide care and attend doctor’s appointments; which may not turn up any laboratory evidence of illness. This can be referred to as a “somatoform” disorder; which presents with symptoms suggesting an underlying medical condition, yet such a condition is not found on examination, or doesn’t fully account for the level of impairment the child or adolescent is experiencing.

How does this happen? 

The younger the child, the less they understand what they’re feeling and have fewer ways to communicate it to others. Children and adolescents share our language, but not the same understanding of how they feel, how things work or how to feel better. It’s still a world of magic in many ways with adults holding the secrets and understanding. Children are increasingly expected to “hold it in” or “deal with it” to get through a brief, difficult situation.

When the situation is more chronic and there isn’t an opportunity or means to communicate and “release” our distress, the mind has its own ways to use the body as an outlet which can produce physical symptoms:

• Recurring abdominal pain accounts for 5% of pediatric office visits.
• Headaches have been reported to affect 20-55% of all children.
• 10% of teenagers report frequent headaches, chest pain, nausea and tiredness.

What can a parent do?

• If your child or adolescent is experiencing frequent stomach aches, nausea, headaches, breathing difficulties or racing heart, first see a physician to rule out a physical cause to determine if there is treatment.
• It’s important to acknowledge the impact of the symptoms on your child’s life, including work and play. This also includes examining the larger impact on the family.
• After physical causes have been ruled out, take a closer look at how your child reacts to stressful situations.
• Be a team: Identify symptom triggers, factors  that make the symptoms more tolerable and minimize the impact to your child’s life and feelings of control.
• As with any illness but especially with chronic illness symptoms, help your child cope. Whether physical or psychological, one of the greatest tasks as parents is teaching children to focus not only on cause but adapting to the world.
• Similar to poker, we don’t always have a choice in the hand we’re dealt, but we have a choice on how to play the hand we’re given – accept the parts that can’t be changed, while supporting and encouraging  your child to control the pieces they can.

For more information on Nationwide Children’s Hospital Behavioral Health services, click here.