What puts children under pressure?
Elke H. is sitting in the paediatrician's waiting room with her 11-year-old daughter Sarah. In recent weeks and months, Sarah has had recurring headaches, sometimes had to stay at home and couldn't go to school. Recently, she has also had trouble sleeping. Now the 42-year-old is unsettled and wants to finally find out what is wrong with her daughter.
The paediatrician will examine Sarah a little later and look for a medical cause. He will also ask the girl about her eating, sleeping and media habits. And whether she is stressed at school or with friends. The paediatrician knows that in addition to the classic infectious and childhood illnesses, more and more children and adolescents are coming to his practice with stress-related and psychosomatic complaints.
Not only physical causes are possible.
In addition to the possible physical causes, Sarah's paediatrician also considers a mental imbalance that triggers the discomfort. Or a mental disorder that causes physical complaints - such as depression, an eating disorder or AD(H)S. For this reason, in addition to the physical symptoms, the doctor will also ask about Sarah's life circumstances and possible stressors - both Sarah's and her parents'.
In our rather top-heavy media and performance-oriented society, it's not just children who are under pressure. Many parents also experience stress due to the double burden of work and private life. The dissatisfaction of parents - the most important caregivers - has a negative impact on the family climate and also stresses the children. Single parents are particularly affected by this; they are usually very busy at work and often lack a partner to provide support and balance for a happy family life. Single parents - and their children - therefore suffer particularly frequently from health problems.
Even teenagers show symptoms of burnout
For Michael Schulte-Markwort, child and adolescent psychiatrist at the University Medical Centre Hamburg-Eppendorf, stress is an illness-causing factor that has become increasingly important in recent years. Young people are no longer able to cope with the daily stress of school, homework, demanding hobbies or competitive sport and show physical and psychological symptoms, including burnout.
According to a study conducted by the German health insurance company AOK in autumn 2013, one in five children in Germany had stress-related health complaints ranging from malaise, dizziness and light-headedness to nervousness, irritability and headaches, abdominal pain, back pain and sleep disorders.
In a 2015 study, Bielefeld University found that almost 20 per cent of children have a high stress level, while a WHO study found that almost 20 per cent of children between the ages of 11 and 17 feel overwhelmed and exhausted as a result of actual or perceived pressure to perform. As a result, children are more likely to suffer from illnesses and develop symptoms that are usually more stress-related in adults.
If the parents suffer from an illness, the children can also become ill.
However, it is not only social conditions and expectations that lead to mental stress. There are also conflicts in the parents' partnership or even mental illness in the mother or father. Children suffer as a result and can become ill themselves.
Developmental disorders due to too much media consumption?
According to a study by the Rheinische Fachhochschule Köln, the intensive use of digital media can also lead to developmental disorders in children. According to the study, feeding and sleep disorders in babies are possible if parents use media at the same time while caring for their children, language development disorders in toddlers and concentration disorders at primary school age. For the study published in 2017, 5573 parents and their children were surveyed on their use of digital media.
One result of the study is particularly striking: 70 per cent of under-six-year-olds play with their parents' smartphone for half an hour every day. As a result of the intensive use of digital media, these children increasingly suffer from motor hyperactivity as well as concentration and language development disorders. This can also be seen in the group of 8 to 13-year-olds who consume digital media for more than 60 minutes a day.
Other studies prove the connection betweenincreased consumption of sweet drinks and sweets and an increased body mass index (BMI). Such statistical correlations do not prove a cause-and-effect relationship between media consumption and developmental disorders or other health consequences. However, early exposure to age-appropriate media skills and moderate use are certainly recommended.
It is better to teach children how to use their devices correctly than to impose a smartphone ban. «Rashly prescribing occupational and speech therapy alone will not avert the dangers,» says paediatrician Uwe Büsching from the Professional Association of Paediatricians, who was also involved in the study. «Especially if the behaviour or development is conspicuous, inappropriate use of media by parents and children should always be taken into consideration.»
Do we need to promote digital media skills?
In future, early detection examinations should therefore be supplemented by media counselling appropriate to the child's age. This is because there are indications that there is an increased risk of not being able to control the use of digital media if digital media skills are not learnt at an early age.
Alongside the home, school could be a place where such skills are taught. However, past reforms have focussed more on what children need for their later working life and less on what children need to develop optimally. This increases the pressure on children and raises stress levels - for both children and parents. The result is increasing uncertainty among parents and consequently rising enrolment figures for assessments, support measures and therapies.
Poverty is another factor that can make children ill and also has a negative impact on their development and educational opportunities. According to a study by the Robert Koch Institute, children and young people from families with a low social status are two to three times more likely to have poor general health. They are more likely to have mental or behavioural problems, be overweight or even obese, do less sport and have an unhealthy diet.
Children and adolescents from families with a low social status are more likely to have poor general health.
A child poverty study by the Bertelsmann Foundation concludes that growing up in poverty is often associated with psychosomatic symptoms such as enuresis, sleep disorders, stomach aches and headaches, lack of concentration, nervousness or depressive symptoms, even in Western countries with a high level of prosperity.
In 2015, a study by the University of Bochum showed that growing up in poverty affects the development of children of kindergarten age. Developmental deficits were found more than twice as often in five to six-year-olds whose families live on basic state benefits than in children who grow up in secure income situations: they speak German less well, have poorer counting skills, suffer from poor concentration more often, are overweight more frequently and have poorer coordination skills.
Strengthening resilience - how does that work?
The ability of children and adolescents to cope with stress or unfavourable developmental conditions varies greatly. Nothing can be done to change a person's basic genetic make-up.
However, it is known from epigenetic research that environmental factors can very well have an influence on children's health. This means that it is important to avoid severe or prolonged stress during pregnancy. Current or past stressful life events or unfavourable conditions, but also protective factors, have a significant impact on the development of a child.
Risk factors, increased susceptibility (vulnerability) and protective factors such as high resistance(resilience) can be found in the child, in the family, in the environment (friends, kindergarten, school, work) and in socio-cultural and social conditions. Children should feel safe and secure with their parents.
Sensitive - not spoiling - parents make a significant contribution to their child's later attachment security. It is important to take children's needs seriously, listen to them, ask questions and be open to their concerns and ideas. Parents can seek counselling alone or together with their children if they are unsure. It is better to share your parental concerns and questions with your partner, colleagues or a specialist if you are at your wit's end.
An «emotional bridge» reduces the risk of permanent psychological stress for the child.
Happy and contented children also need happy and contented parents. Single parents should share childcare, spend time with other mums and their children or go out with a good colleague.
Separated parents should try to live together as amicably as possible, build an «emotional bridge» for their child to the other parent - and be as loyal as possible. This considerably reduces the risk of lasting psychological stress for the child.
Parents have a duty
We live in a fast-paced world that places high demands on us. The effects are not only felt by the adults affected. Children also suffer - with consequences that can include serious illnesses. Parents have an enormous responsibility here, which on the one hand increases the pressure even more. On the other hand, it is possible to avoid the cliff of a sick child.
A balanced diet, consistent attendance at paediatric check-ups and recommended vaccinations as well as a sufficient amount of sleep, adapted to the individual needs of the child or adolescent, contribute significantly to health and can protect against pathogenic influences.
At the same time, children and adolescents need age-appropriate freedom, room for manoeuvre, stimulation and a certain parental calmness. Children can learn from the example of their parents, family and close friends, experience relationships, exchange ideas and learn about boundaries.
Children must be allowed to deviate from the concept of life planned for them and develop according to their individual talents - without fear of consequences. We should not lose sight of who is causing the stress and suffering - is it really the children themselves, or is it their parents, the school or others who are concerned and are pushing for clarifications and investigations? And how do we organise the living environments of children, young people and families?
It is not just the parents who are called upon here, but the communities, society and politics have a responsibility to create the best possible conditions for the development of children and young people.
Image: fotolia.de
The authors:
Book tips:
- Kurt Albermann (ed.): When children step out of line. Mental development disorders in children and adolescents. Beobachter Edition, Zurich 2016
- Remo Largo: The right life:what constitutes our individuality and how we can live it. S. Fischer Publishing House, Frankfurt, 2017
Online dossier Burnout
Read more:
This article is part 1 of our ongoing series «What makes children ill» from the 04/18 magazine.
- Teil 2: Was stresst unsere Kinder und wie helfen wir ihnen?
Ausserdem:
- Burnout: Wenn Jugendlichen alles zu viel wird