Introduction 

As exam season approaches, many students, especially teenagers, go through a range of emotions. Exam anxiety, often called exam fever, is a common but overlooked issue, affecting around 40% of children and teenagers. It's characterised by increased stress due to the pressure to study, especially before important exams. Many students feel alone in their struggles. 

As caregivers, we often use terms like "stressed out," "depressed," or "anxious" to describe these emotions. However, these words can carry significant weight as they represent clinically diagnosed disorders. Using them casually may harm a child rather than help. Let's explore and understand these terms better to support our children in a positive way. 

By exploring these indicators, the aim is to provide targeted support and foster a more comprehensive understanding of mental well-being within educational settings.

Stress

Exam stress is the tense, anxious sensation that results from taking tests. It's common to experience some anxiety before big exams, papers, presentations, or assessments. In fact, a little worry can push you and motivate you to put in more effort. When exam stress affects your performance and prevents you from meeting your learning and academic objectives, it becomes a problem. 

Exam stress symptoms can include: 

• Being distant from friends and enjoyable activities, feeling depressed, anxious, or overwhelmed, having problems making judgements 

• Losing appetite or overeating, having trouble falling asleep, having trouble getting out of bed, having trouble getting motivated to study, tense muscles, or headaches 

• Feel cold hands, butterflies in your stomach, a pounding heartbeat, nausea, fidgeting, biting your nails, grinding your teeth, feeling disoriented, or having a blank thought during the test. 

• Exam stress is common and reasonable due to uncertainties, the need to retain extensive information, the impact on course or career paths, family expectations, difficulty in understanding the material, and a sense of being unprepared or lacking study time. 

Depression 

During exams, it's quite normal to experience occasional feelings of sadness, hopelessness, gloominess. However, if you've been feeling down for more than two weeks, especially when good things happen or your surroundings don't seem to make a difference, you might be suffering from depression. 

• Depression can manifest as any of these 3 main symptoms : 

• The individual usually suffers from depressed mood, loss of interest and enjoyment 

• Reduced energy leading to increased fatigability and diminished activity.  

• Marked tiredness after only slight effort is common.  

   

Other common symptoms are:  

• Reduced concentration and attention 

• Reduced self-esteem and self-confidence 

• Ideas of guilt and unworthiness  

• Bleak and pessimistic views of the future 

• Ideas or acts of self-harm or suicide 

• Disturbed sleep 

• Diminished appetite. 

Distress, and restlessness may be more noticeable than feelings of sadness. Mood changes can be concealed by behaviours like irritability, dramatic actions, worsening fears, obsessions, or excessive health worries. Specific symptoms, such as loss of interest in enjoyable activities, emotional numbness to pleasurable surroundings, early morning awakening (typically 2 hours before usual time), observable psychomotor changes, significant loss of appetite, and weight loss, may indicate clinically important features of depression, which may need immediate professional attention. 

The majority of people during exams feel anxious, which includes sensations of worry, trepidation, and fear. Considering that anxiety is a reaction to stress, you may feel some uneasiness prior to the exam preparation or when sitting in the exam hall. However, you may have generalised anxiety disorder (GAD) or another anxiety disorder if you have severe or persistent anxiety most days in the past several months. 

The key aspect is persistent and widespread anxiety that isn't tied to specific situations; it's more general and not strongly connected to any particular environment (referred to as "free-floating"). These symptoms typically include: 

• Apprehension (worries about future misfortunes, feeling "on edge", difficulty in concentrating, etc.  

• Motor tension (restless fidgeting, tension headaches, trembling, inability to relax) 

• Autonomic overactivity (lightheadedness, sweating, tachycardia or tachypnoea, epigastric discomfort, dizziness, dry mouth, etc.) 

• Complaints of continuous feelings of nervousness, trembling, muscular tension, sweating, light-headedness, palpitations, dizziness, and epigastric discomfort are common. 

Panic Disorder

One may also experience some changes in body like having fears of passing out, choking, breathlessness etc. which may be a sign of having a panic disorder. 

The other symptoms are: 

• Sudden onset of palpitations 

• Chest pain, choking sensations, dizziness,  

• Feelings of unreality (depersonalisation or derealisation)  

There is also, almost invariably, a secondary fear of dying, losing control, or going mad. 

Individual attacks usually last for minutes only, though sometimes longer; their frequency and the course of the disorder are both rather variable. An individual in a panic attack often experiences a crescendo of fear and autonomic symptoms which results in an exit, usually hurried, from wherever he or she may be. 

In cases where these symptoms become pronounced and challenging to manage independently, seeking professional help is advisable. Recognising the potential severity of these conditions and understanding their distinct characteristics can empower caregivers to provide appropriate support and intervention for the well-being of students.