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ADOLESCENT STRESS

Adolescent Stress

Chloe Birkholt

Creighton University

Lifestyle Medicine
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Adolescent Stress Is Real

Stress is a physical, mental, and emotional factor in a medical or biological context,

causing strain on the mind and body. It is common for many adults to view a child’s life as

happy and carefree. Children do not have jobs or bills to pay, and therefore many believe adults

face more stress than a middle or high school student. While adulthood is perceived to more

stressful, pre-teens and teenagers also experience stress just like adults. The transition into adult

life is not an easy bridge to cross. Consequently, these struggles into adulthood tend to cast a

shadow over the feelings adults once experienced in middle school or high school that are easily

forgotten. Indeed, adolescents encounter numerous stressors that are easy for adults to overlook.

It is simple, everyone deals with stress on a daily basis, no matter the age, race, or gender. Yet,

some people handle stress in healthier ways than others. One thing to keep in mind is that there

will always be several ways to perceive a situation, and it is important not to discredit or think a

teenager’s stress level is less than or insignificant as compared to an adult. It is easier to help

someone, especially a younger person, cope with stress by approaching the situation with a non-

biased perspective. Whether or not stressors are the same or different, acute or chronic, stress can

have immediate and long-term effects on an adolescent’s physical and mental well-being. This

scientific review of adolescent stress aims to create an understanding of the types of stress, the

effects of stress, and both unhealthy and healthy ways to cope with stress.
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There are Different Types of Adolescent Stress

Acute Stress

Acute stress is usually a cause of undesirable and unexpected life events. Most people

experience acute stress daily, whether it is a good, bad, or neutral situation. For example,

teenagers might experience positive acute stress while playing in a state championship sports

game. Conversely, negative acute stress maybe encountered by a teenager arguing with parents

about poor grade performance. Examples of neutral acute stress may be when a teenager gives a

well-received speech in front of their class. Whether it is good, bad or neutral, the body has

several ways it responds to stress. Dr. Lenz explains that “acute stress most often does not have

lasting effects, but too much can lead to physiological symptoms.” (Lenz, 2018) Examples of

physiological symptoms may take the form of an upset stomach, adrenaline, tension headaches,

increased blood pressure, or accelerated breathing rate. The hyperarousal of the acute stress

response, also known as the fight-or-flight response, is a physiological reaction that occurs when

the body responds to a perceived harmful event, attack or threat on a person’s survival. In

particular when the body experiences acute stress, the heart rate and blood pressure increase,

sending a surge of adrenaline to encourage a person to either fight or flee. A time when a student

might experience this type of stress response is if they are being bullied or are the bully.

“Vaillancourt found that 31% of Grade 4 through 12 students reported being physically bullied

by peers and 12% reported being cyberbullied, whereas 51% and 37% reported being verbally

and socially bullied, respectively” (Vaillancourt, Trinh, et al. 2010, as cited in Hymel &
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Swearer, 2015). While physical and cyberbullying still occurs, students are clever and often

recognize that they are less likely to get caught if they engage in verbal or social harassment. No

matter what specific type of hateful or intimidating behavior, such as bullying tactics still cause

adolescents a significant amount of stress that can lead to depression, self-harm or suicide.

Acute Episodic Stress

Being bullied can cause another type of acute stress, which is acute episodic stress. This

is when a person usually experiences acute stress several times throughout the day. Types of

Stress & Effects on Health - Acute, Episodic & Chronic Stress, illustrates that “[p]people with

this kind of stress will oftentimes take on more responsibilities and projects than they can handle.

They may seem like they're constantly in a rush, always running late, and are disorganized.”

(2018) Individuals who often have episodic acute stress believe how they act and feel is normal.

Many people experiencing acute episodic stress, however, believe their symptoms are just

building on the ones they already have from chronic stress, which makes the tension worse. One

example of acute episodic stress is when a high-schooler already has chronic stress from their

parents getting a divorce, then goes to school, and feels acute episodic stress because they have

several tests throughout the day, which may cause them to experience an anxiety attack.

Chronic Stress

While acute stress is a product of anxiety lasting a short time, chronic stress spans over

weeks, months or years. Chronic stress is “stress resulting from repeated exposure to situations

that lead to the release of stress hormones. This type of stress can cause wear and tear on your

mind and body.” (Cliche, 2017) Middle school and high schoolers may experience chronic stress
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from living in poverty, unhealthy relationships, dysfunctional home life, poor school

environment, loneliness, being a parental figure for their siblings or caring for a chronically ill

family member. Those are just a few examples from a long list of factors that could contribute to

chronic stress. Dr. Lenz explains that chronic stress “develops when an individual feel that they

cannot escape from an unhappy situation.” (Lenz, 2018) When a child does not have the

resources to help them cope with chronic stress in a healthy manner, it becomes a slippery slope

in affecting their long-term health both physically and mentally. Prolonged stress has the

potential “to change a child's brain chemistry, brain anatomy and even gene expression.” (Phang,

2017) This type of stress dramatically impacts and weakens the development of a child’s brain

over time, which in turn may cause issues throughout their entire life in learning, behavior,

including physical and mental health. Many adults as they age start to notice wrinkles and age

spots, when all they want to do is to look younger. Had those people taken care of their skin or

managed their stress more constructively, the physical sign of getting older could have been

slowed down. Genetics, however, does play a role in how our bodies mature.

The Effects of Stress

Damage to Telomers

A large factor in the way a body ages is impacted by telomeres, which are the caps at the

end of each chromosome. The purpose of telomeres is to protect and prevent each chromosome

from fraying or sticking to each other. With each cell division telomers shorten, and their length

also decreases with age. Stress accelerates the shortening of telomeres, which increases the aging

process. In Childhood Maltreatment and Telomere Shortening: Preliminary Support for an

Effect of Early Stress on Cellular Aging, the researchers examined the damage to telomeres
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caused by stress. They used the perceived stress scale, childhood trauma questionnaire,

demographic characteristic, telomere measurement, and the Structured Clinical Interview for

DSM-IV. The authors noted that “both emotional neglect and physical neglect were linked to

shorter telomeres; thus, it is possible that in addition to the psychological effects of stress,

physical stressors such as inadequate nutrition or illness contributed to the findings.”(Tyrka et

al.) Their research found that adolescent stress and neglect impacts the child’s development,

resulting in chronic disorders.

Stress Negatively Impacts Cortisol Levels

Lenz describes cortisol as “a steroid hormone involved in the regulation of blood

pressure, the regulation of insulin release to maintain proper blood glucose levels, and is

important for proper immune system functioning.”(Lenz, 2018) Small doses of increased cortisol

is beneficial for the body because it is a key factor that helps with the “fight or flight” response.

On the other hand, stress may cause an overwhelming amount of cortisol for an extended period

of time that causes significant harm to the body. Such harmful effects may include weight gain,

high blood pressure, poor sleep, undesirable mood, decreased energy, and diabetes.

There are many stressors that adolescents experience that need to be taken into

consideration when trying to maintain a healthy amount of cortisol. One factor that is often

forgotten is race. It is important to understand that stress does not discriminate; however, the

factors that cause chronic stress do discriminate which negatively impacts certain races more

than others, such as the African American community. One of the most harmful side effects of

high cortisol levels is a dramatic rise in blood pressure. Daniel T. Lackland’s research found that

“of US children aged 8–17 years found systolic blood pressures to be 2.9 mmHg and 1.6 mmHg
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higher in black boys and girls compared with age-matched white boys and girls. With the

consistent racial differences at all ages it is evidence disparities in hypertension represent a

lifetime consideration.” (Lackland, 2014) Lackland explained that the outcome of his research

would be applicable to epidemiological studies and clinical trials focusing on the analysis of the

racial disparities causing stress to increase blood pressure levels and hypertension-risks. The lack

of equity between the different socioeconomic statuses creates an environment where people

become vulnerable to harmful chronic stressors. Allen, et al. explained that: “psychosocial

stressors linked to poor health outcomes for black men include: (a) negative, narrow stereotypes

of Black males; (b) interpersonal and structural discrimination; (c) disproportionate poverty,

unemployment, and underemployment; (d) residential segregation in investment-poor,

underserved, and decaying neighborhoods; (e) inadequate health care; (f) negative interactions

with the criminal justice system; and (g) barriers to fulfilling valued masculine roles.” (Allen,

Watkins, Chatters, Geronimus, & Johnson-Lawrence, 2019) Imagine being targeted by

police while simply going for a walk or having people move seats on the bus because your skin

color makes them suspicious or nervous. This constant feeling of being watched, judged,

wrongfully accused, or people being scared, causes the cortisol levels of people in the black

community to be a significantly higher.

Problems of Not Managing Stress with Chronic Illness

The importance of coping is to prevent the development of physical, cognitive, social,

and emotional areas from being negatively impacted by chronic stress. Adolescent Health

Highlight notes that “Compared with adults, adolescents have low rates of chronic conditions.

Nonetheless, adolescence is a pivotal time for focusing on these conditions and their

implications” (Park et al., 2013). Teenagers with chronic illnesses need to make it their top
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priority in managing their conditions during the transitional period between childhood and young

adulthood by minimizing stress. Park et al. also emphasize that “they will increase their chances

of entering adulthood with the ability to participate in typical adult social, educational, and

economic activities to the fullest extent possible.” (Park, J. M., et al., 2013). Children and teens,

especially those with chronic illnesses, need to watch for signs and symptoms of acute stress, so

they know when they need to take extra precautions. Kids should be aware of signs of stress,

because it is not always noticeable until it is too late. Children should be explained that stress

might make them feel like their heart is beating in their throat or that they may become hyper-

aware of everything around them. (Cliche, 2017) Parents can also help by watching for signs of

stress such as “lack of motivation, persistent anxiety, restlessness, chest pain, fatigue, headache,

angry outbursts, misuse of drugs and alcohol, over or under eating, frequent colds or infections,

bedwetting, and feeling overwhelmed.” (Dowshen, 2015) Both parents and children should learn

how to take a healthy approach to coping with stress, especially before it’s too late and their

health is permanently affected.

Healthy vs. Unhealthy Stress Coping Mechanisms

There are several coping mechanisms that young adults tend to utilize of dealing with

stress. Some coping mechanisms are healthy, while others are incredibly unhealthy. Providing

healthy options reduce the chances of teens resorting to harmful coping mechanisms. For

example, teens should avoid: spending too much time in front of screens, refraining from lashing

out at friends, teachers and family; trying not to excessively sleep in on the weekends; using

drugs; drinking alcohol; isolating themselves from others for excessive periods of time; over or

under eating; and ignoring professional help. One of the main stress factors for young adults is

not getting enough sleep due to improper homework and studying habits, such as cramming.
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Associations of time spent on homework or studying with nocturnal sleep behavior and

depression symptoms in adolescents from Singapore found that “adolescents who spent ≥5 hours

on homework/studying per day on weekends had greater symptoms of anhedonia and anxiety.”

(Yeo, Tan, Lo, Chee, & Gooley, 2020) Studying too late at night leads poor quality of sleep.

Yeo, et al. states that “seven-12 years old’s need 10-11 hours and teenagers need around eight to

nine hours of sleep every night.” (Yeo, Tan, Lo, Chee, & Gooley, 2020)

The pressure children experience in order to excel in school makes them feel as though

they do not have time for other activities such as spending time with family or exercising. Adults

should help children recognize when to seek help and identify when they are stressed to take a

step back and find a healthy way to cope. Breathing is a great way to help with anxiety attacks. A

type of breathing technique that Lohmann explains perfectly is to “lie on the floor and put one

hand on your chest and the other on your stomach; now take a breath like you normally would.

Do you feel your chest rise and fall or do you feel your abdomen inflate like a balloon? The goal

is to have your abdomen inflate and deflate. Keep practicing taking deep, slow abdominal

breaths.” (Lohman, 2014) Relaxing and focusing on breathing is a quick fix, but getting outside

just a few minutes a day can improve productivity and mood. Finding time to have a good laugh

during or after a stressful day is great stress relief, by setting off positive endorphins and

boosting the immune system.

It is just as crucial for the adult to cope with the stress in a healthy way as it is for the

child. Adults should try to refrain from taking work and personal frustrations out on children, not

giving them freedom to express themselves, not allowing free time away from schoolwork and

extracurricular activities, and putting high amounts of pressure and expectations on them. Middle

school and high school students need a healthy balance of school, family and friend time, sleep,
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exercise, extra-curricular activities, and time for themselves. The only way children are going to

be able to manage their stress is if they take care of their health.

The Final Stress Relief

Most stress factors pre-teen and teenagers experience will only be present throughout

their adolescent years. As we age stressors change and previous stressors are often forgotten. Our

bodies, however, do not automatically erase of the damage caused by years of high-level stress

after we graduate high school. The best way to cope with stress therefore is taking preventative

measures to create a low-level stress environment. Such preventative measures may include:

healthy eating habits; setting routine times for getting up and going to sleep; getting 8 hours of

sleep each night; and regular exercise. Stress can be monitored with the help of adults and

medical professionals, but looking out for the episodic acute stress that leads into chronic stress

is the crucial step for positive adolescent development.

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References

Allen, J. O., PhD, MPH, Watkins, D. C., PhD, Chatters, L., PhD, Geronimus, A. T., ScD, &

Johnson-Lawrence, V., MS, PhD. (2019, August). Cortisol and Racial Health Disparities

Affecting Black Men in Later Life: Evidence From MIDUS II. Retrieved 2020, from NCBI.

Cliche, M. (2017, November 04). Acute vs. chronic stress. Retrieved September 18, 2020, from

https://humanstress.ca/stress/understand-your-stress/acute-vs-chronic-stress/

Dowshen, S. (Ed.). (2015, February). Childhood Stress (for Parents) - Nemours KidsHealth.

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Hymel, S., & Swearer, S. M. (2015). Four Decades of Research on School Bullying. American

Psychologist, 70(4), 293–299.

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