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By Dennis Miller, BHC Senior Writer

The American Psychological Association (APA) recently released its annual Stress in America Survey, and the results were somewhat sobering. Adult stress levels have risen to alarming levels over the past year, which may be unsurprising in this economic climate. But what was surprising was a previously unrecognized high level of stress among America’s children. And that stress was not limited to what are thought of as typical childhood concerns, such as schoolwork or sibling rivalries. Instead, the survey found that children are increasingly taking on their parents’ concerns about family finances or job security in these difficult economic times.

“I think one thing that’s really important for parents to realize is that kids are very attuned to what their parents are experiencing even if the parents aren’t talking about it,” explains Lynn Bufka, Ph.D., Assistant Executive Director of Practice Research and Policy at the American Psychological Association. “In some ways, that’s actually more dangerous. If the parents are feeling distressed and are not talking to their kids about what’s going on, the kids are going to try to search for explanations, and will come up with explanations of why their parents may be seeming distressed or overwhelmed that may or may not fit with reality. So they may be very concerned about things or magnifying concern even to a greater extent than what the parents are.”

The answer to this problem, says Dr. Bufka, is not to work harder to conceal financial issues and other so-called ‘adult concerns’ from children, but instead to be more open about it. “Don’t tell the kids more than they can handle, but don’t think that telling them nothing is keeping them protected either, because they’re picking up on something going on,” she advises. “It can be really important to tell children age-appropriate information. You don’t want to tell them the whole saga of what’s going on, but you want to let them know what’s reality, and also what Mom or Dad are doing in order to provide for their children and to safeguard them from larger concerns. So if a parent has lost a job and is very stressed about that and what’s going to happen with the family, it’s very reasonable to let the children know that. And to continue to provide some sort of structure and order for kids so they aren’t imagining things to be even worse than they actually are.”

While the finding that children experience stress vicariously from parents was somewhat surprising, school still topped the list as the highest source of stress for young people. Because this is the first year the APA has included children in their annual survey, there’s no baseline to tell whether it’s on the rise or not. But Dr. Bufka does see some trends that suggest to her it may be. “We may want to be looking at how much we are piling onto kids. We may also want to look at what are realistic expectations for kids in schools. It may be that the workload is not necessarily excessive (although in some jurisdictions or school systems, it may be). It may also be the meaning and pressure that kids experience around school.

“I’ve talked with parents who have children in elementary school who are very concerned about getting their elementary-age child into the right magnet program at an elementary level, so that they can get the right grades and learn the right material, so that they’ll be better prepared for middle school so that they can get into the best middle school, so that by the time they are in high school they’re going to be exposed to all sorts of information and have advanced courses and get the right grades so they can get to the right college. It’s very distressing to me to think that there are third graders who are worried about getting into the right college! If parents are giving that message along the way of how important everything that you do in school is going to contribute to college, there’s not a lot of space in there for a kid to be a kid.”

For Dr. Bufka, there’s also a far more serious implication than just letting kids have a happy childhood — or, for that matter, for adults to enjoy more comfortable adulthoods. “Most of us feel stressed at some point in our lives but really when you get to the point of feeling overwhelmed and you don’t have the resources to meet the demands in your life, that’s a level of stress that is particularly concerning, because that may lead to some longer term health issues, both physical health or mental health.”

To learn more about the APA’s 2009 Annual Stress in America Survey and read the report, visit the APA website. To hear our entire conversation with Dr. Bufka, click on the audio icon above. Or, keep reading for a complete, edited transcript.

BHC: Give us an overview of some of the key findings from this year’s Stress in America Survey.

LB: Well, what we’ve been trying to do over the past couple of years is to get information from the public in the U.S. about their experience of stress. Not only what causes them stress — sources of stress — but also what they’ve experienced as their subjective experience of stress. We’re particularly interested in trying to understand that experience of feeling really overwhelmed by demand. Most of us feel stressed at some point in our lives but really when you get to the point of feeling overwhelmed and you don’t have the resources to meet the demands in your life, that’s a level of stress that is particularly concerning, because that may lead to some longer term health issues, both physical health or mental health.

So that’s the intention of this survey — to get a handle on what’s going on. But we’re also looking at much more specific things relating to experiences of stress and what causes stress. So, one of the things that was a little different with this survey, in addition to tracking trends as it relates to adults’ experiences of stress, was that we worked with Harris Interactive to survey children between the ages of 8 and 18 about what they experience in terms of worry or stress. And one of the things that we found with that piece of it was that the kids, both the tweens and teens, report experiencing more worry than what the parents reported for children.

So parents may not necessarily be picking up on the kinds of stress that their kids have or the extent to what their kids may be experiencing stress. And that’s not inconsistent with a lot of what we know just in terms of psychology generally. But it was very marked in the survey results that parents seemed to be really underestimating what their kids might be experiencing, and also not recognizing what the kids were reporting as sources of stress.

The kids might be reporting feeling stresses about finances or pressures related to school. Parents weren’t really recognizing that the kids were also feeling some worries related to finances. Parents often recognize the school-related worries and stress, but they were more likely to see stress related to, say, sibling relationships or things like that, which the kids were really saying was not an issue.

BHC: So that was a pretty significant difference. Was this the first year that you actually studied stress in that age range?

LB: Yes. This was the first year that we surveyed the kids to find out what they reported in terms of their worries and what they were experiencing in terms of stress.

BHC: Any other notable findings in terms of stress in general in American society?

LB: In general, certainly significant portions of Americans are reporting high levels of stress. Many who say their stress has increased over the past year, but there are also others who are reporting stability in terms of levels of stress, or even not reporting as much as had been reported in previous years.

But one of the reasons we feel that’s so important to highlight is that there’s been a lot of research linking stress as contributing to chronic illness or other kinds of health difficulties, with the realization that if people can address what causes them stress and their reactions to events that they experience as stressful, and that experience of feeling overwhelmed, if individuals can deal with those kinds of stressors differently and ideally more effectively, that may help them in their overall health as well. So that’s one of the things that we’re very attuned to.

The people in the survey often reported that they have difficulties making the kinds of lifestyle or behavior changes that might help them improve their health. We know there are things that we can do in terms of changing our behavior that helps us to manage stress differently so that it has less of a deleterious impact on our health.

BHC: Can you could identify what some of the key stressors were? I mean, surely the economy is one of them — what else is? What are some of the primary causes of stress?

LB: Certainly people reported a lot of concern about the economy and money. That has been an ongoing concern for many of the respondents in the survey. And that makes absolute sense given the level of unemployment that the nation is facing and the concerns about what’s going to happen financially to families who maybe are working but are feeling that they don’t have the resources that they perhaps once had.

That tends to come out as a pretty clear area of stress for many respondents. Individuals often will report other areas of stress as well, perhaps related to family relationships or ongoing health concerns that individuals may have. For children, it can be sensing the kinds of things that their parents are stressed about. Children can often be stressed about [the same things]. And for children and teens, school is a definite source of stress for them.

BHC: What can parents do to make sure they don’t unnecessarily pass along their stress levels to their children?

LB: I think one thing that’s really important for parents to realize is that kids are very attuned to what their parents are experiencing even if the parents aren’t talking about it. In some ways, that’s actually more dangerous. If the parents are feeling distressed and are not talking to their kids about what’s going on, the kids are going to try to search for explanations and will come up with explanations of why their parents may be seeming distressed or overwhelmed that may or may not fit with reality. So they may be very concerned about things or magnifying concern even to a greater extent than what the parents are.

So it can be really important to tell children age-appropriate information. You don’t want to tell them the whole saga of what’s going on, but you want to let them know what’s reality, and also what Mom or Dad are doing in order to provide for their children and to safeguard them from larger concerns. So if a parent has lost a job and the parent’s very stressed about that, and what’s going to happen with the family, it’s very reasonable to let the children know that. “This is a hard time for me. I’m really working hard here to find a job. So here’s the kind of things that I’m going to do to ensure that as a family we’re still going to have dinner. And here’s what our backup plan is.” And to continue to provide some sort of structure and order for kids so they aren’t imagining things to be even worse than they actually are.

So that’s one thing that’s very important — to give age-appropriate information about what’s really going on. Don’t tell the kids more than they can handle, but don’t think that telling them nothing is keeping them protected either, because they’re picking up on something going on.

But the other piece of it is just being available to listen to what children are going to be experiencing and what the kids want to talk about. And allowing time for children to bring up their concerns with their parents and allowing time for there to be some space — that it’s not rush, rush, rush from one event to another. And that parents are showing interest in what the kids are talking about and what the kids are interested in doing and letting the children know that they are available to them to just listen to what’s going on and to be really fully present for them. That has a significant benefit for the parenting relationship — for the kids, and for how the relationship is.

So it’s sort of two things there. Let your kids have appropriate information about what’s going on, but also be really available to listen to them and hear what’s going on with them, so that they understand that you’re available to them.

BHC: I understand that family money concerns were a key stressor for kids, but also that the primary stressor for most was school. Are we needing to take a second look at how much we are piling on to kids in schools?

LB: We may want to be looking at how much we are piling onto kids. We may also want to look at what are realistic expectations for kids in schools. It may be that the workload is not necessarily excessive — although in some jurisdictions or school systems it may be. It may also be sort of the meaning and the pressure that kids experience around school.

I’ve talked with parents who have children in elementary school who are very concerned about getting their elementary-age child into the right magnet program at an elementary level, so that they can get the right grades and learn the right material, so that they’ll be better prepared for middle school so that they can get into the best middle school, so that by the time they are in high school they’re going to be exposed to all sorts of information and have advanced courses and get the right grades so they can get to the right college. It’s very distressing to me to think that there are third graders who are worried about getting into the right college!

But if parents are giving that message along the way of how important everything that you do in school is going to contribute to college, there’s not a lot of space in there for a kid to be a kid. They’re worrying about their future at an awfully early age. And I see that certainly in the greater Washington, D.C.-area. I see that among parents here.

So it may be managing the expectations for what’s appropriate. Not that you don’t want your kid to do well and, say, work hard and to do their best, but to have the child believing that what they’re doing right now is going to have an impact on their future fifteen years down the road, in a way that’s never changeable, [that] puts a huge amount of pressure on a child.

BHC: For mental health clinicians, what are some of the key takeaways from this year’s Stress In America Survey?

LB: I think it reinforces the kinds of things that mental health clinicians, psychologists and social workers and other providers are doing already, and that is, working to help families talk with each other and have effective communication about what’s going on — developmentally-appropriate communication. And I think on an individual level, psychologists have been very tuned in to trying to support patients in managing their lives in ways that are much healthier than what they might be doing currently. So I think that’s a key aspect of receiving any sort of mental health care.

For individuals who have clear symptoms and distress that’s related to, say, depression and things like that, knowing how to manage your mental health is really important. But for individuals who are generally just stressed, knowing how to manage the various demands in life can often be a major focus of care. And sometimes it’s almost a preventative kind of thing. You want individuals to know how to say no, and how to protect their time so that they have time for their own relaxing and recovery, so that they can go out and deal with the rest of the world.

The survey reinforces what many of us who provide behavioral healthcare — many psychologists and other clinicians — what we know about trying how to help people be healthy, but we’re not so sure that the larger society around us recognizes how intimately our mind and our body are, and how important it is to manage the stressful demands that we have that have an impact on us psychologically as well as physically in order to have the best health that we can have overall.

BHC: Dr. Bufka, I’ve spoken to specialists in mental health epidemiology and one in particular was very clear on this point. He indicated that the most significant modifiable health risk is stress. And his explanation is, well, people might focus on smoking or not exercising or other bad health habits. His point was that so many of those behaviors are actually driven by stress. What’s your reaction to that? would you agree with that?

LB: I think that’s a very plausible description of what goes on. People develop actually unhealthy habits as a way to manage stress, without actually managing the kinds of things that are causing them the distress in the first place. We often forget how much control we might have over our situation. We may not be able to change our boss, but we can change how we react to our boss. We can learn to set limits around the demands that we’re given at work if it feels excessive or we’re not able to manage those things.

If things are not happening the way we would like them to happen at home, we have some control over that, of trying to change the situation at home. And to think about what can we do to make this situation one that’s not overwhelming me — that I have the resources to meet that. Sometimes it requires being really creative and connecting with friends and neighbors in order to find solutions to problems that maybe people in a neighborhood are dealing with. Or being willing to do things like carpool more regularly so that one parent’s not always driving kids everywhere. Or to see if there’s flexibility in work schedules, to see if there’s a work-from-home option which eases the commute, to see if that’s a possibility. Sometimes we’re reluctant to look for the kinds of things we can change that might make it easier for us to manage the demands of our lives. And we definitely can do, make those kinds of changes.

We also can look very clearly at how do we react to things. Sometimes we have a tendency to look at bad news and think of it as being, “This is how the rest of my world is going to be, the rest of my life.” We tend to catastrophize things. We can be really good at finding the negative in events or experiences. And if we’re continually finding catastrophe and finding the negative or predicting bad outcomes, that’s going to have a huge impact on how we approach the world. That’s going to definitely bring us down, make us more negative about things, have an impact on our mood, make our mood less positive, and make us much more negative. And that’s going to have an impact then on how we’re able to cope with things. If our mood’s not as good, if we’re feeling overwhelmed mentally and emotionally, we’re not going to be able to cope with demands on us. So certainly how we think about the things in our life — even if we can’t necessarily make them occur differently or change them in some way — how we’re thinking about it can change our reaction to them, and make us better able to cope.

And then we can look very behaviorally at the kinds of things we’re finding that do help us reduce stress. Many people talk about smoking as something that helps them reduce stress and makes them feel more relaxed. But smoking has long-term negative health impact. So then it becomes important to figure out, “Okay, what’s a behavior that’s going to help me feel relaxed right now that’s not going to have a negative impact on my health, but is actually going to have a positive impact? Can I learn yoga or meditation?” — things that have a positive impact on health.

And learn to do those things instead of reaching for cigarettes or reaching for a bag of candy or lying on the couch and clicking the remote control. Do things like get up and go for a walk, change my perspective, get engaged in a hobby or activity that may be very stress-reducing and has a more beneficial health outcome as well.

BHC: Anything we haven’t discussed here about the report that you think is also important to mention?

LB: I think that it’s important to recognize that experiencing life means that stress will be part of it. Stress is inevitable. Many of us have the internal resources or the external resources to manage the stress and demands in our lives, but if it gets to the point where an individual or a child — if you’re responsible for children — if it’s getting to the point where they aren’t able to manage, they feel overwhelmed by the demands and really stressed out, or their behavior is somehow changing where they’re not as productive and employed, or they’re not able to manage their role as a Mom or as a sibling or as a student, that may be a sign that it’s important to find a licensed mental health professional such as a psychologist and get some additional support for managing stress.

BHC: Dr. Bufka, where can people go to get a look at the report and get some more information on about it?

LB: Sure. We’ve got a couple of different links to information related to stress. We have the APA Help Center at www.apahelpcenter.org. We also have a blog on mind, body, health where a lot of our reporting on the Stress in America Survey happens, and that’s at www.yourmindyourbody.org. And actually you can follow the APA Help Center on Twitter for people who are into that technology and that will provide some updates on what we’re learning and trying to connect it to the literature and provide helpful information.

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