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While headaches, stomach aches, insomnia and rebellious behavior are often viewed as typical of childhood and the adolescent years, they're also the symptoms of stress. That's why unhealthy levels of stress often go undiagnosed by parents and schools, according to findings of a recent American Psychological Association study.

"Kids are feeling stressed, but parents aren't noticing," says Frank Iannetta, M.D., FAAFP, a family physician with Changebridge Medical Associates in Montville, N.J., who regularly treats young patients experiencing stress.

"Most of the time parents will bring in their children for a physical symptom that is being caused by stress. After you rule out the physical causes, you have to lead them down the path to stress."

Stress is defined as the way "our body responds to the demands made upon us by the environment, our relationships, and our perceptions and interpretations of those demands."

Stress can affect people of any age, from infancy, where it manifests itself as "failure to thrive," through childhood and adolescence and into the adult years. Serious stress can lead to anxiety, depression and even suicide.

What's Really Causing the Stress?

Dr. Iannetta sees young patients come into his office "several times a week" with symptoms of stress. He cites a wide range of causes - over scheduling, pressures to do well in school or in sports, family finances in a bad economy, bullying, and divorce.

"Today there are kids living with only one parent, or changing between homes in a divorce situation," he says. "That's already a stressful environment. Then you add pressure to do well in school or to make first string of a sports team. It's hard to be good at everything, and kids are not emotionally mature enough to say, ‘It's too much; I can't do this.'"

Parents May Miss Recognizing Stress in Their Own Children

While children across America report experiencing more stress than they did a year ago, the American Psychological Association study revealed that parents do not always recognize the signs of stress in their children. The study, which surveyed 1,206 children ranging in age from 8 to 17, found the following:

• Nearly half are worried about school, while only a third of their parents thought their children saw school as a problem.
• Thirty percent are worried about family finances — just 18 percent of parents think that's on their kids' list of stressors.
• Twenty-nine percent of teens report worrying about what comes after high school - getting into a good college or finding work — but only 5 percent of the parents of teenagers think that this is causing stress for their children.
• Tweens (30 percent) and teens (42 percent) say they get headaches vs. 13 percent of parents recognizing that they do.
• Tweens (39 percent) and teens (49 percent) cite difficulty sleeping vs. 13 percent of parents recognizing that they do.
• Tweens (27 percent) and teens (39 percent) report eating too much or too little vs. 8 percent of parents recognizing that they do.

What Are the Symptoms of Stress?

Dr. Iannetta sees stressed-out children and teenagers in his medical office "at least a few times a week." He helps parents recognize the signs of stress in their children.

"When adults get stressed out, they tend to be more verbal than children or adolescents," he explains. "They may cry. They may turn to alcohol or drugs. Teens would do that too, but it's less readily available to them. So they tend to act out more. They may get a piercing or a tattoo if it's something that would anger their parents. They may become rebellious. Younger children might become clingy or develop a fear of going to school for example. Sometimes if there is a change in personality, such as an outgoing child becoming withdrawn, that can indicate stress."

According to the National Association of School Psychologists, symptoms of stress in children and adolescents include the following:

• Irritability or unusual emotionality or volatility.
• Sleep difficulty or nightmares.
• Inability to concentrate.
• Drop in grades or other functioning.
• Toileting or eating concerns.
• Headaches or stomachaches.
• Unexplained fear, increased anxiety or clinging behavior.
• Regression to earlier developmental levels.
• Isolation from family activities or peer relationships.
• Drug or alcohol experimentation.

"Any underlying illness will be worsened by stress," says Dr. Iannetta. "If a child is prone to migraine headaches or high blood pressure, those will increase. Stress can worsen gastric ulcers. If you have a child undergoing cancer treatment, stress can affect that as well. Stress is a serious problem with real effects."

What Can You Do About Stress?

The first line of defense against stress is recognizing that it's there, according to Dr. Iannetta. "There is no medicine for stress," he notes. "We might refer patients to family counseling or individual counseling to help identify the underlying causes of the stress. We would only medicate if it's gotten to the point where there's a problem with depression, anxiety and potential suicide."

"One of the most important things is to talk to your kids," says Dr. Iannetta, "and find out what's going on. Tell them they're not alone. A lot of kids feel like they're the only one who feels this way. But everyone, sooner or later, feels stress. The smart response is to get the help you need, so you can get through it."

— ANDY LAGOMARSINO, NEWJERSEYNEWSROOM.COM