MONTREAL -- With still weeks to go before school bells start ringing across Quebec, a Montreal child psychologist is already seeing increased levels of tension and distress among some returning students.

It's something she attributes to chronic pandemic fatigue.

“Yes, some of our patients are much more anxious about going back to school, particularly now in the context of this possible fourth wave, with the Delta variant,” said Catherine Serra Poirier, who works with young children and adolescents at the Montreal Children’s Hospital.

Children who aren’t old enough to get the vaccine are anxious, she said, because “they have a fear of contaminating the people they love.”

Those types of daunting concerns are hard enough for young people to handle. When they’re combined with the uncertainty that’s affected their daily lives for so long now, it’s understandable their defenses are low, the psychologist explained.

“Certain kids are coming back to school already very tired, very stressed, very depressed, '' Serra Poirier said.

Of particular concern are children with mental health problems, like eating disorders, a condition that has been more prevalent over the last 18 months.

“These kids are very fragile. So this transition now is for sure going to increase the stress,” she said.

Her message to parents is to try and see the world through their child’s eyes - to empathize.

“Sometimes as adults, we have solutions for simple problems and we want to provide that for kids. But sometimes little things can be very hard for children.

“An eight-year-old who doesn’t make the sports team - that can feel like grief to them. Try not to dismiss those emotions, sit with them and validate them,” Serra Poirier said.

The psychologist provided tips on how to help children cope with back-to-school stress, and any stress that develops in the future.

FOUR SIGNS A CHILD IS STRESSED

1 - Change in mood

A talkative child or teen might become withdrawn and quiet; a calm child or teen might be irritable, cry with little provocation or overreact emotionally to a situation.

2 - Feel sick

A child or teen might experience physical ailments like headaches, upset stomach, or general discomfort or uneasiness. They aren’t lying. The symptoms are real, but the child or teen might not realize they are due to stress.

3 - Change in behaviour

The child might suddenly have a hard time falling asleep or might wake up in the middle of the night. They might start having nightmares or restart wetting the bed. Changes in appetite are another clue a child is stressed. They might suddenly start eating a lot less or a lot more – mainly comfort food such as sweets. Also, they could stop playing or doing their favourite activity. They might sit in front of a toy or colouring book but not engage.

4 - Avoidance behaviour

When stressed, a child or teen might try to avoid the people, places or things causing their stress. They might not want to go to school or a particular class. They could avoid going to the store or local pool, or passing by the mean-looking dog next door.

FOUR TIPS TO HELP THEM COPE

1 - Get them talking

It can be difficult for a child to express their feelings. Show interest in their lives and ask some questions to help them pinpoint the cause of their stress, for example: Are you sad your team didn’t make the playoffs? Are you nervous about the start of school? Let them talk about their emotions, and then validate their experience. Explain that stress is something everyone lives from time to time and that eventually, it will pass.

2 - Avoid avoidance

Help the child problem-solve so they can find healthy ways to cope with their stress. For example, it can be hard to go back to everyday activities after many months in lockdown. Proceed gradually. Suggest the child start with shorter outings with a limited number of friends, for example, close to home or in a park.

3 - Maintain a household routine

Children and teens respond well to a structured life. It gives them a sense of control and predictability, which is reassuring. Before going back to school, it is important to re-implement the family’s routine as much as possible. Get up at the same time, eat at the same time, encourage a regular bedtime routine including going to sleep earlier.

4 - Be a role model for stress management

Remember, what parents do is just as important as what they say. They should talk about their feelings when they are stressed, angry, or sad, and encourage children to do the same. Demonstrate how to manage stress and other emotions like frustration or sadness.

If the child’s stress seems out of control and is starting to affect their health and well-being, Serra Poirier said, the family should seek out a family doctor who may refer them to a psychologist if the symptoms warrant.