Eight-year-olds with anxiety disorders? Eleven-year-olds suffering panic attacks? Children are burdened with more stresses than ever before, writes Claire Keeton
John gets bullied 24 hours a day. Kids he knows call him names on Facebook and make prank calls, pretending to sell him condoms in the middle of the night. The 13-year-old has been taunted and sent hate messages through cyberspace for more than two years. At school he gets punched and shunned.
"I was always the short one and was teased about my height. In Grade 5 I was branded an outcast and now they just like to terrorise me," says John, who goes to a private co-ed school. "People say they are jealous of what I've accomplished, but I think they just get a kick out of it."
Cyberbullying and staying connected 24/7 is one element in a range of stresses confronting suburban school pupils in 2010 - and triggering anxiety disorders, depression and suicide attempts.
One out of every 10 teen deaths in South Africa is from suicide. But it is also affecting much younger kids. Children as young as four are aggressive, eight-year-olds have anxiety disorders and 11-year-olds have panic attacks, according to South African psychologists, doctors and teachers.
"I'm seeing younger and younger kids," says Dr Brendan Belsham, a Johannesburg psychiatrist.
South Africa is seen as a "post-traumatic stress" society and children are just as vulnerable to this as adults.
Johannesburg family doctor Dr Lorraine Becker says: "Kids suffer as much stress as adults, if not more."
Stressed children are common in South Africa today, with an estimated 6-8% coping with learning difficulties and a higher proportion with anxiety disorders and depression.
"Often it is stress not ADHD (Attention Deficit Hyperactivity Disorder) that makes it hard for children to concentrate. Many conditions may be masquerading as ADHD," says Belsham.
Withdrawal and aggression, refusing to go to school, defiance, crying, disturbed sleep, and stomach aches or headaches are among the symptoms of stress in children. School results may deteriorate although anxious children can do well. Today's kids are forced to grow up faster.
CYBERBULLYING
BlackBerrys, Mixit, Facebook and Twitter dominate the lives of many middle-class teenagers and they frequently bare their hearts and souls through this technology without being aware of the fallout.
Wits University psychiatrist Professor Christopher Szabo says: "The increased access to all forms of electronic media and information increases the vulnerability of children. This is a significant change."
Using the electronic media "to tease, humiliate, harass, embarrass and threaten people" is cyberbullying, says UCT psychologist Liane Lurie.
It has made John's life a misery even though he is smart enough to block the cell numbers of known offenders and has the skills to control his Facebook page.
But younger children do not always know how to use this technology, which can make them targets.
Becker observed that social networking sites can erode children's privacy and expose them - for instance, a photo taken of a drunk girl at a party.
Another problem with this technology is more practical: sensory overload and sleep disruption with texting or making calls when they should be asleep.
Children who are the targets of cyberbullying are at greater risk of depression than traditional bully victims, warns a new US study.
"Cyberbullying, or electronic aggression, involves aggressive behaviours communicated over a computer or cellphone. Notably, cyber victims reported higher depression than cyber bullies or bully victims," the authors reported in the Journal of Adolescent Health.
As evidenced by some schools in SA, school bullying is common. A previous US study found that 20.8% of American adolescents in school had been bullied physically at least once in the past two months, 53.6% had been bullied verbally, 51.4% bullied socially (excluded or ostracised), and 13.6% have been bullied electronically.
THE IMAGE GENERATION
The opportunity to stay connected all the time encourages the need for the latest gadgets and highlights the culture of image among adolescents.
"If you do not have a BlackBerry or the latest Nikes you do not fit in," says John.
Judging people by what they own cuts across class and location.
Clinical psychologist Rafiq Lockhat, who works with children from the Cape Flats, says he asked an 11-year-old boy what he hoped for in a new stepfather after his mother started dating again.
"First he wanted to see his cellphone, then his car and the shoes he was wearing," he says. "We have developed a want-it-now generation ... that want to live out the bling fantasy they see on music DVDs."
Among Model C school students, image - wearing the latest brand, being thin, having the right accent - and peer pressure still hold sway, and tolerance for difference is low, he says.
"A uniquely South African problem is that of acculturisation among children moving from township schools to former Model C schools. They are not completely accepted at the new school and must deal with abuse when they go home on weekends," he says, adding that they get rejected by peers in both areas.
Johannesburg psychiatrist Dr David Benn confirms these children are often marginalised and can have "difficulty fitting in", given the jump in educational demands and switch in languages.
NO TIME TO PLAY
Well-off schoolchildren frequently have demanding extramurals like Kumon maths, ballet and piano up to eight times a week - and limited time left to chill.
Benn says some young children have no time for unstructured play and this will lead to developmental problems later on.
"Children's play is not purposeless," he says, encouraging parents not to overschedule them and overburden them with unrealistic expectations which they internalise. The SA Depression and Anxiety Group (SADAG) gets calls from young children worried about school performance.
TRAUMA FALLOUT
Becker also sees children who refuse to go to school because they are being bullied or feel panicked.
"If a parent is hijacked, the kids experience secondary trauma," says Becker. "They hear the story about how awful the hijack was get repeated again and again. Or when parents talk about emigrating, the kids may worry about losing their friends. Adults forget that children are sponges, they hear everything."
SADAG operations manager Cassey Chambers says: "We saw a five-year-old after his family was hijacked who cannot be left on his own now. He is insecure if they drive somewhere and he is still in that moment.
"So many South Africans from an early age are consistently exposed to trauma and stories about trauma that they have complex post-traumatic stress disorders that you would find, for example, among soldiers who had been in war."
Some four million South African children are affected by PTSD, says Dr Eugene Allers, ex-president of the SA Society of Psychiatrists. The role parents can play in mitigating trauma has also shifted. For example, girls of 16 can request an abortion without parental consent.
ACCUMULATED STRESS
The stresses on pupils come on top of the age-old pressures like those to achieve academically and on the sports field, and peer pressure to experiment with alcohol, drugs and sex.
But the exam stress for students in matric this year is enormous, after they missed weeks of schooling with the World Cup and the national strike.
And sporting competition at school is so intense that some pupils are waking up at 5am to train and taking illegal drugs to boost their performance.
Alcohol and drug abuse is a long-standing problem among adolescents and modern technology makes access easier.
Living with parents who depend on alcohol or drugs is extremely stressful for children who suffer from the unpredictable behaviour of addicted parents.
Belsham says he treated an eight-year-old girl who refused to go to school and had selective mutism because her father was an alcoholic. "She did not want to leave him alone and was anxious," he says.
In many township schools, pupils have to deal with extreme stresses like gangs threatening them, widespread rape and poverty, which means many young people are unsafe and hungry at school.
Chambers says: "When children call our helpline it is often not just one reason that makes them depressed or stressed. It's a combination of problems and sometimes they all come together in a moment, which puts them at risk."
WHAT ADULTS CAN DO
First of all, communicate openly with your children. Be consistent, have appropriate boundaries and routines, and model the behaviour you wish to see.
Talk to your children before problems arise and listen to them. Acknowledging what they say does not mean you agree, but they need to be heard.
You need to find out the underlying cause of any stress and not make assumptions. Do not trivialise their problems and fears. Demand a zero tolerance policy to bullying from schools and be aware of any changes in your child.
Parents need to be aware of what they say in front of their children and not fight in front of them.
- For more information contact the SA Depression and Anxiety Group on 0800 567 567 or sms 31393