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The family, friends and teachers of Tina Dziki, a bright 15-year-old south

London student, were grief-stricken after she died as a result of taking an

overdose. She left a suicide note that described a number of troubles

including anxiety about two GCSE exams she was due to take a year early.

There are few people who can sail through exams without so much as a raised pulse rate. But most do struggle through, somehow surviving the high levels of stress associated with this period more or less intact. Tragically, others, like Tina, don't make it.

In the last few years there have been a number of teenage suicide cases where exam pressure played a part. Amy Burgess, from West Mersea, Essex, jumped from the top of a multi-storey car park the day she was due to take her GCSEs. An open verdict was recorded into her death. Sixth-former David Tebby from south Wales, also killed himself by jumping from a multi-storey car park because of anxiety about A levels. Tim Russell, 16, from Cannock, Staffordshire, killed himself with his father's shotgun because he believed he had failed his physics paper. Shaun Begley, 16, from Southampton, hanged himself from a tree because he believed he would not pass his maths GCSE.

Professionals who work with children and aim to diffuse excessive exam stress, say the situation is getting worse. 

According to Peter Smith, hospital director at the Priory in Roehampton, south London, youngsters increasingly struggle to cope with the pressures of GCSE and A levels. He says exam stress manifests itself in a range of mental health problems from anxiety to eating disorders and self harm.

Sonya Goldsmith empathises with everyone who is preparing to sit exams and suffering from acute anxiety. "For my GCSEs I learned everything by rote. I had no sense of how to organise my revision time. I locked myself in my room for whole days and wouldn't come out, even though I wasn't retaining much. Instead of doing something sensible like taking a break and getting some fresh air, the more nothing went into my head the more determined I was to sit there and try and cram facts in. It was very self-defeating - a way to punish myself for not absorbing enough information - and my levels of anxiety just kept on building up until I felt I could scream."

The day before her Latin GCSE, the feeling of wanting to scream finally became irresistible. "I sat there revising and decided that I didn't know a single thing. I started to say over and over again: "I know nothing." My sense of hysteria grew and I leaned out of my bedroom window and just screamed and screamed and screamed. Somehow I managed to do the exam the next day and I got an A."

Sonya, now 19 and studying for a psychology degree, says that there was no pressure on her at home to achieve spectacular grades. In fact, her mother, Millie, kept trying to get her to spend fewer hours holed up in her bedroom revising and more time taking breaks. "The pressure came from me," she says. "I felt that if I didn't get reasonable grades I would be letting myself down. I went to an independent school and there was quite a lot of pressure there to achieve."

ChildLine, the children's charity, says that it has just recorded the highest ever number of calls since it was established. Between April 2003 and March 2004, more than 900 children spoke to ChildLine counsellors about exam stress - a rise of more than 50% on the previous year when 600 calls were received. The majority of callers were aged between 12 and 15 and five times as many girls as boys called. Young people talked about feeling panic-stricken, overburdened and overwhelmed. Often they felt that their whole future depended on their exam results and that the pressure to succeed could be unbearable.

Adrian Brown, of ChildLine, says that if children have other areas of stress in their lives such as abuse or the breakdown of their parents' relationships, worrying about exams can be the last straw. "We know that the 900 calls we received only represent the tip of the iceberg," he says.

Maureen Pearson, of Parentline Plus, believes that high-achieving, perfectionist children are most likely to crack under exam pressure but that there are plenty of things parents can do to alleviate pressure in the run up to exams.

"This is a very busy time for us. We get a lot of calls from parents who are trying to find the balance between wanting their child to do well and not putting too much pressure on them." She says that emphasising to children that doing their best is all that matters is very important. If they seem overwhelmed by the sheer volume of information they need to commit to memory, helping them break it down into bite-sized pieces in a revision plan can help. Pampering is another vital component of revision. Simple things like running your child a warm bath and allowing their choice of TV programme to take precedence over competing requests from other family members can also be helpful.

"Teens have a rotten time," says Pearson. "Their hormones are all over the place and they do get moody and stroppy. Don't be too tough on them if they do leave their room looking like a pigsty. Acknowledge that exams can be a scary time. It is important to let them know that you get a second chance at most things in life, and that includes exams. Tell your children that, ultimately, whatever result they get, you will still love them."

Child Psychiatrist in London

Linda Blair, a clinical psychologist at Bath University, also believes that exam stress is on the increase. She says that children feel pressure from teachers who are themselves under more pressure to achieve impressive results because of the introduction of league tables. The sheer number of exams that children are expected to sit also exacerbates exam stress - this generation is described as the most tested in history.

"The breadth of knowledge children are expected to have is a good thing but the breadth of testing is not." says Blair. "Parents themselves feel pressure from changing patterns of employment - jobs are no longer as secure as they used to be and pensions have gone Awol. These feelings can be transmitted to children and we can underestimate the effect of our behaviour on our kids. It's not just a question of what we say to them.

"If we're emoting all the time about how badly we need a promotion, what kind of a message is that giving? It is important to emphasise to children that it is effort, and not results, that counts. And that is a message that can be reinforced all year round to build up their self-esteem."

For Millie Goldsmith, no amount of boosting her daughter Sonya's self-esteem and urging her to take breaks seemed to work. "I remember when I was sitting exams at her age that I came top of my school in music and biology in the mocks. When it came to the real thing I was paralysed by fear and failed both. Sometimes these anxieties are inherited and there's not much you can do to change them."

How to help your children survive exam nerves:

· Emphasise that it is never too late to revise

· Offer treats to help them get through

· Encourage them to talk about how they are feeling

· Let them know that however they do you are still there for them and still love them

· Talk to them about life after exams - plans for later in the summer etc

· Encourage them to contact teachers during study leave if they get stuck

· Give them good, healthy food to eat and keep their sugar intake low

· Encourage them not to revise in front of the television as this teaches them to have a short concentration span

· A reasonably regular but not a rigid schedule helps

· Tell them that if they study for more than four to six hours a day the brain cuts out and remembers nothing

· Help them to keep exams in perspective - they are not the most important thing in life

· ChildLine's leaflet for children, Exam Stress and How To Beat It is available to download at 

· If you are concerned about your child being depressed, having suicidal thoughts, presenting with self-harming behavior or                 

  with extreme levels of anxiety you must consult a specialist Child and Adolescent Psychiatrist.

Testing Times
What parents can do to ease children's exam anxiety

Extract from "The Guardian" 2 June 2004
​By Diane Taylor

Dr. Viviana Porcari, Consultant Child and Adolescent Psychiatrist