Exam Stress and PTSD

stress exam emdr cork

Helping students to cope with study and exam preparation

As we enter into the season for examinations at secondary school and at collage level it is important for parents and carers to understand the complexity of exam stress and the impact it can have on preparation and performance for students and further how it affects their families.

Students have been working hard for a long period of their lives and the leaving certificate or collage examinations can seem to be the defining of all of that hard work. It is inevitable that stress and anxiety will be at a heightened point the closer the student gets to final examinations. Care needs to be taken to ensure that students have all the supports necessary to assist them through this important period of their transition to collage or transition to careers.

Sometimes past events (traumas) can be remembered during this time of heightened stress as the body “holds the score” or the shape of what the trauma felt like back when it occurred. Sometimes past traumas are not adaptively processed and remain like a misfiled memory that consequently re-emerges when the body is under stress. In such cases it may be supportive for the student to seek support to clear this and to “put the past in the past”, as Francine Shapiro describes in her book on EMDR.

One important factor that sometimes goes unnoticed at this time is the impact that past traumas or PTSD has on the psychological wellbeing of anxious students.

What is PTSD?

Currently, for a diagnosis of PTSD, the student needs to have experienced a traumatic event where they perceive a threat to either themselves or to others and this distress invokes horror, helplessness and a sense of hyperarousal (Kataoka et al. 2012). Traumatic events can range from childhood trauma, physical or sexual assault, effects from a medical procedure or sickness or other single incident or repetitive traumas such as bullying in class or amongst peers, an assault or robbery, a major car accident etc. Some features of Post-Traumatic Stress Disorder (PTSD) are: re-experiencing of the event, hyper-arousal (leading to angry outbursts, difficulty with sleep patterns, and irritable patterns of behaviour.
With younger children this can be seen in their repetitively re-living the trauma in their play or no longer engaging in previously enjoyable activity)

Sensitivity to sounds or lights along with hyper-vigilance, loss of concentration ability and flashbacks where previous experiences are relived are indicative of PTSD and can re-emerge during stressful periods of our lives. The first step is to realise the presence of the above symptoms and to seek supports Many students may describe days when they feel the difficulty of concentrating on study for exams and they are “zoned out” or dissociative with difficulty in staying focused and connected.

School or College student services are there to support students where emotional distress is affecting their preparations and on many occasions students may be offered changes in time allocations or space options to enable them to complete their progress. But receiving support isn’t always easy for people with PTSD, and signing up with disability services can spark feelings of shame. We assume that our trauma doesn’t count. But it does.

Internal resources include coping skills, strength and resilience age and genetics whereas external resources are anything that is outside of you that provides you with support, strength, and relaxation. External resources might be your network of friends, your family and your community. Other key elements include the structure of sleep and nutritional balance along with exercise. Engaging with a therapist who specializes in trauma will ensure that you find an empathic response to the distress being felt.

For some students suffering from PTSD it is important to provide an appropriate environment from which they can have maximum protection from background sounds or the people around them. Practice some kind of relaxation technique, such as yoga and make the decision to engaging in physical activation such as by stretching your hands or tapping your feet Maintaining a good diet including limiting coffee, sugary, fatty foods and drinks. Sipping water reinforces the activation of the saliva gland and is a very useful resource to regulate right/left brain activity Other resources include listening to guided imagery CDs and doing some journaling.
The above are just some of the tools for maintaining wellness as you prepare for your examinations. When in doubt talk to a therapist who can guide you with further supports and assist you through this important period of your education.

Larry O Reilly is a Senior Counsellor / Psychotherapist and Clinical Supervisor and specialises in complex trauma and PTSD distress in clients.