How do children present with Stress, Depression or Anxiety?

When children present with intermittent vague abdominal discomfort, avoidance with going to school, "feeling sick", and sometimes even vomitting, one needs to consider stress as a possible cause.  However, this is a diagnosis of exclusion and hence, the Doctor has to exclude all possible physical causes before we can be confident that it is due to stress.  This does NOT mean that we have to withhold the implementation of any stress management until all the investigations are done.

A mood diary maybe helpful in order to differentiate whether is is stress related or not.  For example, if the symptoms are always in the morning prior to school, and not evident on the weekends, then it may suggest stress with school as the cause.

As highlighted above, sometimes, as clinicians, we would investigate possible physical causes, and at the same time, also address any mood issues through counselling.