Exam Stress And Suicidal Thoughts: What Parents Need To Know And When To Act

As board exams and competitive tests approach, stress becomes almost a rite of passage for many Indian students. While a certain level of anxiety can motivate preparation, mental health experts warn that in some adolescents, exam stress can spiral into emotional distress, depression and, in rare but serious cases, suicidal thoughts. According to the World Health Organization (WHO), suicide is one of the leading causes of death among young people globally. In India, data from the National Crime Records Bureau (NCRB) consistently show that students form a significant proportion of suicide deaths each year, with "failure in examination" cited as a contributing factor in several cases.

Dr. Ravindra Agarwal, Consultant - Psychiatry, Manipal Hospital, says parents often underestimate how deeply exam pressure can affect children. "What worries me is how often parents don't realise how deep the struggle has become until it's already severe," he explains. Here's what parents need to know, and when to act.

When Is It More Than "Just Stress"?

"Exam season quietly tips many students from 'normal stress' into real emotional suffering," says Dr. Agarwal. "For some it just feels intense and exhausting, but for others the pressure can spiral into anxiety, hopelessness, and in rare but serious cases suicidal thoughts."

Research published in journals indexed by the National Institutes of Health shows that chronic academic stress is associated with anxiety disorders, depression, sleep disturbances and psychosomatic symptoms in adolescents.

Dr. Agarwal emphasises that early warning signs are often subtle: "Very often the first clues are not dramatic; they're small changes that parents brush aside. You might notice your child is unusually irritable, withdrawn, or crying more easily, or they say things like 'I can't do this anymore' or 'no one cares if I'm here.'"

He adds that repeated complaints of headaches, stomach aches or nausea, even when medical tests are normal, may reflect emotional overload rather than a physical illness. A "deep sense of worthlessness, feeling like a burden, or suggesting that life is not worth living" should never be dismissed as typical exam tension.

Also Read: Exam Stress And Negative Self-Talk: How To Boost Confidence And Resilience In Teens

Behaviour Changes Parents Should Watch

Adolescents often struggle to verbalise distress. Instead, it may show up in behaviour. Dr. Agarwal lists common red flags:

• "Big shifts in sleep, like sleeping very late, waking in the night, having nightmares, or sleeping excessively to avoid anxiety."
• Noticeable changes in appetite.
• A sudden drop in grades, or extreme overstudying driven by fear, not motivation.
• Withdrawal from friends and family.

The UNICEF has also highlighted that social comparison, particularly through peer pressure and academic competition, can worsen anxiety and low self-esteem among teenagers. "Dependence on constant comparison ('everyone in class is doing better') or hiding their preparation from you can be a sign they feel ashamed or trapped," Dr. Agarwal notes.

How To Start The Conversation

One of the biggest fears parents have is: What if asking about suicide puts the idea in their head?

Evidence from suicide prevention research supported by the Centers for Disease Control and Prevention (CDC) shows that directly but gently asking about suicidal thoughts does not increase risk, it can reduce it by opening a safe channel for help.

Dr. Agarwal advises: "If you sense something is off, the most important step is to open a conversation gently and without interrogating them about marks." He suggests saying: "I've noticed you seem really overwhelmed lately, and I'm worried about you. Can you tell me how you're really feeling?"

Parents should listen more than they speak and avoid minimising statements like "this phase will pass" or "others have it worse." "You don't have to fix it all at once," he says. "What helps most is simply saying, 'It makes sense that you feel this way, and I'm here with you.'"

What Many Children Are Really Afraid Of

In clinical practice, certain themes repeat frequently. "In my clinic, several themes come up again and again around exams," says Dr. Agarwal. "A fear of disappointing their parents. A belief that their value depends entirely on marks. A sense of being trapped, as if 'if I don't do well, there is nothing left.'"

The American Academy of Child and Adolescent Psychiatry notes that adolescents are particularly vulnerable to "all-or-nothing thinking," where one setback feels like total failure. Children may worry they will lose love, respect or security if they underperform, fears that require repeated reassurance, not just one conversation.

When To Seek Professional Help Immediately

Parents should seek urgent help if their child:

• Mentions self-harm or wanting to die
• Talks about "not being here anymore"
• Gives away belongings
• Has made a suicide attempt or describes a plan

"Please seek urgent professional support if your child mentions self-harm, dying, or 'being better off dead,' even if it sounds slightly overdramatic," Dr. Agarwal stresses.

Early intervention by a psychiatrist, clinical psychologist or school counsellor can significantly reduce risk. India also has 24-hour suicide prevention helplines, and emergency medical services should be contacted if immediate danger is suspected.

Also Read: Exam Stress And Unhealthy Coping Mechanisms: Psychologist Shares How To Spot And Change Habits Early

Supporting Your Child At Home

Parents cannot eliminate exam stress entirely, but they can buffer its impact. Dr. Agarwal recommends:

• "Make it clear that your child's safety and mental health matter more than any exam result. Say this explicitly and often."
• Maintain regular sleep and meal routines.
• Avoid making every conversation about marks.
• Spend quiet, pressure-free time together.

"If you're unsure how serious their stress is, don't wait for worse signs before seeing a mental health professional," he says. "A single session can be preventive."

Exam stress is common, suicidal thoughts are not. The difference lies in early recognition, open communication and timely professional support. As Dr. Agarwal reflects, "Exam stress is part of life for most students, but it should never be so heavy that it steals the joy, safety, or the future of a child." For parents, the message is simple but powerful:

Notice small changes, listen without judgment, and act early. Doing so can quite literally save a life.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.