Dealing with stress. (Ask the Expert).

Q: How can I help my children cope with the increasing stress in their world, particularly the stress of terrorism and war?

A: There are a wide range of emotional and physiological reactions that children may display following disaster or war. Children often don't have the word power to tell adults what they're feeling. But you can look for some symptoms (which apply to any stressful or fearful situation children may encounter). These include crying, whimpering and screaming, nightmares, losing trust in adults, changes in eating or sleeping habits, disobedience, irritability, confusion, refusal to go to school or reluctance to leave home, behavior problems in school and, for older children, alcohol and other drug.

To help them through it, reassure your child and provide extra emotional support, maintain your normal routine and structure as much as possible, limit media exposure, yet reassure your children that authorities are doing everything possible to keep everyone safe, answer all their questions as honestly as possible and do a lot of listening. Also keep in mind that children often take on the anxiety of the adults around them, so try to find a balance between sharing your own feelings with your children while at the same time not placing your anxiety upon them.

Another thing that helps children--or anyone who feels overwhelmed with a stressful situation--is to provide a sense of empowerment. And, let your kids know that they are safe. Emphasize the positive--the family, friends and community still intact around you, the strength of those working to improve things. (For more information on helping children cope with stress, particularly around violence and war, visit the National Youth Violence Resource Center Web site at www.safeyouth.org.)

Q: What are the dangers in compartmentalizing stress?

A: If you compartmentalize A stress, and so try to ignore it, it may manifest itself in depression, anxiety or other emotional symptoms, as well as in physical symptoms such as headache, stomach aches and fatigue.

The healthier way to cope with stress is to be realistic about how much you can do. If you keep taking on a lot of different activities, learn to say no. It's also important that you maintain a sense of flexibility. Don't get trapped into thinking there's only one answer. And develop a strong social support network. This turns out to be one of the best things you can do to not only enjoy life but to also protect yourself from disease.

So let family and friends know that you're overloaded and that you might need help, and let other people give you support. Don't try to cope alone. Seek professional help if the symptoms begin interfering with your work or relationships.

Susan J. Blumenthal, MD,MPA U.S. Assistant Surgeon General and Rear Admiral, U.S. Department of Health and Human Services and Clinical Professor of Psychiatry at Georgetown and Tufts University Schools of Medicine