Exam anxiety in secondary school: how students and parents can overcome it

What is exam anxiety, and when do helpful nerves turn into anxiety that blocks memory?

Exam anxiety is the tension a student feels before or during an exam, and a moderate amount of it is normal. The UK's National Health Service (NHS) calls exam nerves a natural reaction that can be put to good use, and a guide from one NHS trust reminds students that getting excessively nervous is what works against them. It becomes a problem when it grows so large that it crowds the mind instead of sharpening it: your child sits down in front of the question paper after revising well, then feels that everything they learned has vanished.

• Helpful nerves: push the student to revise and keep them alert, feel manageable, and don't stop them sleeping or eating.
• Disabling anxiety: scatters revision, steals sleep and appetite, and peaks in the exam hall, so the student forgets what they know.

A study published in 2021 in the journal Educational Psychology Review explains that test anxiety has two parts: worry, meaning a preoccupation with performance and with the consequences of failing, and physical arousal, such as a racing heart, sweating and nausea. Many researchers believe that anxious thoughts compete for the "working memory" the mind needs to solve a question, although how big this effect is remains debated. A meta-analysis published in 2018 in the Journal of Affective Disorders, which pooled 238 studies, found that test anxiety is linked to lower scores in university entrance exams and lower grade point averages, although the link was small to moderate.

Causes of exam anxiety: why do some students worry more than others?

• How much the exam matters and how hard it feels: the same meta-analysis found that anxiety rises when an exam carries high stakes and when the student sees it as difficult, which is exactly the case with Thanaweya Amma, Egypt's general secondary certificate. A student's self-esteem was one of the strongest factors linked to their anxiety.
• Ways of thinking and studying: comparing yourself with others, predicting disaster and blaming yourself, studying all night, memorizing without understanding, and drinking too much coffee, tea or fizzy drinks, as a guide from one NHS trust points out.
• Pressure at home: the NHS cites Childline, a UK helpline for children and young people, as saying that many of the young people who contact it feel that most of their pressure at exam time comes from their family.

Exam stress symptoms: signs during revision and in the exam hall

Your child may never say "I'm anxious", but their body and behavior often say it for them. Signs listed by the NHS include:

• Worrying a lot and feeling tense
• Headaches and stomach aches that keep coming back
• Poor sleep, and being quick to snap
• Eating less or more than usual
• Losing interest in things they used to enjoy
• A negative or low mood, or feeling hopeless about the future

In the exam hall: when the mind suddenly goes blank

In the exam hall itself, physical symptoms such as a racing heart, sweating and nausea can get stronger, and the student may feel that their mind has gone completely blank, unable to recall the answer to a question they know. This is the "my son forgets everything he studied as soon as the exam starts" complaint that so many parents repeat. It does not necessarily mean your child didn't revise or has a weak memory; anxiety may be taking up part of their attention at that moment. To understand what anxiety does to the body, read about the physical symptoms of anxiety, and if the symptoms come as a sudden wave of intense fear, read about panic attacks.

Helping your teenager with exam stress: words that help and words that add pressure

The NHS advises parents to stay calm themselves, to listen, offer support and avoid criticism, and to reassure their child that failing is not the end of the world. A guide from one NHS trust adds that unrealistic expectations from adults add unnecessary pressure, and that it is better to help the student set goals they can actually reach.

Words that help

• "I'm proud of how hard you're working, whatever the result."
• "Tell me what's worrying you. I'm listening."
• "How can I help you study more comfortably this week?"
• And after each exam: "What did you answer well?", then moving on together to the next subject instead of picking apart the hard questions.

Words that raise the pressure

• Comparison: "Look at your cousin. Why can't you be more like him?"
• Catastrophizing: "If you don't get the marks, your future is ruined."
• Tying your approval to grades, or reminding them how much you have spent on private lessons.
• Interrogating after every exam: "How many questions did you get wrong? Why didn't you revise that part?"

Be flexible, too: it's fine if their room isn't tidy during these weeks, because, as the NHS reminds parents, exams do not last forever. Agree on small rewards after each exam, such as a favorite meal. And if your child seems not to be coping, talk to their teachers or to the school psychologist or social worker.

Sleep, breaks and study rhythm: how to protect your child's concentration

Staying up until dawn the night before an exam is a common habit, but it works against the student. As the US National Heart, Lung, and Blood Institute (NHLBI) explains, sleep helps the brain learn and remember and improves attention, while a teenager who doesn't get enough sleep may find it hard to concentrate, get lower grades and feel more stressed.

• Enough sleep: most teenagers need 8 to 10 hours a night, according to the NHS, which says that cramming all night before an exam is usually a bad idea.
• A buffer before bed: about half an hour between studying or screens and going to sleep.
• Study in chunks: small portions with regular breaks, rather than long unbroken sessions.
• Daily movement: walking or any physical activity boosts energy, clears the mind and eases stress.
• Balanced meals: some parents find that foods and drinks high in fat, sugar and caffeine, such as energy drinks and sweets, make their children more tense and irritable.
• A quiet, comfortable place to study, and a realistic timetable that spreads the subjects over the days that are left.

Exam tips for secondary school students: before the exam and in the exam hall

In the days before the exam

1. Practice under exam conditions: do past papers against the clock, and face your fears instead of avoiding them, as the NHS advises.
2. Remind yourself of what you know and the effort you have put in, not only of what is left.
3. Get your things ready the night before, and leave early so you can arrive and settle in before the start.
4. Eat healthy food at regular times, and don't go into an exam hungry.

In the exam hall

1. Start with your breath: close your eyes and take several slow, deep breaths before you begin.
2. Read the instructions twice and look over the whole paper, then start with the easier questions and keep an eye on the time.
3. If your mind goes blank, don't panic: breathe slowly and deeply for about a minute, and if the answer still doesn't come, move on to another question and come back to it later.
4. Write what you know, even if it is only part of the answer, because writing something is better than leaving the question empty.
5. After you walk out: focus on what you answered well instead of going over the hard questions again and again, then move on to the next subject.

Stay-awake pills and stimulants: why they are a real danger, not a shortcut to better grades

During exam season some students pass around pills "for staying up and focusing", getting them from a friend or buying them without a prescription. The US National Institute on Drug Abuse (NIDA) reports that some high school and college students misuse prescription stimulant medicines to try to improve their academic performance, and that doing so, especially when taking large amounts, can cause a dangerously high body temperature and an irregular heartbeat, and can even lead to heart and circulatory failure or seizures. Repeated misuse can lead to paranoia, psychosis or addiction.

And these pills don't deliver what people claim. A study published in 2017 in the journal Addictive Behaviors followed 898 students at a single US university who had no medical condition calling for these medicines. Those who took them without a prescription saw no improvement in their grade point averages and gained no advantage over their peers. The researchers concluded that the promised academic benefit is likely an illusion, and that turning to these pills is a sign of academic difficulties that need support.

When does exam anxiety need a therapy session rather than tips?

Many students calm down once the exams are over, but not all of them. The NHS advises getting help if your child's anxiety or low mood is severe, lasts and interferes with their everyday life. Signs that mean you shouldn't wait include:

• Anxiety stops them revising or sitting the exam, or their mind goes blank in exam after exam despite preparing
• Their sleep or appetite has been disturbed for weeks, or they keep complaining of headaches and stomach aches
• They lose interest in what they used to enjoy, or seem sad and hopeless about the future, signs that can point to depression in teenagers
• They turn to pills or other substances to stay awake or to calm down
• The anxiety continues after the exams, or spreads to other situations in their life

Test anxiety treatment: how do therapy sessions help?

The reassuring news is that exam anxiety responds to psychological treatment. A meta-analysis published in 2019 in the Journal of Anxiety Disorders pooled 44 randomized trials of therapies and training programs for university students with test anxiety. These interventions reduced test anxiety and improved academic performance compared with control groups. Behavior therapy had the strongest evidence, while cognitive behavioral therapy and study-skills training looked promising, though the researchers cautioned that the small number of studies, poor reporting and possible publication bias mean the results should be read with care.

Depending on the student's needs, sessions usually combine exercises that calm the body and ease the fear of exam situations, work on the thoughts that exaggerate the danger, and help with organizing study. No medicine is started unless a doctor decides on it after an assessment.

At Oxygen Center, male and female students aged 15 and over can start with a therapy session, or with a psychiatrist appointment if a broader assessment is needed, with a guardian's consent for those under 18. Parents can also come on their own first. The center does not provide services for children under 15, and for them we recommend seeing a psychiatrist who specializes in children. For any question, get in touch with us.