Marks Falling, Chest Tightening: Arjun's Five Weeks
Arjun, 17, is in Class 12 in a Punjab town. His father, a small shopkeeper who did not attend college, has told relatives that Arjun will become an engineer. In the last three tests Arjun's physics marks fell from 85 to 74 to 62. For six weeks he has woken around 3 a.m., reported a tight feeling in the chest and headaches before school, and eats little at dinner. Last month he stopped playing cricket with his friends because 'there is no time', and he now avoids family conversations about results, though he talks for an hour at night to a cousin studying in another city. He told the class teacher he is 'fine' and asked her not to inform his parents. The school counsellor visits twice a week, the next board examination is in five weeks, and his younger sister is in Class 8.
1. Analyse Arjun's condition using the general adaptation syndrome. Which stage is he in, and what is the evidence for and against that placement?
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Alarm stage (first weeks): 3 a.m. waking, chest tightness, headaches before school and appetite loss are the physiological mobilisation of the alarm reaction - sympathetic activation with sustained cortisol. Six weeks of these symptoms shows the alarm response has not subsided.
Resistance stage (the dominant picture): he is still attending school, still sitting tests, and still functioning - the body is adapting and resisting while drawing on reserves. The falling marks are the price of that adaptation: cognitive resources are going into managing arousal rather than into retrieval and problem-solving, which fits the 85 → 74 → 62 trajectory better than a sudden loss of ability.
Early exhaustion signals (the warning): withdrawal from cricket, avoidance of family conversations, reduced eating and the flat statement 'I am fine' suggest resources are depleting. Exhaustion proper would show collapse of functioning - absence from school, inability to sit a paper - which has not yet occurred.
Evidence against a simple stage reading: the marks decline is monotonic across three tests, which could also reflect gaps in specific physics topics; the case gives no topic-level data. The symptoms are also consistent with a developing anxiety or sleep problem, and a stage model cannot distinguish these. The correct conclusion is that this is a stress response requiring assessment, not a diagnosis. The teacher should describe and refer, not label. The 3 a.m. waking specifically matters: it is a hallmark of heightened arousal and, if it continues, will itself degrade the memory consolidation he needs for the board examination, creating a loop.
2. Analyse the appraisals involved and identify which coping strategies are already present. Which should be strengthened now, and why not the other one alone?
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Primary appraisal: the situation is judged as a threat, not merely a challenge - the stakes are his father's public expectation and his own self-image as a good student. The falling marks are read as evidence of personal failure rather than as information about topic gaps.
Secondary appraisal: his coping options look thin. He has no study plan, no topic-level feedback, no one at home he can talk to about the fear, and he has just removed his main source of restoration. Low perceived control converts a challenge into a threat, and that is exactly what has happened.
Emotion-focused strategies already present: avoidance of family conversations about results, suppression ('I am fine'), and reducing demands by dropping cricket. These regulate feeling in the short term but worsen the situation: avoidance prevents the conversation that could lower the pressure, and dropping cricket removes the exercise and peer contact that were regulating his arousal.
Problem-focused strategies already present: cutting leisure to study, and nightly calls with the cousin - the latter is both emotional support and instrumental help.
What to strengthen now: both, in sequence. Problem-focused first and concretely - a topic-by-topic error analysis of the three physics papers, a five-week plan with daily targets, and a request to the physics teacher for two specific areas of feedback. That is fast, visible and reduces the threat. Emotion-focused next - sleep timing, 45 minutes of cricket or walking three times a week, and one planned conversation with the father, prepared with the cousin and the teacher.
Why not problem-focused alone: more study will not help while 3 a.m. waking and chest tightness are impairing attention and consolidation, so the arousal must be treated as part of the problem rather than as a distraction from it. Why not emotion-focused alone: reassurance without a workable plan leaves the marks trajectory untouched, and the threat appraisal will simply return.
3. The teacher was asked not to inform the parents. What should she do, and what would a defensible five-week support plan look like?
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On confidentiality: she should not promise unconditional secrecy. Honest framing is: 'What you tell me stays between us unless I believe you are at serious risk; if I do, I will tell you first and we will decide together who else needs to know.' Arjun's request is understandable and should be respected where possible - his fear is that disclosure will confirm failure, and that fear is part of the problem.
Immediate steps: refer to the visiting counsellor this week; the counsellor is available twice weekly, so the appointment should be booked before anything else. Document the symptoms (sleep, appetite, headaches, marks), because a dated record is what allows escalation to be judged on evidence.
Five-week plan: (a) Counsellor meets Arjun twice weekly, with a joint session including the cousin as a trusted third party; (b) physics teacher provides a written topic breakdown of the three tests and two priority areas for the next fortnight; (c) sleep and activity routine agreed with Arjun, with the 3 a.m. waking tracked; (d) a prepared family conversation in week 2 or 3, ideally with the counsellor or a respected relative present, framed as health and workload rather than as failure; (e) weekly review of marks, sleep hours and symptom frequency.
Escalation rule: if sleep worsens, if he expresses hopelessness, or if school attendance breaks down, parental involvement and medical referral become non-negotiable and Arjun should be told this in advance. Involving parents need not mean handing over control; the small shopkeeper father is not the enemy here, but the conversation must be prepared so that it lowers rather than raises the pressure.