By Melissa Jackson
BBC News Online health staff
Recent news that a teenage girl had apparently committed suicide because she was worried about her GCSE exams will have sent pangs of anxiety among parents across the country.
Exams are a stressful time for pupils
Fifteen-year-old Tina Dziki died at a London hospital after taking what is thought to be an overdose of anti-malarial drugs.
It is that time of year again when students are sitting GCSEs, A-levels and finals - their supposed passport to a successful career.
But at what price? For a small minority, the pressure of trying to succeed can become too much, with very serious, often fatal consequences.
Childline - the confidential 24-hour helpline - has seen an increase in calls about exam stress.
Latest figures show that from 31 March 2003 to 1 April 2004, the number of such calls had risen to just over 900 - compared to 600 for the same 12-month period in the previous year.
The majority of calls were from children aged between 12 and 15.
Among the callers there was a very small number of young people who had expressed suicidal thoughts, when talking about exam stress.
Childline counsellor Kate said: "What comes across very strongly is how desperate and alone these children can feel.
"Their suicidal feelings can be exclusively exam related or there can be other factors involved.
"In a sense, to them, it doesn't matter where the feelings are coming from. The important thing is that they're heard and taken seriously."
Why do some children cope better than others with exam stress?
Kate thinks that some children feel they will only be accepted as a valuable person if they do well in exams.
This is more to do with our perceptions of exam success being the key to success in other areas of our lives.
Kate said: "We do hear from pupils who don't want to let down their parents or teachers and need reassurance that it's not their fault.
"Or sometimes, it may be that young people feel that if they add to their mum or dad's problems by getting lousy exam results, it's going to be too much for them.
"I think society has to wake up to the number of children who have to deal with these issues."
Martin Cooper, exam officer at Queen Elizabeth's School in Wimborne, Dorset, told BBC News Online there wasn't a great deal of flexibility within the exam system.
He said, if people came forward beforehand, measures could be taken to assist those affected by conditions such as asthma, or stressful events such as family bereavements.
But he said students he had seen affected by exam stress did not tend to experience long-term problems.
He said: "I don't think I've ever come across students becoming suicidal.
"I've occasionally come across people stressed enough to be sick, and recently someone had a nosebleed because of a combination of hay fever and stress."
Learning to study
Phillip Hodson - a Fellow of the British Association for Counselling and Psychotherapy - has worked extensively with young people.
He said students, their parents and society as a whole should recognise people could be successful in non-academic ways.
He used the example of David Beckham.
"You would dismiss Beckham as a peasant academically, but he has a huge financial success," said Mr Hodson.
"Parents should not be obsessed with academic qualifications - they should be looking at a child's whole range of skills, not just whether they are good with a pencil and paper."
Mr Hodson said parents concerned their children may not be coping with exam stress should watch out for changes in their eating, sleeping and spending habits or they do not change their clothes any more.
He added: "It does not hurt to probe into children's emotions and ask them how they are feeling."
Many of Mr Hodson's views are shared by Anne Parry, chair of Papyrus - an organisation committed to the prevention of young suicide.
She believes both parents and teachers can help to prevent suicides linked to exam pressure.
She said: "Parents, teachers and children are sometimes setting themselves unrealistic targets.
"There is a very fine line between encouragement and pressure."
A former teacher herself, Mrs Parry advised: "I would say to teachers and parents 'always be there to listen and encourage a young person, to talk to them, not be judgemental and tell them that you care about them'.
She is keen to see schools setting up a support network for their pupils where they can talk in confidence to a trained counsellor.
She said: "These vulnerable children need to be seen quickly because of their impulsive behaviour."
Papyrus is also setting up a helpline for anyone who needs advice on dealing with a suicidal young person.