Academic performance is entangled with self-worth, family honour, and future security in today’s competitive and image-driven society. This academic, social, and emotional strain has led to a troubling rise in anxiety among young people, many of whom struggle silently with mental health issues during what should be a structured, supportive time of learning and growth.

Founding psychologist of The Healer Nepal, Sabina Giri, who has an educational background in MA Clinical Psychology and Postgraduate School Counselling, explores the psychological impact of exam-related stress on students, emphasising how untreated emotional distress can obstruct both academic achievement and personal growth.

Can you explain the common pressures students face during exam season? How do these pressures together influence their mental health?

During exam season, students often face a convergence of academic, social, and familial pressures that can impact their mental health. Academically, the demand to perform well, meet high expectations, and secure future opportunities creates stress and self-doubt.

Socially, comparisons with peers and fear of judgment can heighten anxiety and feelings of inadequacy. Familial pressure, whether through explicit expectations or the desire not to disappoint loved ones, adds another layer of emotional strain.

These pressures don’t act in isolation, they often compound each other, leading to burnout, sleep disturbances, and lowered self-esteem. From a psychological perspective, this multi-directional stress load can trigger or exacerbate mental health issues like anxiety and depression.

How do Nepal’s cultural and societal expectations shape students’ anxiety and stress during exams? Are there specific norms or beliefs that heighten this pressure?

In Nepal, cultural and societal expectations heavily influence students’ anxiety and stress, particularly during high-stakes exams like the SEE. Academic achievement is tied to family pride, societal status, and perceived future success. Professions such as medicine (MBBS), engineering, chartered accountancy, and law are seen as the ultimate benchmarks of success, and students are often pushed sometimes from a very young age towards these paths, regardless of their interests or abilities.

Those who struggle in exams or fail to gain admission to these fields are often labelled as failures, with their self-worth questioned not only by others but also by themselves. In extreme cases, the inability to meet these expectations has led to a rise in mental health issues, including depression and suicide, which can be seen after the results of SEE are published. We hear such news on both mainstream and social media platforms. Tragically, there are reports of students taking their own lives after failing or not performing as expected, highlighting how unbearable the pressure can become.

This pressure doesn’t remain confined to the individual; instead, it radiates through the family, causing feelings of shame, disappointment, and unspoken trauma that can affect relationships and even influence how the next generation is raised.

What are some less obvious or overlooked psychological and behavioural signs that indicate a student might be struggling with exam-related anxiety or stress?

Some overlooked psychological signs that a student might be struggling with exam-related anxiety include subtle changes in their daily habits and emotional responses. These can include increased irritability, social withdrawal, or a sudden disinterest in activities they once enjoyed. Students may also become unusually perfectionistic, spending excessive time on minor details or redoing tasks unnecessarily. Sleep disturbances such as difficulty falling asleep, waking up too early, or sleeping too much are common but often dismissed. Physical complaints like headaches, stomachaches, or fatigue without a medical cause can also be stress-related.

Procrastinating or avoiding studying might look like laziness, but it often reflects a fear of failure. You might also notice a decline in confidence, frequent self-criticism, or a superficially cheerful demeanour masking internal distress. These signs are easy to overlook, especially in high-achieving students who perform well on the surface, making it important to look beyond grades and closely watch for emotional and behavioural changes.

How effective are current support systems—such as counselling services, peer support, or family involvement—in addressing students’ mental health challenges during exams? What gaps remain?

Counselling services, peer networks, and family involvement have begun to address students’ mental health challenges during exams in Nepal, particularly in urban settings. However, their effectiveness remains limited by societal stigma, lack of awareness, and inconsistent support. In cities, access to school or private counselling has improved, but many students still hesitate to seek help due to the fear of being judged or labelled. Some even resort to self-diagnosis using tools like ChatGPT or Google, coming into therapy sessions already convinced they have certain conditions.

Even when students do come for therapy, stigma often prevents them from continuing. Many drop out after a session or two, fearing what others, especially family, might say. Peer support, while comforting, is not always helpful. Peers may be struggling and offer harmful advice as they are also struggling to navigate their own lives.

Family involvement, sadly, can often add to the pressure rather than relieve it. For many parents, academic success is the only metric of worth. Emotional support, empathy, or open communication is frequently lacking. One particularly painful example from my therapy experience involved a client whose mother accused him of making constant excuses to avoid studying.

On the other hand, father was a great businessman who never had time for family. As we explored further, it became clear he had never felt loved, validated, or supported by his family. He had quietly gathered means to end his life, convinced that his death would be a relief to them. Fortunately, through therapy, he is now on a path to recovery but his story is not rare.

These examples highlight critical gaps in the current support landscape. Professional counselling needs to be more normalised and accessible, with long-term follow-up and family education. Peer networks must be guided and monitored, and families need to move beyond grades and begin nurturing their children’s emotional worlds.

What long-term impacts can sustained exam pressure have on young people’s mental wellbeing, and what preventive measures would you recommend to mitigate these effects?

Sustained exam pressure can have serious long-term impacts on young people’s mental well-being. Chronic academic stress during formative years can lead to persistent anxiety, low self-esteem, depression, sleep disturbances, and emotional burnout. Over time, students may develop an unhealthy association between self-worth and performance, creating a lifelong fear of failure and perfectionism. This can manifest in adulthood as imposter syndrome, workaholism, or difficulty coping with setbacks. In some cases, unresolved exam-related trauma can even affect identity formation, relationships, and decision-making, making it hard for individuals to trust their own judgment or take risks.

Preventive measures must begin early and involve a multi-layered approach. From an early age, exams should not be perceived as a burden or a measure of familial pride; rather, the focus should be on the individual level and needs of each student. Families and parents, instead of threatening or forcing, need to start by loving and listening to their children, understanding their strengths and challenges.

Integrating mental health education into the school curriculum is essential, along with teaching students how to manage stress, build resilience, and seek help when needed. Schools should have trained counsellors and emphasise emotional intelligence and social skills alongside academics and extracurricular activities.

Parental awareness is equally crucial; families must shift their focus from results to effort, growth, and emotional well-being.