How to Manage Pre-Exam Anxiety Before the High School Entrance Exam

As the high school entrance examination (commonly known as the Zhongkao in China) approaches, many students experience heightened psychological stress—including symptoms such as insomnia, irritability, difficulty concentrating, gastrointestinal discomfort, and accelerated heart rate. These manifestations reflect a physiological stress response mediated by the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system activation. While mild anxiety can enhance alertness and motivation, persistent or severe distress may impair cognitive performance and undermine well-being.

Evidence-based strategies to modulate pre-exam tension include structured sleep hygiene—such as maintaining consistent bedtimes, limiting screen exposure one hour before sleep, and avoiding caffeine after noon. Cognitive-behavioral techniques, including diaphragmatic breathing (e.g., 4-7-8 breathing: inhale for four seconds, hold for seven, exhale for eight), have been shown to reduce autonomic arousal and improve vagal tone. Brief daily mindfulness practices—such as five minutes of guided body-scan meditation—can decrease rumination and enhance emotional regulation.

Physical activity also plays a key role: moderate aerobic exercise (e.g., brisk walking or cycling for 30 minutes most days) increases brain-derived neurotrophic factor (BDNF) levels, supporting neural plasticity and resilience. Importantly, students should avoid last-minute cramming marathons; instead, spaced repetition and active recall—backed by robust learning science—promote durable knowledge retention more effectively than passive re-reading.

Parents and educators can support students by normalizing stress as a natural, adaptive response—not a sign of inadequacy—and by emphasizing effort and process over outcome. Open, nonjudgmental communication helps identify early signs of burnout or escalating anxiety that may warrant referral to a licensed mental health professional. When distress significantly interferes with daily functioning—for example, persistent anhedonia, marked fatigue, or recurrent panic attacks—clinical evaluation is recommended to rule out generalized anxiety disorder or major depressive disorder.