COVID Is Stressing Kids Out Helping Kids Cope With Stress

by Ned Ketyer, MD Originally Published on www.ThePediaBlog.com

COVID Is Stressing Kids Out

Generalized Anxiety is the most common mental health condition diagnosed by pediatric providers, affecting approximately 12% of children worldwide. Depression is second. In normal times, returning to school after a fun and relaxing summer can be expected to exacerbate anxiety and depression in children. The pandemic has only added fuel to the fire, helping to produce a “global crisis” of mental health problems in children and teenagers, according to a new study in JAMA Pediatrics.

Tami D. Benton, MD and colleagues assess the sobering data contained in the study:

Prior to COVID-19, global estimates for depression and anxiety, 2 of the most common mental health conditions of childhood, were estimated to be 8.5% for depression and 11.6% for anxiety. The meta-analysis by Racine and colleagues suggests significantly higher rates for clinically significant depression (23.8%) and anxiety (19%) for children and adolescents, a more than 2-fold increase in prevalence rates compared with those reported prior to the pandemic. The study’s authors think they know why so many kids are stressed. (Hint: it’s not because they are being asked to wear face masks in school):

The COVID-19 pandemic, and its associated restrictions and consequences appear to have taken a considerable toll on youth and their psychological well-being. Loss of peer interactions, social isolation, and reduced contact with buffering supports (eg, teachers, coaches) may have precipitated these increases.

In addition, schools are often a primary location for receiving psychological services, with 80% of children relying on schoolbased services to address their mental health needs. For many children, these services were rendered unavailable owing to school closures.

Ken Downey Jr. discovered additional factors leading to the spoke in mental health symptoms over the last year-and-a-half:

According to the AAP, more than 40,000 children in the United

States have lost a parent to COVID-19, the trauma of which is often compounded by the loss of material stability and economic hardship and has been associated with poor educational and mental health.

That’s not all:

Families living in poverty and in under-resourced communities may be at an additional risk, the AAP noted. Children who are refugees and seeking asylum, children with special health care needs and children on welfare and in the juvenile justice system are also at a higher risk.

Many families have had a difficult time coping with COVID-19:

“We were already experiencing a mental health crisis in our children and teens before the pandemic,” AAP President Lee

Savio Beers, MD, FAAP, said in a statement. “Families have been under considerably more stress over the past year and a half, only making this crisis worse.”

The stress has been enormous for adults with pre-existing mental health conditions:

The AAP said parents may also be suffering from mental health challenges. It recommends that during every office

visit, clinicians ask parents and guardians about the impact of the pandemic on the well-being of the child. Integrating these questions into routine visits can help make sure all concerns are addressed, the AAP said.

“The emotional well-being of children is tied closely to their parents’ well-being,” Beers said. “That is why children are said to be the emotional barometers of the family. We recommend that families let their pediatrician know about anything going on in a child’s life that might be stressful. The pediatrician is a safe and supportive source for the whole family.”

Read about the signs and symptoms children and teenagers exhibit when they are not coping well with stressors (an unprecedented global pandemic is a fair example) here.

Helping Kids Cope With Stress

The last two years have been tremendously stressful for everyone everywhere…The American Academy of Pediatrics explains why pandemic-related stressors and trauma are having lasting effects on the developing minds of young people:

An estimated 40,000 children in the United States have lost a parent to COVID-19, for example. Many families have also lost financial stability during the pandemic. At the same time, children have had vital supports including school, health care services, and other community supports interrupted by the pandemic. And many have experienced or witnessed increased racism and xenophobia during the pandemic, particularly toward families of Asian descent.

Parents may find it difficult to recognize when their children and teenagers are struggling with their emotions. Toddlers and young children who have a hard time expressing in words what they are feeling inside may start to backtrack on their developmental milestones and budding social skills, and exhibit behavioral changes such as: > Fussiness and irritability, startling and crying more easily, and be more difficult to console. > Falling asleep and waking up more during the night. > Feeding issues such as frantic nippling, more reflux, constipation or loose stools, or new complaints for stomach pain. > Separation anxiety, seeming more clingy, socially withdrawn, hesitant to explore, and seeming to fear going outside. > Hitting, frustration, biting, and more frequent or intense tantrums. > Bedwetting after they’re potty trained. > Urgently expressed needs while seemingly unable to feel satisfied. > Conflict and aggression or themes like illness or death during play. The AAP warns parents that teenagers “may try to hide their struggles because of fear, shame, or a sense of responsibility to avoid burdening others.” Having trouble coping with feelings of stress, anxiety, and depression, can lead to a number of worrisome signs and symptoms as they go through adolescence and enter adulthood, including: > Changes in mood that are not usual for your child, such as ongoing irritability, feelings of hopelessness and rage, and frequent conflicts with friends and family. > Changes in behavior, such as stepping back from personal relationships. If your ordinarily outgoing teen shows little interest in spending time with, texting or video chatting with their friends, for example, this might be cause for concern. > A loss of interest in activities previously enjoyed. Did your music-loving child suddenly stop wanting to practice guitar, for example? Did your aspiring chef lose all interest in cooking and baking? > A hard time falling or staying asleep, or starting to sleep all the time. > Changes in appetite, weight or eating patterns, such as never being hungry or eating all the time. > Problems with memory, thinking, or concentration. > Less interest in schoolwork and drop in academic effort. > Changes in appearance, such as lack of basic personal hygiene […] > An increase in risky or reckless behaviors, such as using drugs or alcohol. > Thoughts about death or suicide, or talking about it.

Living through this dreadful pandemic has been stressful for everyone, not just our kids. Sometimes parents forget that the stress we experience can be contagious:

Parents set the tone in the household. Expressing extreme doom or fear can affect your children. It can be challenging to stay positive, especially if you’re struggling with your own stress. But try to stay positive and relay constant messages that a brighter future lies ahead. It helps to set aside time to take care of yourself when possible, and seek the support you may need for your own mental health.

Read more about “Mental Health During COVID-19: Signs Your Child May Need More Support” from the AAP here. If you think your child is struggling with his or her mental or physical health, pick up the phone and give the pediatrician’s office a call. We can screen for mental health issues and provide guidance to help your child cope with what’s on their mind.