How Depression & Isolation are Leading to Exploitation of Children The pandemic’s emotional toll BY JAN EDWARDS
Given the current environment, many children are at home 24/7, missing their friends, playing sports, experiencing those important interpersonal social interactions and instead are turning to online relationships. In fact, there is even a name for their new ‘online’ friends #IBF, Internet Best Friend.
Our children are ‘bonding’ with people they may never meet in person – which is a perfect breeding ground for predators to circle their prey waiting to step in and be a child’s #IBF. Our children are facing unprecedented challenges today, many experiencing complete isolation which can lead to depression. With the holidays fast approaching, the impact of this isolation can lead to loneliness that may seem never ending. As we know, their prefrontal cortex is not fully developed until their mid-twenties and these new neural patterns can potentially lead to some dangerous side effects, both at home and online. Upsets, unchecked anger, fighting over little things at home or letting their guard down online by over-sharing with a stranger (#IBF), putting them in precarious positions from which it seems next to impossible to remove themselves. “The uncertainty of the circumstances we all find ourselves in is something our minds are not really equipped for,” according to Emiliana Simon-Thomas, science director at the Greater Good Science Center at UC Berkeley. “It ultimately ends up being a chronic stressor, even for people who don’t normally feel that way.”(1) Including children – or said another way, especially children. How many times have you heard how ‘resilient’ our kids are in managing changes but we now see that is not the case. We’ve talked about ACE Scores (Adverse Childhood Experiences) in previous articles and our present time is definitely one for the books. Adverse Childhood Experiences not only present short-term health issues, they carry over into adulthood. Discovering the challenges our families are dealing with and impacting them sooner rather than later, can save lives and needless heartache. The last time I checked, there is no cure or treatment for death. I don’t mean to be flippant, however, that is what we are dealing with here – we must treat depression now, talk about the impact isolation is having on our families and what we can do today to prevent heartache tomorrow. Lovingly asking the tough questions can prevent an untimely death of a child. Don’t believe me? Well here is a startling fact; the suicide rate for children 10-15 years old has risen 299% between 2011 and 2018.(2) I imagine we will see another increase in that number once things settle down and there is less focus on COVID-19, and we can see
the longer-term impact of this crisis. We can count on health professionals continuing to see on the frontlines: increased depression well before parents do, as many of them are experiencing symptoms of depression as well.
What should providers look for? A child being groomed and recruited online, once in too deep, may show signs of depression, masking the guilt and shame they are experiencing, or they may become confrontational, threatening to run away or hurt themselves if things don’t go their way. This type of sudden alterations in behavior is one sure sign something is amiss. The questions we suggested in previous articles are appropriate to learn more about what your patients are dealing with today. It’s a great way to begin an easy interaction with a patient. That’s why you, the frontline professional, are a most important key element in disrupting the cycle of exploitation, which leads to a whole host of mental and physical maladies that will require treatment over their lifetime. This is why the challenges with the current environment are so pressing; children are attached to their phones. Sadly, the rise in attempted and completed suicides by young people has a direct correlation with their access to smartphones. Many health professionals attribute the rise in suicide attempts to the effects of social media and how teens and young adults communicate with their peers. Developmentally, teen years have always been difficult, but that’s been taken to the next level by smartphones, social media and the constant pressure to be online.”(3) They are expected to put on their brave face – always. There is never a break. Always looking perfect, right lighting, right angle, hashtag, etc., etc. It’s exhausting. Put that on top of isolation, separation and loneliness and it’s a recipe for increased online exploitation and addiction. Dr. Ackerman with Nationwide Children’s Hospital in Columbus, Ohio noted that “young brains are less adept at dealing with complex situations,” likewise he believes social media plays an important role in the suicide crisis among the young.(3) I concur with Dr. Ackerman and so does the documentary the “Social Dilemma”. I think we can all agree, we are dealing with some pretty complicated, complex situations right now and our children are feeling it.
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So how can you make a difference with your young patients, and their parents trying to navigate this time in their lives, escape with as few scars as possible with maybe some hope to hang onto? Glad you asked. I will keep sharing this because I believe they are the most powerful tools to use when discovering what your patients are dealing with: asking powerful questions and listening. Dr. Wetter with Cedars-Sinai has some great suggestions of signs to look for and questions to ask if you or a parent are concerned about a depressed child. Key signs to look for are changes in mood or behavior that are different from the norm. Here are some questions to ask your patient or their loved one: • Do they seem to be more withdrawn than usual? • Are they behaving more erratically and impulsively? • Are they more irritable? • Did they typically respond quickly to a text or phone call, but now they are not responding at all? It’s also important to pay attention to the content of what a friend or loved one is talking, texting or posting. Do they avoid talking about future plans? Are they making references of wanting to escape or that they have nothing to live for? These could be cues that someone is feeling hopeless and may even be entertaining serious thoughts of self-harm.(4) Sometimes the very simple act of reaching out can have a positive impact. A simple call, quick text or expression of gratitude can make difference to someone who feels alone. Here are some tips to offer your patients and your staff: • Let them know that you are there for them and they matter to you. • Acknowledge that the holiday season can be difficult and that it’s OK to feel sad vs happy. • Tell them you are grateful they are in your life. • Remind them that even though this might be a difficult or even painful time, things do change. • Offer to go to the doctor with them or spend time in conversation. • Most importantly, let them know that you love and care for them.(4) You may recall the signs of trafficking and a few of the questions to ask from our earlier articles and you can always ask: • Are you feeling pressured to do something you don’t want to? • How are your friends doing? Are you spending time with them online? • Any new video games you’ve been playing?
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