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Navigating back to school brings anxiety

How to care for kids’ mental health in the midst of a pandemic
Sunday, August 23, 2020

The uncertainty and constant changes experienced in a pandemic exacerbates mental health struggles for children just as much, if not more than adults.

Austin Regional Clinic’s pediatrician Dr. James Anderson says their limited life perspective may mean that these disappointments will play a bigger role in the shaping of a generation. It’s also a huge learning opportunity for time management and taking care of mental health at an early age.

As a sub-specialist in mental and behavioral health issues, Anderson says there is a lot parents can do to catch changes in mental health early and approach the new normal in a healthy way, especially as kids prepare for the start of school.

Once parents and doctors learned that children were at lower risk of contracting COVID-19, an initial worry subsided. As schools closed and spring breaks were extended, Anderson said many kids with anxiety and depression felt better with a much needed break.

But as the stay-at-home orders dragged on and activities were gradually canceled, some kids experienced anxiety and depression for the first time from a new source; uncertainty and disappointment.

“It’s the stress of not knowing,” Anderson said. “Am I going to be virtual? In person? Partially remote? Will I get to see my friends? The kids are thinking this was supposed to be 2-4 weeks.”

Many kids, especially those with ADHD, struggle with remote learning. Learning from home involves making a schedule, organizing and managing free time, something that had always been taken care of by a teacher and that many kids learn for the first time when they start college.

“They have had things taken away and had uncertainty of when the school year is going to start,” said Anderson. “With people changing their minds frequently and continuing to take things away, they can get really depressed and anxious because they don’t know what the future holds.”

Students are unsure whether they will have to finish a year of school at home or if they will ever play their sport again. Many students looked forward to returning to campus even in a semi-limited capacity because they need socialization.

Elementary school students are not as affected by anxiety and depression as middle school and high school students. They miss their friends and sports but usually can fulfill their social needs at home with their family and in their neighborhood in smaller groups.

Teenagers, however, are at a developmental stage where they are looking to rely more on friendships amongst peers and are starting to step out independently by trying new activities and discovering passions. Online learning doesn’t allow them to do that easily.

“Teenagers are looking about 6-12 months ahead. They don’t have the life experience to know that we will get past this with a new norm,” said Anderson. “They are stopping looking forward to things because they are expected to have more disappointment and there is a risk of shaping a generation that expects disappointment.”

Every time dates get pushed back and normal changes yet again, it’s a sense of loss and disappointment. The pandemic has taken away what mattered to high school students: education and friends. School was synonymous with purpose for many. The repetition of things being taken away and uncertainty about the future leaves kids feeling depressed and anxious in an almost post-traumatic-stress-disorder type of reaction.

Anderson also says a constant stream of negative press related to the pandemic is also a common source of anxiety for kids, as well as adults. He recommends turning off the 24 hour news cycle and wisely choosing a few reliable sources to check in on the news once a day.

To prevent these mental health issues, Anderson recommends taking things day by day. Acknowledging that kids need socialization, he recommends trying socially distant activities outside.

For the stress of working remotely, he challenges students to make the day how they want it to be by breaking the day down into the categories of classes, exercise, social time and physical and mental rest.

“Give them that power back,” Anderson said. “Ask your kids ‘What would the day look like if you could have the best day ever?’ Let’s not let this take control of us, let’s take control of it.”

The unique opportunity of learning to take care of mental health at a young age will help kids for the rest of their lives.

He encourages talking about fears, helping them understand anxiety and finding answers if possible.

Reframing being at home as time to come together as a family and communicate more often can have a positive effect on everyone’s mental health.

Parents should look out for when kids stop doing things they normally enjoy, or appear to get less joy out of those things. Being withdrawn, spending excessive time alone in their room, staying up late at night and sleeping all day, looking sad in appearance, crying more, talking less and keeping to themselves more are all signs of anxiety or depression.

A good way to approach kids when they might be anxious or depressed is to show you are bringing it up because you care, Anderson says. Something to the effect of, “To me you seem sad, and very down, and I don’t want you to be sad. I’m worried about you being sad. ”

Anderson recommends offering to see your family physician or pediatrician; during an annual checkup is a good time. Many physicians don’t feel comfortable treating anxiety and depression but some do. The ones who don’t may refer you to a psychologist or psychiatrist. Its important in these cases to find a doctor the child works well with.

“I would go sooner rather than later,” said Anderson. “I don’t think people realize the significance of the negative impact of anxiety and depression on children, particularly in preadolescence. They don’t talk to us much that age. If there is any indication that they are depressed, we need to act on that because a lot of kids will try to manage it themselves, self-medicating with drinking alcohol, cigarettes or marijuana.”

Anderson says just as mental health issues come and go for a season, sometimes it may call for medication for a season, sometimes for a short time and sometimes for a longer time.

For parents who are worried about medication, Anderson says to think about how your child felt before they were anxious or depressed, and understand that the medication is not meant to make kids feel different from themselves, but is meant to make them feel like their normal selves without the anxiety or depression.

Cognitive behavioral therapy is a non-medication option to talk with a doctor about, that parents can work on together with their kids.

On returning to school, Anderson is optimistic about the effect on kids’ mental health. “I think they are going to be happy to be back with their friends, once the school work starts, there is going to be an increased vigor and eagerness to learn and be part of the school. There will be a resurgence of kids wanting to go back and learn and be part of the school.”


Twitter: @StephJGates

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