Q: My children are having a hard time as the pandemic continues. What are the signs that they need more support, and how can I help?
A: The ongoing stress, fear, sadness and uncertainty of COVID-19 has weighed on all of us. Many children and teens have also had a hard time dealing with it.
More than 120,000 children in the United States have lost a primary caregiver to a COVID-19-associated death. Many have lost their jobs and many are facing financial difficulties due to the pandemic. There are also uneven effects of the pandemic on black and brown people and increased racism and xenophobia towards Asian families.
The usual support for children, such as school, health care and community, was also interrupted in many cases. Check in with your children regularly and watch and listen for signs that they are having a hard time. Invite your children to share how they feel. Feeling depressed, hopeless, anxious and angry can be normal reactions to stress. However, if these feelings are constant and overwhelming, or if they affect your child’s ability to continue doing what they usually do (such as going to school, finishing their work, or having fun), these may be signs that they are more need support. Keep in mind that younger children may not know how to talk about these feelings but may show changes in their behavior or development. Teens and young adults may try to hide their feelings out of shame or because they don’t want to bother others.
Signs of stress and mental health problems are not the same for every child or teen, but there are some common symptoms. Young children may begin to behave as they did when they were younger. They may also have more problems with:
— Worry and irritability, easier to cry and harder to calm down.
– Fall asleep and wake up more during the night
— Feeding problems, such as increased nausea/vomiting, constipation or loose stools, or new complaints of stomach pain
— Anxiety when they have to separate from their family, affectionate, unwillingness to socialize and fear of going outside
— Hitting, being frustrated, biting and more tantrums
— Wetting the bed after they are toilet trained
– Aggressive behavior
Older children and teens may show signs of anxiety with symptoms such as:
– mood swings that are not common, such as persistent irritability, feelings of hopelessness or anger, and frequent fights with friends and family
— Changes in behavior, such as distancing from personal relationships. For example, your outgoing teen doesn’t spend time texting friends or video chatting.
— A loss of interest in activities they used to enjoy. Has your music-loving child suddenly stopped listening to music?
— Difficulty falling asleep or staying asleep, or sleeping a lot
— Changes in appetite, weight, or eating habits, such as never being hungry or eating all the time
— Problems with memory, thinking or concentration
— Less interest in schoolwork and lower grades
— Changes in appearance, or they stop taking care of their hygiene
— An increase in risky or reckless behavior, such as using drugs or alcohol
— Thoughts of death or suicide, or talking about it
Your pediatrician can advise you on ways to best support your child and help them build resilience, which is “the ability to deal with and recover from stress.” Always contact your child, ask him how he is feeling and remind him that you are there to talk if he wants to and/or when he is ready.
Some children or teens may need more time and space to express their feelings. Some may do better with gradual conversations and other activities besides talking, such as painting, drawing, or physical activity to manage stress. Others may feel more comfortable with direct conversations or activities.
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 give consistent and hopeful messages. It helps to set aside a few minutes each day to take care of yourself. This will help you, your child and your entire family in the long run.
If you’re concerned, ask your pediatrician’s office to monitor your child’s social and emotional health.
ABOUT THE WRITER
dr. Evelyn Berger-Jenkins is a general academic pediatrician in New York City and a member of the AAP Committee on the Psychosocial Aspects of Child and Family Health. For more information, visit HealthyChildren.org, the AAP’s parent website
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