Covid-related anxiety in children and how parents can help

With many schools returning to in-person learning this fall, there has been a lot of talk about the high levels of stress and anxiety in children and adolescents. While the COVID-19 pandemic has been emotionally challenging for many of us, children and teens may have experienced its effects more acutely due to the uncertainty and constant change. As we conclude the second year of restrictions and significant uncertainty due to COVID-19, we should take time to reflect on the potentially traumatic situations children may encounter to understand the possible ramifications for their mental health.

Stress and anxiety in children & adolescents

Although some kids and teens may prove to be remarkably resilient to the dramatic changes brought on by the pandemic, others could become traumatized by their experiences. In a recent HuffPost article, Talkiatry’s own director of child and adolescent psychiatry, Dr. Ilisse Perlmutter, spoke about how a highly stressful event like the pandemic can affect children, explaining, “After any disaster or traumatic experience, while the wish and hope is for a rapid return to ‘normal,’ the psychological and emotional aftermath greatly exceeds the more defined boundaries of the trauma itself. Children’s reactions may appear immediately…or may not appear for days, weeks, even years.” 

Pandemic-related causes of anxiety

We are always vulnerable to anxiety when our circumstances change. However, often, kids can’t articulate their feelings related to stress and anxiety as they may not fully understand the concepts yet. It’s the parent’s job to pay attention and look for signs that may be present. Below are some factors to consider that may help you assess your child's social, emotional, and mental wellbeing. 

Changes in routine

Since the pandemic began, precautionary measures have changed frequently. As a result, our routines have been disrupted, resulting in children and parents struggling to find a sense of normalcy. Routines are an essential part of development as they provide children with a sense of safety while also helping them develop life skills and build healthy habits. However, due to the uncertainty caused by the pandemic, it can be challenging to maintain consistency in school, social activities, and friendships, which can trigger anxiety in children. 

Separation anxiety

With social distancing recommendations of the past 18 months, families have spent more time together. Although spending more time together has turned out to be beneficial for many families, it may also have the unfortunate side effect of creating unhealthy habits in children. Having spent most of 2020 and 2021 at home, children may have difficulty adjusting to less family time as they return to in-person learning at school. A child with a separation anxiety disorder (SAD) becomes anxious and fearful when separated from their loved ones. Children suffering from separation anxiety may experience significant distress and be unable to enjoy their everyday activities, such as attending school or playing with other children. 

Grief

It’s possible your child or adolescent experienced grief for the first time during the pandemic. Whether these deaths were COVID-19-related or not, traditional grieving processes like funerals or burial services couldn’t occur due to social distancing efforts and official limitations on gatherings and travel. “For the thousands who lost parents, grandparents, and other loved ones, the loss is immeasurable, and grief and bereavement can take many forms,” explained Dr. Perlmutter. The absence of a normal grieving process may seriously impact a child's ability to come to terms with that death, and this may ultimately affect their mental health if they are still struggling with this grief months later.

Symptoms of anxiety in children and adolescents

While coping with the situations listed above, children and adolescents may display various signs and symptoms of anxiety. Even if you cannot pinpoint an event or problem like those listed here, there are psychological and physiological symptoms to be aware of. As a parent, make sure to be observant of your child, so if they're showing any of these symptoms, you can help them get the support they need to overcome their anxiety. 

Signs of anxiety in children and adolescents may differ depending on their age. Here's a list of symptoms and behaviors that may indicate your child is struggling with anxiety, based on age group. 

Symptoms of anxiety in children:

• Regressive behaviors such as thumbsucking, bedwetting, and clinginess
• Nightmares
• Extreme outbursts
• Withdrawn or disengaged
• Nervous habits such as nail-biting
• Extreme sensitivity to parental reactions

Symptoms of anxiety in adolescents:

• Unhealthy eating and sleeping patterns
• Difficulty with attention and concentration
• Withdrawal from social activity
• Avoidance of difficult or new situations
• Dropped grades or refusal to attend school
• Substance use
• Somatic complaints
• Suicidal thoughts

One type of anxiety parents may see their children exhibiting in 2021 is reemergence anxiety. Reemergence anxiety can surface in kids who are still adjusting back to traditional social settings after losing their sense of normalcy during the pandemic. “Children thrive with consistency, and consistency has gone out of the window over the past year,” said licensed clinical social worker Nidhi Tewari, as quoted by HuffPost. 

Children with reemergence anxiety present different symptoms depending on their personalities, but parents should look for the same indicators listed in the previous section. 

Symptoms of reemergence anxiety:

• Changes in behavior
• Fear of separation
• Withdrawal
• Avoidance
• Nervousness
• Worry
  

Keep in mind that with pandemic-related emergence anxiety, children may be experiencing two types of anxiety: anxiety about contracting the virus and anxiety about the constant changes around them. 

Here are some ways children may react to traumatic experiences, like the pandemic:

• Fear for their own and parental safety
• Loss of trust in adults
• Refusal to follow routines
• Antisocial behaviors

Lasting effects of trauma

As society continues to reopen and we return to many of our pre-pandemic activities, it is essential to understand the stress and anxiety children and adolescents face now and be aware of any long-term health effects that may develop in the future. While we don’t know all of the long-term effects the pandemic will have, we know that traumatic experiences often have lasting effects, particularly on children and teens. 

People's reactions to trauma are likely to differ depending on their age when the trauma occurred. A child who experiences a trauma before the age of 8 is particularly vulnerable; other factors include the severity of the trauma and its duration. And while some children and teens may be doing well at this time, parents should be alert to any changes in behavior or long-term effects their children may suffer as we continue to recover from the COVID-19 pandemic.

Potential long-term effects of trauma

• Problems associated with physical health, such as obesity, chronic pain, heart disease, and diabetes. 
• Greater chance of developing mental health disorders such as post-traumatic stress disorder (PTSD), adjustment disorders, substance abuse disorder, depression, anxiety, and insomnia.
• Increased likelihood of turning to unhealthy coping mechanisms, such as drinking and smoking.

How parents (and teachers) can help

Parents must be especially aware of and attentive to their child's mental health. If you’re looking for ways to help your child or teen handle stress and anxiety as they’re heading back to school, physically or virtually, try out the tips below. This is a prime opportunity for you to assist your child in establishing a growth mindset and learning healthy coping mechanisms that will last a lifetime. 

Tip 1: Talk to your child or adolescent

Talk to your kids regularly about how they’re feeling, ask what they’re worried about or what’s making them feel bad--they don’t understand stress and anxiety. Just talking to someone about their problems may help kids feel better--talking is an effective way to deal with stress. 

• Try engaging in an activity while talking. For example, go for a walk, do arts and crafts, or play a game. This will help you and your child feel more comfortable and takes some of the pressure off. 
• When discussing feelings with your child or teen, allow them to express themselves fully before offering comments. Rather than making suggestions, ask if they want help finding a solution or just want to vent. 
• Acknowledge and validate their thoughts, feelings, and reactions. Never tell your child or teen how they “should” feel. Instead, encourage them by letting them know their feelings are real, natural, and ok. Then, allow them to take time to experience and work through those feelings. Be sure to use words and concepts geared towards your child’s age, language, and developmental level.
• Avoid telling them to “get over” an emotion or problem, and instead, think about how you and your child might handle feelings more constructively. Try setting a goal with your child to “get past” bad feelings, making sure you talk through strategies for how this might be done. Depending on the issue, tactics to work past bad feelings might include time, meditation, deep breathing, trying new things, or making new friends. 

For additional guidance on getting the conversation started with a teenager, check out these tips from the CDC’s Parental Resources Kit for adolescents.

Tip 2: Stressbusting strategies

As our daily lives continue to shift, there are several ways parents can help their child or teen learn to cope with anxiety. These strategies will also help prepare your child for a smoother transition back to the classroom.

• Practice stress- and anxiety-reducing strategies like exercise, deep breathing, and meditation. Many free and paid resources exist for learning techniques like this, so don’t hesitate to explore and try different things with your child.
• Spend time together reading, cuddling, listening to music, playing favorite games, etc. 
• Be a source of calming reassurance. Offer extra hugs and make sure your children know you love them unconditionally. 
• Don’t forget to take care of yourself! Dr. Perlmutter says, “It is critical for parents to manage their own distress and worries, as it directly impacts their children’s well-being.”

When to seek professional help

In some cases, your child or teen will need more support than you can offer. For example, if they exhibit signs of depression, adjustment disorders, or other mental health conditions—it’s time to seek outside help from a professional sooner rather than later. In fact, you can use this occasion to teach your children that it is not only ok for them to seek help for their mental and emotional wellbeing but that it is a sign of strength. 

Even (or, especially) if your child or teen gets professional help, make sure to check in with them frequently about their feelings, emotions, and problems. A robust and well-rounded support system made up of family, friends, and professionals can make all the difference in your child’s emotional and mental health. And, whenever possible, Dr. Perlmutter says, “It is most helpful to focus on the resilience of children and to give them many opportunities to return to play and the work of being children.”

Despite many negative and dramatic changes during the past 18 months, one positive was that it made children more confident in dealing with the unknowns. As youths discovered ways to cope with the adverse effects of the pandemic and a time of constant change, they grew and developed resilience. 

How Talkiatry can help

Talkiatry, an outpatient mental health practice, provides diagnosis and treatment plans for children and adolescents to help manage COVID-related stress, anxiety disorders, and symptoms, including psychotherapy and medication. 

Our affordable, in-network psychiatric care model is tailored to meet all your family’s needs. In addition, we offer flexible telemedicine and in-office appointment options to match our therapeutic and modern approach to psychiatric care.

If you believe you or your child are suffering from unusually high stress or an anxiety disorder due to the COVID-19 pandemic, please don’t hesitate to seek treatment from a medical professional. Start the process by taking our free and easy assessment to receive a preliminary diagnosis and better understand the symptoms. You will then be matched with one of our psychiatrists, who will provide you with a customized treatment plan for managing your symptoms.

Take the assessment today to get started.

Talkiatry is a mental health practice, and our clinicians review everything we write. However, articles are never a substitute for professional medical advice, diagnosis, or treatment. If you think you may need mental health help, talk to a psychiatrist. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.