How can you help your children with their mental health?

School closures. Family tensions. Isolated and quarantined friends. Even when young people have not experienced COVID-19 directly, the pandemic has put their mental health to the test. And often, in serious ways.

Even before the recent spate of omicron-related cases, a coalition that included the American Academy of Pediatrics declared a national child and adolescent mental health emergency. In his October statement, he reported on “increasing rates of mental health problems among children and adolescents and their families.”

In December, US Surgeon General Dr. Vivek Murthy addressed the crisis with a report stating that young people face “devastating” mental health issues.

All of these elements can cause parents to ask some important questions.

Which children are at risk?

“Children and adolescents are going through a lot,” said psychiatric epidemiologist Karestan Koenen, a professor at the Harvard TH Chan School of Public Health in Boston. Tweens and teens seem to have been especially hard hit.

He noted that “the greatest risk is that there was any type of previous mental health problem,” such as anxiety, depression or attention deficit hyperactivity disorder.

The surgeon general’s recommendation explains that youth of various racial and ethnic groups are also at increased risk. For example, black youth were more likely to have lost a parent or caregiver to COVID-19, compared to their peers. Asian American, Native Hawaiian, and Pacific Islander youth reported increased stress due to COVID-19-related hate and bullying.

What particular stresses do children face?

During a crisis, children lack the adult advantage in resilience, said Dr. Rebekah Fenton, a Chicago pediatrician. “For many of them, this could be the first big thing they live.”

Children may deal with “stress from losing family members or fear of loved ones getting sick,” he added.

Furthermore, your concerns may also not be obvious from an adult’s point of view.

Koenen recalls that when students were rushed home in March 2020, when the coronavirus first spread, her seventh-grade son’s main concern was the due date of a project he was due. be working in class.

Also, we have the mess of learning with different modes and techniques, Koenen said. “A friend told me that his daughter started high school three times,” bouncing between in-person, hybrid, and distance learning, each with a different set of teachers and peers.

He added that the changes were especially hard for children with learning disabilities, who may depend on the structure that schools usually offer.

Young people can also absorb stress from their parents, he said, who are struggling with their own jobs or how to organize schooling at home.

What is the effect of all that stress and worry?

A global analysis of youth published in JAMA Pediatrics found that depressive and anxiety symptoms doubled during the pandemic, with 25% depressive symptoms and 20% anxiety symptoms.

Statistics from the Centers for Disease Control and Prevention revealed that as of early 2021, US emergency room visits for suspected suicide attempts averaged 856 per week for girls aged 12 to 17 and 196 per week for boys of the same age. That was 50.6% higher for girls and 3.7% higher for boys compared to the equivalent period in early 2019.

“There are people who have never had experiences with mood issues, like depression or anxiety, who are now struggling with those things,” Fenton said. “Others had it to a lesser degree, which seemed manageable, but now they feel it bad enough to need therapy or medication.”

What should parents watch for?

Stress and anxiety can take many forms. Fenton, for example, has seen children who say they feel tightness in the chest or have trouble breathing, or that they had elevated heart rates related to anxiety and high blood pressure.

The issues aren’t always so clear cut, said Koenen, whose son is 14. She acknowledges that it can be difficult for a parent to distinguish normal teen moodiness from a problem that needs professional help.

For her, it all comes down to how much the behavior interferes with her day-to-day functioning. It would be normal, for example, for a child who played sports to feel discouraged if the matches were cancelled; and, “It’s normal for teens to want to spend a lot of time alone in their room and stuff. But if they’re more withdrawn, or not eating, or expressing their own distress, then you have to take them seriously,” Koenen said.

Fenton’s warning signs would include a teen who:

‒ is spending more time on your phone with activities other than connecting with friends;

‒ seems sadder or more anxious, or has new physical complaints; or

‒ is developing anxieties about food or your body.

The American Academy of Pediatrics lists other symptoms of distress at healthychildren.org.

How can parents comment on their concerns?

“You can always start by asking questions openly about it and recognizing that a lot of these things don’t have easy answers,” Fenton said.

It is not about finding an immediate solution, but about listening, and “keeping the lines of communication open so that adolescents can recognize that their parents are someone who is there for when they are ready to talk.”

What else can parents do?

Be supportive. New information published in the Journal of Adolescent Health suggests that supportive relationships with family and friends, as well as healthy behaviors such as physical activity and improved sleep, may protect adolescent mental health during the pandemic. A study published in the journal European Child and Adolescent Psychiatry last July also highlighted the importance of good sleep habits, spending less screen time and connecting with parents.

Koenen said that parents should also take care of themselves “because that will help our children.” One of the biggest predictors of depression and anxiety in children is a parent’s own mental health and distress, she added.

The Surgeon General’s Report offers online resources for youth, parents, professionals, and educators. For someone in crisis, the National Suicide Prevention Lifeline offers immediate help at 800-273-8255 or at suicidepreventionlifeline.org/help-yourself/en-espanol. The crisis line number is scheduled to be reduced to three digits – 988 – in July.

Koenen said mental health services are overwhelmed right now, but pediatricians are a good place to start. Many health insurance plans offer options for mental health services, which can also be provided through employee assistance programs. Accessing services by video or phone could be an option.

“My role is really to listen first and see if there’s any support that I can offer,” Fenton said. Often, the consultations “are the first time that adolescents tell me that they have had suicidal thoughts or that they have harmed themselves.”

From there, one could talk about the value of therapy or medication.

Fenton also talks about the value of getting vaccinated against COVID-19, which allows as much freedom as possible at this time, and relieves a major source of stress.

Hope must also be maintained, he added. She has seen patients who are supported and now thrive, or at least find their way. “That cheers me up a lot,” she said. “Is working”.

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