How COVID-19 will affect children's long-term mental health

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If you're worried about how your children will weather the storm of the coronavirus, you're not alone. Here's what you need to know about protecting their mental health now and in the future.

For the most part, kids are resilient and tend to bounce back from adversity easier than adults, experts say. But that doesn't mean tragedy and trauma can't leave their marks on kids. And in the wake of the COVID-19 pandemic, many parents are left wondering if months of isolation, lack of structured schooling, and the potential loss of loved ones will have long-lasting mental health implications for their children.

COVID-19 is "this great unknown," says Robin Gurwitch, Ph.D., professor of psychology at Duke University Medical Center. "We don't know how long this is going to last." And that can heighten anxiety in children, as it can for adults.

While it's uncertain how long anxiety will last after the pandemic is over, experts say parents and caregivers can play a role in preventing long-term mental health issues. The first step is understanding how kids are affected by the world right now.

Kids are feeling the impact

Children aren't becoming sick from the coronavirus in the same numbers as adults, so the fear of contracting the virus isn't the biggest driver of anxiety for them. What's affecting them most is the new normal they are living through.

"Children certainly are being impacted by this because it's changed their worlds," says Dr. Gurwitch. That's especially true if they've had sick family members or loved ones who have died. And the loss of routine and the inability to socialize with friends can add to the feelings of anxiety and upheaval they're experiencing.

Past public crises show that children can suffer mental strain. Children survivors of Hurricane Katrina, for example, showed symptoms of disruptive behavior disorder, as well as mood and anxiety disorders, and many needed intensive case management up to four years after the storm.

But as with any large-scale crisis, members of marginalized communities will be more likely to develop lasting mental health concerns as a result of the coronavirus pandemic. With an increase in job and food insecurity, "disadvantaged people that were disadvantaged before COVID-19 will be further disadvantaged after COVID-19," says Dr. Gurwitch. "And that has a trickle-down to children. If I am unsure of my living situation, if I'm unsure about food—all of that takes a toll and creates greater risk for mental health problems."

How can parents help?

The good news is that as parents and caregivers, it's in our direct power to lessen the impact of this upheaval on our kids. "Just because kids are resilient doesn't mean we don't need to do anything to help them," says Dr. Gurwitch. "The majority of children are resilient because we, their trusted parents or caregivers, do something."

Jennifer Johnston-Jones, Ph.D., a California-based psychologist and author of Transformational Parenting says how we parent during the pandemic is the most important indicator. "The long-term mental health effects on children from the pandemic will vary. How we choose to parent during the pandemic will determine if our children come out of this traumatized, or able to sense that they will be OK," she says.

Regardless of their age, adds Dr. Johnston-Jones, children look to their parents as a guide. Here are ways to help them through the pandemic.

Focus on the positive

Research shows focusing on the positive and gratitude can improve mental health, help with sleep, and increase optimism. And even in times of stress and fear like what we're experiencing with the COVID-19 pandemic, there are still opportunities to elevate positive experiences.

Dr. Johnston-Jones suggests making a game of it. "Play the 'glad game'—where we try to find something to be glad about in every situation. This positive thinking game became well known in the 1913 novel Pollyanna by Eleanor H. Porter where Pollyanna is able to find the good in the most challenging situations," says Dr. Johnston-Jones.

Validate Your Children's Feelings

Supporting kids through the pandemic can take many shapes and look different for every family, but the most important thing we can all do is to be proactive in asking them how they're feeling, listen when they express their feelings, and validate those thoughts.

And don't hide your own feelings either. If you have a cry in the kitchen, don't run off and put yourself together and act like it never happened, says Dr. Gurwitch. Acknowledge that it's a hard, scary time, that we're all feeling a little scared and anxious right now, and that's OK. But reassure your kids that your family is handling it together, as a team.

Teens and tweens are better at hiding their feelings so parents may have to work a bit harder to break the shell, but don't give up and assume they're OK just because they may be putting on a brave face. After all, they still need reassurance from their trusted adults.

Make a Plan

After you've talked to your kids about how they're feeling, it's important to talk about all the ways you're staying safe and how you can help those around you. "When worry can fester on its own without any action steps for how to relieve that worry or anxiety, it can overwhelm us and our children," says Dr. Gurwitch.

Talk to your kids about what can be done, like staying home to keep your family and other people you care about safe, as well as washing their hands for 20 seconds.

From there, come up with some things you can do at home to help. Whether it's chalk drawings on the sidewalk or signs in the windows, sending a letter to grandparents, or thank you notes to first responders and health care workers, letting children feel like they are helping is important, says Dr. Gurwitch.

Encourage Social Interaction

With kids out of school for a long stretch of time and not being able to spend time with friends, it's critical for parents to recognize how important those social interactions still are to them. With tweens and teens, who are able to text and video chat without help or encouragement, parents can take a step back, aside from making sure they're staying safe online.

But elementary and preschool-age children, who still miss their friends, may not have the same ability to just pick up their phone and text their BFF. Parents can help by facilitating some sort of virtual interaction by helping them FaceTime with their school friends.

Monitor Them After the Pandemic

Once we've established a new normal and the immediate threat of the pandemic has subsided, parents should continue to pay attention to their child's emotions. Experts say to look out for signs of lingering trauma like withdrawal, anxiety and fear, sleep disturbances, and changes in eating habits.

Therapy is always a valid choice, but after a global crisis it may be more important than ever for children to learn how to process their emotions and resume a normal life.

The bottom line

Kids are resilient and they can come out of the COVID-19 pandemic feeling reassured as long as parents and caregivers help them through it. Make sure to validate their feelings, explain how they are making a difference by just staying home, and help them keep their social interactions strong. Don't hesitate to reach out for professional help either.

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