depressed adolescent boyFirst of all, let’s all acknowledge that the Covid19 pandemic of 2020 has had an impact on all of our lives, from the very youngest to the very oldest. And while we as parents and pediatric professionals are justifiably concerned with the effects of the pandemic on our children, we should also be addressing the effects of the pandemic on ourselves. We will be better caregivers and professionals if we take care of ourselves too. 

What does the pandemic look like for our children? (Please note that all of these examples are fictitious, but they bring up some of the issues facing families.)

"Loneliness may be particularly hard on a child that is part of a large friend group, someone that is very outgoing and social."

James is a 5-year-old child who loves soccer and baseball, riding his scooter and playing with his dog. He was in pre-K prior to the pandemic and now participates in school at home. His mother is a stay-at-home parent and his father, a policeman, is an essential worker that works the night shift. James is not used to being indoors and being quiet, but his father needs to sleep during the day before going to work. James’ mother is used to him running around at school and playing soccer in the afternoons, her protected time to get housework done and maybe have a chance to read her favorite novel. Now he is all energy all the time and she needs to help him release it safely. They have been taking lots of walks with the dog, they go to the park to allow him to practice his soccer skills. This all helps with the energy. But James is also worried when his father leaves for work that he won’t come home. He’s become clingy when he used to be pretty independent. And he’s worried that Santa will get Covid19 and die.

depressed teenage girlKate is a 16-year-old high school student aspiring to be an actress. Just before the pandemic hit, she had been cast as the lead in her school’s performance of “The Little Mermaid”. She was very active in dance and vocal classes, had loads of friends, and spoke frequently about moving to New York and performing on Broadway. When the pandemic began, she struggled with online classes along with many of her friends. She had no performance classes and the academic classes were boring. Most of the kids found clever ways to cheat on exams and the teachers were frustrated and out of ideas. Nine months later, she spends most of her time behind closed doors on the computer or her phone texting with her friends. She has lost interest in school and performing. When she does talk to her parents, she no longer talks about the future and her career aspirations. Her parents are worried about her deepening depression, but they are also struggling with finances and trying to make ends meet.

Nate is a 10-year-old in the fifth grade. He has two siblings, one in middle school and one in first grade. They are all participating in remote learning. He is a bit of a science nerd and was really looking forward to being in the science fair this year. He doesn’t really mind being home because he was picked on at school last year. His parents both work from home. His mother helps the youngest after she is done with her workday. The eldest is pretty much on auto pilot. He knows he can ask either parent for help with homework but feels bad because they are already really busy. He tends to keep to himself and stay out of the way. He’s a bit nervous about returning to school in person.

The pandemic has introduced many difficulties into the already difficult job of raising children. There are the health risks, from Covid19 infection as well as the result of decreased access to routine health care. There are increased mental health risks, with many children experiencing new or worsening depression and anxiety. Young children may experience regression in developmental milestones, not sleeping through the night or wetting the bed. Children of all ages may experience their parents’ anxiety, economic hardships, behavioral challenges. Children may worry about their parents getting sick and having to go to the hospital. Those that crave social interaction have a difficult time quarantining and those that have social anxiety fear leaving quarantine. Whether taken individually or collectively, these all seem like insurmountable challenges. What can we do to help?

Even though children are not “little adults”, it is just as important to maintain communication with them as it is with friends, family, and colleagues. It is okay to discuss your feelings with your child using age-appropriate language, but don’t forget to include the ways you plan to tackle the challenges you face. Ask your child what challenges they might have and brainstorm ways to address each one. Small steps are easier to manage than big steps, so sometimes the answer may be a series of actions. You may even want to add a small reward after each step has been successfully completed. 

Everyone needs some form of exercise, whether it’s jumping jacks, yoga, running on the treadmill, riding bikes, or taking a long walk around the neighborhood. Make sure you are giving your children breaks during the day (as their classes allow) to stretch and move. And when class is done for the day, before homework or other sedentary activities, do something active with your children. If weather doesn’t permit outdoor activity, find things online or create your own routine. parenting in pandemic

Loneliness may be particularly hard on a child that is part of a large friend group, someone that is very outgoing and social. Social interactions certainly look different right now, but it is still possible to stay in contact with friends via online meet ups and video chatting. Although this may be a bit difficult, allow your child some privacy with friends so they can talk about the things that interest them or are important to them. As our children get older, it is natural for them to seek out support from peers rather than family members, and privacy allows for open conversations. Loneliness not only affects those that are very outgoing and social, it also affects those that are quiet and keep to themselves. The middle child that doesn’t demand any attention, stays in their room all the time, does not want to bother anyone … that child is also lonely. Even if the younger children need more support with school activities, make sure to touch base with all of your children throughout the day. And remind your child that if ever a friend mentions an intent or thought to hurt themselves or others, it is essential to let a trusted adult know. 

Consider making a family toolkit with your children, a special box or container decorated by all of you that includes the things that help you to calm and feel better. Examples might include a squeeze ball, chewing gum, a special blanket or pillow or stuffed animal, a beloved book, some essential oils, chocolate or other special treats. Openly use the things in the box when you are feeling stressed, asking your child(ren) if they need something from the box too. This can open dialogue about stress management strategies and how you can help each other. 

There are a lot of opportunities online right now for those interested in science, the arts, cooking, whatever. There are dance classes, photography classes, writing classes, acting classes. A lot of professionals are donating their time to provide interesting content. Sit down with your child and look around for online opportunities. You might even find something that interests you. If you have space outdoors, create a garden with your children. Give each child a job in the garden based on their interests and take time throughout the week to work in the garden. If the garden is productive, guide your children in preparing gifts from the garden for elderly neighbors.

Holidays are definitely different this year. No large family gatherings, gift exchanges at school, Christmas pageants, or the like. But this does not mean that the season has to be any less joyful. Contact your religious affiliation to see if they are taking collections to give to those less fortunate. Create new family traditions by making gift bags or plates of cookies for elderly neighbors. Become the “Secret Santa” for your block by putting a basket of canned goods and other necessary items (eg hand sanitizer, toilet paper) on each neighbor’s porch. Helping others helps our children to manage stress and disappointment. 

Now you’ll notice that all of the kids in the examples above have a home and two parents. They aren’t struggling with abuse at home or lacking enough food to eat. None of them has special needs, like autism or ADHD or cerebral palsy. The parents aren’t addicts or severely mentally ill. Their parents accept them for who they are, without gender or sexual preference concerns. Any and all of these situations severely worsen the impact the pandemic has on our youth. If any of these is your situation or your child’s situation, seek the help of your school counselors or teachers, clergy, extended family, friends or friends’ families, coaches, doctor or therapist, someone with whom you can talk honestly and comfortably. 

The American Academy of Pediatrics has a number of resources on the website to help parents and professionals with issues arising during the pandemic. 

Kari Kassir, MD

Kari Kassir, MD

Pediatrics / Adolescent Medicine

I have been a hospital-based pediatrician for many years, taking care of all ages, from premature infants to young adults, in all types of circumstances. I particularly enjoy working with adolescents and young adults, helping to manage the full gamut of issues facing young people including anxiety and depression, gender fluidity and LGBTQ concerns, eating disorders, family relationships, autism/Aspergers, chronic illnesses (cancer, POTS, EDS), transitions from middle school to high school to college, substance use, and general health and wellness. I'm a mom to two young men ages 18 and 20 and a  red mini poodle. All of our experiences have helped to expand the scope of my practice. I have loads of interests including gardening, writing, yoga, music, and theatre. I seek to keep an open mind and help whenever I can.

I am accepting patients to my virtual practice at Cirrus Medical Network. To get started click here.