By Dr Sheri Fanaroff MBBCh FCFP MFamMed, a Family Physician, practicing in Melrose, Johannesburg. Fanaroff is a member of GGPC (Gauteng General Practitioners Collaboration) which has created a platform for doctors to share resources during Covid-19. Look for #voicesthatcare on the GGPC Facebook page.
Just like adults, children (both big and small) are also experiencing anxiety during these unusual times. It is crucial that we keep a check on our kids mental health during Covid-19.
Let’s identify why they may be experiencing anxiety and then look at ways of keeping them mentally fit.
What is causing anxiety in children?
- Being off school
- Going back to school after a prolonged absence
- Social isolation (not seeing or being allowed play dates with friends)
- Missing grandparents, cousins and extended family
- Limited play
- Worry about getting sick
- Worry about parents or grandparents getting sick
- Stress about completing academic year
- Anger and frustration about missing out on parties, dances, sporting and cultural events
- Academic pressure (from parents and from school)
- Online schooling
- Large amounts of schoolwork
- Looming exams and deadlines
- Picking up on parental anxiety
How kids respond to anxiety
Some level of anxiety and sadness in children at this time is completely normal. Children’s response to anxiety will depend on their developmental stage, their previous level of function and how the adults around them respond.
•Very young kids
Very young children tend to feel overwhelmed by sensing their parents’ anxiety. This may present with regressed infant-like behaviours eg. being more clingy, not wanting to sleep alone, toilet training regression. Often anxious children in this age group experience a change in eating or sleeping habits. These behaviours indicate their need to be protected.
•Primary school children
Primary school children may also display regressive behavior. They can also present with somatic symptoms (sore tummies, headaches, vague aches and pains). Kids may be more irritable or emotional with excessive crying. Sometimes school performance suffers and some children do everything in their power to avoid school. Children with OCD may have obsessions and compulsions around hand washing and fears of becoming contaminated.
•Adolescents (and preteens)
Adolescents can also present with behavioral disturbances. This may manifest as acting out and irritable behaviours, as they attempt to express their frustration and they may become oppositional and defiant. But just as worrying is a teen who becomes more withdrawn than usual. Look out for difficulties in concentration and attention, excessive sadness or worry and avoidance of activities they used to enjoy. There is a risk that the teen will turn to alcohol, tobacco or drugs to self-medicate.
Teens with ADHD may find planning and keeping a routine at home challenging. Restricted movements and activities may cause restlessness and lack of freedom may exacerbate frustration.
How to deal with this anxiety
Parents are often tempted to try to keep life as normal as possible for their children and to keep going as though nothing has changed. Even young children are very aware of COVID or at least that life has changed drastically. To keep kids mental health during Covid-19 positive, try to:
- Be open and provide age appropriate information about the virus.
- Listen to what they are feeling.
- Let them know it’s ok if they feel upset.
- Validate their feelings with clear simple messages.
- Be empathetic rather than punitive.
- Respond directly about how you can work together to make the situation more bearable.
- Reassure your child that they are safe.
Remember that they will absorb and mimic your behaviour. Share with them how you deal with your own stress so that they can learn from you how to cope. If you feel you need some extra help, ask your GP or health care provider ; your child may benefit from referral to a child psychologist or play therapist.
Healthy habits to protect kids mental health during Covid-19
• Get enough sleep.
• Eat healthy meals.
• Exercise regularly.
• Keep a consistent schedule with predictable wake up times and bedtimes.
• Make realistic schedules for completing work with enough time for breaks and relaxation.
• Limit your family’s exposure to news coverage of the pandemic, including social media. Children may misinterpret what they hear and be frightened about things they don’t fully understand.
• Be a role model for your child – take breaks, get plenty of sleep, exercise, eat well and connect with friends and family.
• Spend time with your child engaging in meaningful activities- reading together, exercising, playing board games.
• Loosen restrictions on social media within reason; it is important for them to be able to connect with their peers. Be flexible with schedules and change them if they are creating anxiety.
Red flags to watch out for in kids and teens
• Suicidal ideation (talking about suicide/ death)
• Self harm
• Violent acting out
• Delusions (firmly held false beliefs)
• Altered functioning (not managing school or activities of daily living)
**Seek help if they are displaying any of these symptoms** – consult your GP, a psychologist or a psychiatrist.
Take home message
Let’s keep our perspective. Take things day by day and week by week. These challenging times will pass. Meanwhile, be patient with and kind to your kids and yourself. Schoolwork will be caught up and activities will resume.
Reassure your children and ensure that they feel safe and loved. Hopefully they will associate this time in their lives with happy memories of time spent with family.
Find very useful advise about ways to cope and protect yourself, your family and your community in these articles written by concerned Gauteng doctors:
- So you have Covid-19. Now what? By Dr Karin Van Der Merwe and Dr Varanna Dogan
- Someone in your home tests positive for Covid-19. Dr Daniel Israel
- Are you having Corona over for coffee? Dr Daniel Isreal
- Coronavirus Parties- a bad idea Dr Sheri Fanaroff
- Quarantine: When and how to do it? Dr Isabel Thompson
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