Children and the COVID-19 pandemic: the psychological impacts

mother putting a face mask on her son
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The COVID-19 pandemic has dramatically changed the lives of people all around the world. From state lockdowns to school shutdowns to the loss of social contacts with loved ones, the pandemic has made a deep and long-lasting impact on how we live and interact with each other.

Black and Brown communities have been particularly hit hard both from the perspective of illness and loss of life to impacts on livelihood. Many have lost their jobs with the subsequent financial strain and inability to pay their rent or mortgage. This for some has increased their risk of becoming homeless. Shutdowns and school closures have meant that families have been cooped up in their homes, with the stress that this brings.

Children are particularly vulnerable and may have difficulty coping with all the emotional strain. Online school, especially where there is limited access to broadband Internet or computers in the home, has meant some children having to do assignments on their phones.

School closures have also meant less access to friends and an increased sense of isolation. For those young people who struggle with mental illness, the pandemic has been particularly hard. We have seen more admissions for mental health crises and even for attempted suicide.

The increased stress that has been brought by the pandemic and the impact on mental health means that it is important for parents to keep an eye on their children and watch for signs that they may be struggling. It is far too easy to get caught up with all the day-to-day struggles that we can miss the signs that our children need help.

The American Academy of Pediatrics (AAP) describes these signs of stress, which vary across age groups. For instance, younger children may become fussier, cry more easily, and be more difficult to console. They may have difficulty sleeping or start wetting the bed after already being potty-trained. They may also become more aggressive when playing.

Older children and teenagers may become more withdrawn and less interested in activities that they used to enjoy. Their academic performance may worsen. They may engage in risky behaviors like taking drugs or alcohol. They may also become less interested in eating and may even show evidence of depression and express suicidal ideation.

What can parents do?

To get through this, the AAP has some recommendations. First and foremost, it is important to talk to your children and listen to their concerns. Sometimes older children may be more open to speaking with a family friend or close relative about their worries and concerns.

It is important to encourage our children to exercise. Several studies have revealed the negative effects of the pandemic. COVID-19 restrictions such as the closure of schools and parks and the cancellation of youth sports and activity classes have reduced the level of activity that children engage in. In the long-term, this has the potential to increase obesity, diabetes, and cardiovascular disease. In the short term, this results in missing out on some important benefits of exercise. For instance, when we exercise, our bodies release chemicals called endorphins that bring a sense of well-being.

Volunteering time to help others, even doing little things like calling a friend or neighbor who is alone to give them some encouragement can help. Urge your children to do at least one kind act a day.

It is important to manage screen time. This is difficult, especially since screens are now a way of life and how we work and children go to school or even go to doctor visits. Screens are also the source of less healthy types of information. Parents should become familiar with how electronic devices can help create and maintain healthy social connections with educational programs, work, friends, and family members.

Working with your child’s pediatrician is essential. Pediatricians can screen for depression and talk to children about other concerns including anxiety or trouble coping with stress. The doctor may also ask about these symptoms in other family members since this can impact your child’s health, and whether they know anyone who has become sick with COVID-19. Teenagers may need additional privacy during the doctor’s visit to ensure they have the chance to speak as openly as possible.

Note that pediatricians are taking all the necessary precautions to make in-person visits safe during the pandemic, and many are also providing telehealth visits.

Increased risk of suicide

The AAP also recommends additional screening for suicide during this period of high stress. Rates of suicide for both adolescents and adults increase during these times. Your pediatrician can help screen for suicide risk. Any talk about suicide must be taken seriously. If you are worried about your child, it is important to make your home safe by removing firearms from the house and locking away medications.

Seek help immediately by calling the National Suicide Prevention Lifeline at 1-800-273-TALK or by texting the Crisis Text Line by texting “TALK” to 741741. Call 911 in emergency situations where self-harming actions are imminent. In non-crisis situations, talk with your pediatrician about any concerns you have about your child’s mental health.​

Dr. Kiragu is a passionate advocate for children and is a past president of the Minnesota Chapter of the American Academy of Pediatrics and a past president of the Minnesota Association of Black Physicians. He is an associate professor of pediatrics at the University of Minnesota.