Ask the Pediatrician: Mar/Apr 2021

Our mental health has been dramatically challenged over the last year. This is true for adults, adolescents. and children alike. Pediatricians will attest that they are seeing a marked increase in anxiety and depression-related symptoms over the last 10 or 11 months. This comes on top of a steady rise in anxiety and depression in children and teenagers over the last several decades.

Children and adolescents can manifest anxiety in a variety of ways, some age-dependent. Infants, toddlers, and young children may show backward progress in skills and developmental milestones. An infant may wake more at night, and a child who is potty trained may have an increase in bedwetting. Babies may be fussier and more irritable, startling and crying more easily. Separation anxiety may be more pronounced, and toddlers may seem more clingy or hesitant to explore. Tantrums, hitting, and biting may increase as young children become more easily frustrated.

Older children and teens may be able to express their feelings of hopelessness or rage and may seem moodier and more irritable. Anxiety or depression may also show up in more subtle ways. Preteens and teens may display a loss of interest in activities they previously enjoyed or may withdraw from previously cherished personal relationships and friendships. They may forgo basic personal hygiene. There may be marked changes in sleep—either difficulty falling or staying asleep or wanting to sleep throughout the day. Similarly, eating habits may change dramatically and may range from eating all the time to never being hungry and barely
eating at all. Problems with memory, thinking, or concentration can be a sign of depression or anxiety and can manifest as a drop in grades or academic effort. Drug or alcohol use may escalate, and suicidal thoughts may emerge.

Be sure to stay in touch with your child’s pediatrician during this stressful time. Most pediatricians are seeing patients in their offices now, and if you have been avoiding a visit due to quarantine, it is time to consider one. Your pediatrician can screen for mental health issues like anxiety and depression and offer abundant local resources to help should a problem be identified.

On its website healthychildren.org, the American Academy of Pediatrics offers the following recommendations for parents to support their children’s mental health during this difficult time:

Answer questions about the pandemic simply, honestly, and in an age-appropriate way. Make sure to convey that even though there are scary consequences of this pandemic, we know that masks, social distancing, and handwashing help.

Recognize and acknowledge your child’s feelings. Here, the focus should be on listening and trying to understand how they are feeling rather than trying to “make them happy.”

Model how to manage feelings.

Keep healthy daily routines. Unpredictability breeds anxiety. For children of any age, routines help mitigate this unpredictability and create a sense of order to the day that offers reassurance in a very uncertain time.

Take care of yourself. Caregivers should be sure to take care of themselves physically: eat healthy, exercise, and get enough sleep. Find ways to decompress and take breaks. If more than one parent is home, take turns watching the children if possible.