How does COVID-19 anxiety impact children?

Coronavirus is a serious threat that may not come to your home – your family may be spared the disease. Sheltering in place during community lockdown may protect you and your kids from the risk of infection. However, the pandemic impact will ripple out beyond physical health to financial reality and emotional overload. The most vulnerable populations are the very old and the very young. People are social distancing to protect the medical health of the very old. Parents and teachers need to understand the urgency to protect the mental health of themselves and the very young.

Children look to their parents for cues on how to relate to their world. When parents are highly stressed, their children feel stressed. Coronavirus can scare children now, which could create emotional problems for months or even years to come. If a child feels overwhelmed by a continual flow of sad or scary news, they don’t understand it leads to confusion about how the world as they know it has changed. This is especially troubling with young children who don’t have the life experience or vocabulary to tell the adults in their life what hurts. Talking about emotions is essential for mental health. Think of the wisdom given by Mister Rogers to children,

“Anything that's human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting and less scary.”

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Bottled emotions don’t go away, they either blow in toward emotional fears, or blow up into angry or acting out behavior. In older kids these fears can lead to anxiety, depression or self-destructive behaviors like drugs, alcohol or even suicide. COVID-19 will go away. The Centers for Disease Control or World Health Organization will eventually find a vaccine, but untreated psychological damage won’t go away and could go on for years. Parents and teachers need to know what to do to prevent that from happening now. Here’s the first challenge.

Get down to the level of your child to gain perspective

Think about the life of a five-year-old this school year. Leaving mom and dad to go to school for the first time. Then getting used to sitting in a desk, lining up to go to the lunch or recess and then pick up line to answer the predictable question when they get into the van, “what did you learn in school today?” Now those patterns have stopped and these kids are back at home with parents who may be on emotional overload with working from home to keep a job, or fighting with each other about money or the frustration of not being able to manage all the details of a culture changing by the day.

A five-year-old doesn’t know how to handle their parents being a ‘hot mess’. Children can’t speak up to say, ‘could you calm down?’ to their parents, so I will say it for them.

“Parents - Calm down.”

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Take a deep breath. Calm your anxious thoughts. Grab a pen and use this guide to figure out how to help you son or daughter manage the stress of this complex situation to be emotionally healthy. By the way – when you are calm and figuring out options, your kids will calm down and learn to do the same thing.

COVID-19 is complex for parents to understand. It can be a very difficult for small children to grasp, but helpful videos like the ones on PBS where Elmo teaches how to wash your hands to kill germs is a good place to start. Keep it simple with creative approaches about hand washing https://www.cdc.gov/handwashing/videos.html . Coronavirus is serious. Thousands of people will get sick and the overwhelming majority will get better by practicing daily hygiene. Start there. Children of every age can practice handwashing, covering coughs and sneezes, staying hydrated and getting enough rest. These skills will keep them healthy now through lockdown and for the rest of their life.

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Kids don’t worry about global economic indicators because they don’t understand global economy. They aren’t supposed to be worried about global events because they are just kids. As parents you aren’t supposed to be worried about global events because you can’t control them. A parent’s responsibility is to manage their home and children, not solve world problems. When your children see you as a caregiver modeling healthy behavior, they will begin to do the same. Children tend to do what children see.

Communities are on lock-down to stop the spread of the disease. That’s a responsible way to flatten the curve as explained in this PBS video from https://www.pbs.org/video/what-this-chart-actually-means-for-covid-19-ybsbtd/

It doesn’t mean you have to stay in crisis response. Breathe and change perspective. You aren’t ‘stuck at home’ you are ‘safe at home’. You can connect as a family and get through this pandemic with emotional courage to stop confusion and chaos from entering your home. Take care of what you can, act responsible and let go of the rest. Worry about disease or recession won’t help you or your children feel better. Work at wellness and your kids will feel better because you feel better.

Positive action as a family will get you through the lockdown. Schedules, routines, tasks, schoolwork, family game time and meal prep can connect your family in new ways. Take advantage of this time to draw close and have family dinner again. One of the most requested resources American citizens said they wanted more of was time. For a few weeks you and your family will have significant time. Make it count.

Give up fighting toilet paper wars

Decide to focus on your family and home responsibilities first. Energy wasted on panic, “we’re all going to die!” or blame, “why didn’t you buy more toilet paper?” or regret, “why didn’t I go to school to be a doctor?”, or anger, “your coughing is going to get us all killed!” is wasted energy for parents and can be confusing to kids. The ultimate example are moms and dad who may be expressing anger at God, even if they didn’t believe in God before. “Why would God do this to me?” … is not the kind of question that will change your circumstances and distracts you from working on making your home a safe and emotionally secure place.

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Focus energy on an empowering question, ‘What can we do about the situation we are in? What can we do to keep the kids safe?’ Moving from wasted energy to creative change is crucial for parents during COVID-19. Part of this can be reaching out to other parents, Facebook supports, Zoom or YouTube sessions on how to teach your kids algebra at home. There are free resources on almost anything you can think of. Give up the fear and grab hold of new skills to grow through this global experience. Courage to change and creativity is in abundance when you change perspective. (Check out creative ways parents and kids are connecting during lockdown- https://www.forbes.com/sites/tarahaelle/2020/03/15/101-ideas-to-keep-your-kids-busy-during-coronavirus-closures/#7e0ee7d574a4 )

Shelter at home isn’t easy, but it is manageable with a plan. Time moves. Time never stands still. Weeks at home will zoom by with no measurable progress if you don’t have a schedule designed toward purposeful activities. Kids feel afraid if they see their caregivers afraid. Take a breath and begin to map out a daily schedule, 6 days on/ one rest day off, for the children and adults in your home. It’s normal to feel scared, because nothing like this has ever happened in our country.

While it’s normal to feel scared, it becomes unhealthy when people stay idle and silent. Break down the word emotion and you have E-MOTION… get moving as you work your plans and watch how your kids perk up with positive energy. Harvard’s Dr. Richard Weissbourd describes it this way,

“children are more distressed when parents appear helpless and passive, and more comfortable when parents are taking action.”

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Traumatic situations create traumatic emotions – that’s normal for adults and kids. Any event outside the usual realm of human experience which is distressing can create helplessness, anxiety or panic. Traumatic stressors usually involve a perceived threat to one’s physical safety or someone close to them. This is an intense psychological reaction to feeling threatened, which is completely normal.

Traumatic stress overwhelms coping mechanisms leaving children feeling out of control and helpless. Continual exposure to the trauma creates a survival reaction of being depleted, exhausted, or worse, self-destructive. Children experience traumatic stress differently based on age and maturity level as this guide will outline to help parents and teachers.

Here are the normal signs of emotional overload for children, or their caregivers.

Traumatic Stress Symptoms:

· Intrusive fearful thoughts

· Anger, frustration, moodiness or continual irritation

· Sleeplessness or disturbing dreams

· Fear, anxiety or panic

· Poor concentration or difficultly remembering the most basic of tasks

· Indecision or second guessing every decision

· Inability to embrace complex concepts

· Detachment or emotional numbness

· Hyper-vigilance of danger, for instance when someone sneezes

· Hopelessness, dread or self-destructive thoughts

· Sadness or continual waves of grief (lost graduations and prom)

· Inability to listen to instruction, or emotional distancing

· Chronic exhaustion or energy loss

· Physical aches or muscle pain, (usually from an unidentified source)

· Minimizing the severity of the situation, especially among older adolescents

Think about you, your child or partner as you reviewed the list of normal stress reactions. It is likely many of the people you know have some of these symptoms, because they are normal in a time of crisis. The goal is to normalize and calm emotions to make them more manageable for both parents and kids.

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Stay realistic. When children are feeling confused, highly anxious or emotionally numb, their ability to think creatively to do schoolwork at home will be impaired. Adjust expectations about school performance accordingly to focus on their emotional ability to cope. Until their brains are working better by learning how to control their emotions, they might not be able to retain much new information.

How to Help Children during Coronavirus Lockdown

- Ask how they are managing the stress. Listen carefully and compassionately

- Spend time with your children in the same room, it’s more comforting to be together than alone and isolated during lockdown

- Offer a listening ear of support, comfort and encouraging words which can help even the most introverted of children

- Allow your children to reach out to text or call their friends or classmates they haven’t heard from since the lockdown

- Reassure they are safe once stability can be assured as the family is fully practicing CDC.gov or Coronavirus.gov protocols on physical and medical safety

- Guide your children in taking on additional household responsibilities and everyday tasks. Explain you cannot become ‘super-parent’ and need their help. Even a very young child can do something to help. (example would be putting their own laundry in the laundry basket or learning how to fold towels to help mom or drying dishes with dad).

- Avoid taking their moodiness or frustration personally; crisis brings out the best or the worst in children, parents, partners and other family members. Give a lot of grace, since we will all need a lot of grace during this period of lockdown.

- Skip judging other people on how they parent or what they allow their children to do – while you stand firm on hygiene and social distancing protocols. Safety first

- Show compassion on families who may have family testing positive for COVID-19. Share your concern, assure of your prayers and teach your children to pray for others we cannot go immediately help

- Learn to accept frustration as part of the process instead of trying to ‘fix’ people to do things your way. Controlling others doesn’t work and creates more frustration

- Encourage family members to ‘check-in’ to share feelings frequently and then ask about each other’s wellbeing emotionally and physically each day

- Access mental health resources online or via telehealth to guide your family through the surge of stress everyone is feeling. Allowing emotions to flow will prevent emotions blowing up in rage, or blowing into resentment or self-destruction

- Encourage all family members to monitor and discuss stress overload and to keep the conversation moving forward toward emotional coping skills which build resiliency

- No one gets through crisis alone, especially children. Reassure that traumatic emotions are normal reactions to an abnormal situation like coronavirus lockdowns

- Talking through the elevated stress is essential; remember if you can talk through it, you can get through it

Sometimes parents need help identifying stress in children or adolescents. Here are the signs of stress in children, based on age, who have experienced major crisis.

INFANTS AND TODDLERS

- Regression of sleeping, toilet training or eating; slowing down in the mastery of new skills

- Sleep disturbances (difficulty going to sleep; frequently waking)

- Difficulty leaving parent, extreme clinginess

- General crankiness, temper tantrums, crying

3-5 YEARS

- Regression-returning to security blankets/discarded toys, lapses in toilet training, thumb sucking or other age inappropriate behavior

- Immature grasp of what has happened; bewildered; making up fantasy stories

- Blaming themselves and feeling guilty about how the crisis affected their family

- Bedtime anxiety; fitful/fretful sleep; frequent waking or chronic worrying

- Fear of being abandoned by parents or parents dying from coronavirus, clinginess increases as child feels unsafe

- Greater irritability, aggression, or temper tantrums, especially from previously quiet children

6-8 YEARS

- Pervasive sadness: especially when they perceive feelings of being abandoned, or fear of loss of both parents or siblings to the disease

- Crying and sobbing can be a common reaction, and sometimes a healing one to release fears. Once they cry it out, some children may be able to talk it out. This is the stage where children start to understand about their own death, so some kids may focus on a cough as indicator of the reality that their body may be sick.

- Talk about their fears, let them express, then visit trusted sources like www.Coronavirus.gov to see actual facts to read through and reduce fears together.

- Afraid of the world ending, or watching their parents die, or their worst fears coming true, this “catastrophizing” is based on fears, not facts. Shatter that fear by showing the steps you are taking as a parent to stay healthy to not contract the disease and how this will protect the entire family through the lockdown

- Fantasies that the coronavirus never happened, and things will ‘just go back to normal’ like waking up out of a bad dream

- May become overactive or act irresponsibly to avoid thinking about stressful issues, acting disrespectful, rude and hateful are other indicators

- Feel ashamed of the crisis; or feel they are different from other children because of how your family may be taking coronavirus lock down more seriously than others, while their friends on Instagram seem to be going on with ‘life as normal’

ADOLESCENTS:

- Feeling isolated and lonely, separation anxiety increases in kids with other major losses like graduation, prom or the hope of living away from home at college with so many shut down or going to online only

- Major loss, such as losing contact with their peer group through school, sports, fine arts, drama or band and perhaps losing contact with their friend group forever due to job relocation of parents. Students may never see some of these peers again

- Fear loss of stability and security from parents leaving them or parents not available to them because parents are caught up in their own stressful financial career or relationship problems

- Feel hurried to achieve independence, which sometimes is driven by the desire to escape parents’ crisis or financial situation

- Loss of identity for teens who tended to over-achieve academically, in sports or extra-curriculars. These kids may start to feel deep sadness as if they are losing a part of who they are. While your child may not have been headed to the Olympics or Final Four; those events being cancelled may cause some kids to feel like their career dreams has been shattered

- Worry about their own financial future by being laid off from a job, not finding a job, not having the money to go to college

- Preoccupied with guilt over how they must step up to help their parents manage the financial survival of a pending recession

- Chronic fatigue: difficulty concentrating, physical complaints like chronic headaches, backaches, stomach aches may indicate stuffed emotions are triggering very real physical pain

- Feeling deep grief and loss, while not knowing how to mourn loss caused by COVID-19 as they begin to understand the world can be a dangerous and unpredictable place

Strategies to help stressed children

Children look to their parents for support and encouragement during any crisis.

The following is a guide to help parents, caregivers and teachers manage the flood of emotions that may come up during coronavirus lockdown.

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Ages birth to 6

Children under the age of six do not need additional exposure to major traumatic events. Children of this age draw their emotional support from parents When parents or guardians feel safe and secure, the children will feel emotionally secure as well. Parents should speak about home life around children instead of topics such as disease, stock markets or other bad things that happen in the world. Modeling calm and compassion with "let’s pray for families who have sickness in their home," and then going about the normal schedule with the news or financial media turned off. When parents can maintain a sense of calmness, small children will feel safe and secure. They might seem almost as if nothing bad has happened to them, because in their world the important things, (you and their family) are stable and safe.

Ages 6 to 12

Children of this age are more aware of the world around them, yet still need moms and dads to shield them from most of the bad news. If your kids can’t spell Zimbabwe or find it on a map, then direct their thoughts back to the part of the world where they live. News media stories may be confusing to children beginning to understand geography. They need knowledge of where the seven continents are balanced with their own responsibilities in their own country, state or city. Limited exposure to the media is not dangerous because it can open discussions about insecurities your child may be feeling. Television specials, like the one hosted by Kristen Bell on Nickelodeon can be a great conversation starter to open important health topics. Talking is encouraged for this age group, journaling, expressing emotions, or even writing letters to emergency workers to thank them for helping victims is a positive use of energy. Drawing pictures allows for healthy emotional expression and can be a powerful coping skill.

Social distancing outside the home is essential, but you can still hug your kids! Physical touch can bring security to a child. Also remember to have special times of prayer as they learn to give up their worries to God. These steps help children better deal with their fears about bad things that happen in the world as they learn how to sort through new experiences with the support of their family.

Ages 12 to 18

Adolescents have their own impressions of crisis events, in part shaped by their peers or social media connections. The older they are, the more likely they will have strong opinions, and it is healthy for them to process their feelings with friends. Expression should be balanced with family, teachers, clergy or counselors since negative peer pressure can lead to irresponsible behavior. This group may need some time to verbally process how they feel about what happened. Special emphasis should be placed on helping them talk through the issues and not stay isolated from family. Asking how they are managing the stress and what they think might help others in the family could be a good place to start a respectful conversation about being part of a family facing crisis together.

Silence or withdrawal is a serious warning sign the crisis events of the past few weeks have been internalized. Strict limits on news or social media is essential to prevent anxiety or panic levels from rising exponentially from negative media overload. This group may feel the most pressure to escape reality with mind-altering drugs, alcohol, sexual acting out, criminal activity or suicidal actions. Talk openly if you are worried about your teen’s behavior with love and compassion. Reassure them the family can get through this challenging time better together. Escaping or giving up on living doesn’t take the stress and fear go away. Keep the conversation going with the help of national suicide hotlines, which are well staffed to help you and your son or daughter. (Every country has suicide hotlines available. They are free and confidential and easy to find https://en.wikipedia.org/wiki/List_of_suicide_crisis_lines )

Dangerous Warning Signs

This final category maps out indicators of traumatic stress which are beginning to overwhelm the individual and creating a risk to their health. The longer the traumatic stress symptoms occur, the greater the negative impact on the child or caregiver. This does not imply craziness or weakness rather it indicates that the emotions are too powerful for them to manage by themselves. Completely normal, but it can make a person feel powerless, as if they are drowning in their emotions and does require someone else to help them, such as an emotional lifeguard. Children or caregivers who display more than a few of the following stress symptoms may need additional help dealing with the events surrounding coronavirus lockdown. They should seek the appropriate medical or psychological assistance.

Thankfully dozens of trusted resources are available to educate and equip parents and teachers on helping children negatively impacted by trauma. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/talking-with-children.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fcommunity%2Fschools-childcare%2Ftalking-with-children.html

Physical:

Chills, thirst, fatigue, nausea, fainting, vomiting, dizziness, weakness, chest pain, headaches, elevated blood pressure, rapid heart rate, muscle tremors, difficulty breathing, shock symptoms, etc.

Emotional:

Fear, guilt, grief, panic, denial, anxiety, irritability, depression, apprehension, emotional shock, feeling overwhelmed, loss of emotional control, etc.

Cognitive:

Confusion, nightmares, uncertainty, hyper-vigilance, suspiciousness, intrusive images, poor problem solving, poor abstract thinking, poor attention/memory and concentration, disorientation of time, places or people, difficulty identifying objects or students, heightened or lowered alertness, etc.

Behavioral:

Withdrawal, antisocial acts, inability to rest, intensified pacing, erratic movements, changes in social activity, changes in speech patterns, loss of or increase of appetite, experimentation with sexuality, substances, pornography or online gambling for older children.

When in doubt about your children’s medical or mental health needs contact a trusted family member, a physician or certified mental health professional. Remember there are caring people who can help you and your children. You do not have to go through a crisis alone, but you do need to reach out for help. COVID-19 lockdown has not limited access to therapists, counselors, social workers, psychologists or clergy. Children and parents must actively deal with negative emotions now to move past the stress of coronavirus lockdown and find strength to cope with the challenges ahead. Good news – there are many groups available to help you figure it out.

Growing up can be scary, but generations of children grew through global challenges in the past like the great depression and became disciplined and resilient. This generation of children could become mentally and spiritually stronger because of COVID-19. Courageous parenting will create courageous children. That could become the greatest gift to our culture. Disciplined students who have learned how to manage themselves with responsibility and gained skills on how to help others. That might be the brave new world we need, and it will be filled with confident young adults who learned how to cope by watching their parents lean into the coronavirus challenge.

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Talk through it to get through it

This guide can get you started on how to open conversations that will help your children manage the stress of a global pandemic. Learning how to manage emotions in this crisis can prepare your kids to manage any crisis. Teaching them to talk through issues is strategic for them to explore options and keep moving forward in their life.

Spark creativity with regular conversations about managing stress and pressure by discussing issues like these with your children in age appropriate ways.

- What are you worried about or afraid of since the coronavirus lockdown began?

- How is our family affected by the coronavirus?

- Talk about what was important to you before the COVID-19 pandemic and how those core values may have changed or gotten stronger since the lockdown began.

- What will our family look like five years after the coronavirus has been solved with a vaccine?

- Express how grateful you are for each member of the family, what you admire or love about them. Share your heart with your children and watch how quickly they learn to share their deepest emotions with you.

Coronavirus can connect your family in new ways during the lockdown. Family dinner conversations can go deeper into conversations that will build mental wellness and resiliency. To quote Charles Dickens, “It was the best of times. It was the worst of times.” It is the same for your family. This can be the best or worst of times, – that choice is up to you.

Dwight Bain is a Nationally Certified Counselor who writes on managing crisis to create positive change. He lives in Orlando with his wife, two kids and four cats. Follow him across all social media @DwightBain

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