Over the years children and teenagers have been exposed to stressful life events especially the last two years. The teens today have grown up with daily school shootings and mass shooting drills. Imagine being a second grader having to rehearse a man with a gun is on campus and you don’t know if you are going to live or die. Teenagers today have also grown up with terrorist alerts and having to be searched anytime they go in to a concert or places such as Disneyland. Finally they have had to cope with COVID. Over 1,000,000 Americans, and counting, have died from this virus (CDC). Many children and teenagers have lost grandparents, siblings and parents to this virus. Therefore, we also have many children and teenagers who are dealing with grief due to the loss of a loved one. We thought we had turned a corner regarding the Coronavirus, but we found out we have not turned a corner and we are still having spikes in the number of cases. There are still people being diagnosed daily with the Coronavirus and people dying daily from Covid. Many of these people have been vaccinated, however, most people being diagnosed and dying have not been vaccinated. Additionally, this time the virus is effecting teenagers and children. Since schools have resumed on site classes at least 1,000 children have died due to the Coronavirus virus (CDC).
This is a lot for a child or teenager to have to adjust to. Remember, their brains are not fully developed yet. Therefore they cannot understand things like adults do. Furthermore, they have very active imaginations which are fueled by misinformation on social media or from people such as Tucker Carlson on Fox. Having to cope with all of these issues has resulted in a significant increase in depression, suicide, drug overdose and anxiety disorders in children and teens. At my office we get at least 20 requests daily for teenagers seeking psychotherapy due to anxiety disorders.
The fact that we thought we were on the right track with the Coronavirus and we continue to have spikes is confusing and irritating to teenagers. Just as we think we are returning to our normal lives, we see that we need to still take precautions and maybe we will never return to our pre-Covid lives. Again we are not able to give children and teenagers any definite answers regarding when life will return to something normal. Now we have changed the rules again and they are expected to adjust.
With everything teenagers have had to cope with growing up, terrorist attacks, war, the economy collapsing, mass shooting and now the Coronavirus, we failed to make plans for their mental health care. Yes hospitals were running out of beds and physicians have become exhausted, but we are also running out of psychotherapists. Also psychotherapists are exhausted because they are dealing with adults and teenagers daily who dealing with depression, suicide and anxiety. However, psychotherapist do need some breaks so they can keep going. Finally, more and more insurance companies are declining claims or raising copayments so high that families cannot afford their copayments.
This is occurring when children and teenagers desperately need psychotherapy. Prior to the pandemic, anxiety disorders in children and teenagers were at epidemic rates (CDC). Since the pandemic there has been a 25% increase in children and teenagers being diagnosed with anxiety disorders. At this point anxiety disorders are the most common psychiatric diagnosis for children and teenagers (CDC). Yes depression, suicide, grief and trauma diagnoses have increased since the pandemic, but we have seen the largest increase in anxiety disorders (CDC). As a result, many children and teenagers have severe anxiety regarding school and many are stating they cannot go to school due to anxiety disorders. Their anxiety is interfering with teens attending school daily, paying attention in class and completing their homework.
In addition to children and teenagers needing to wait months to get into a psychotherapist or psychiatrist and this is not an exaggeration. If a child or teenager needs to be hospitalized because their symptoms are so severe, they often have to wait a day or two in the emergency room because the psychiatric department has no room. What does this do to a teenager who has raising thoughts or wants to kill themselves, to have to wait in the Emergency Department because there are no beds for them in the psychiatric department? I have had this happen to several patients that I tried to hospitalize.
This lack of mental health care is unacceptable in the United States. Parents call the Human Resource Department at your work. They negotiate your benefits with the insurance companies. Therefore, they can renegotiate your coverage so you receive the benefits your family needs. Also call your Senators and demand that insurance companies need to provide mental health care.
As a result, many parents have asked me how to determine if their child is coping with anxiety and what to do if they are coping with anxiety. I can understand why parents are concerned especially because many children tend to try to hide their anxiety because they don’t want to worry their parents. Additionally, parents are trying to find psychotherapist who can treat children and teenagers are parents are trying to figure out how they can afford therapy with the cost of living increasing and insurance companies restricting coverage.
Therefore, the APA (American Psychological Association) developed guidelines that parents can use to determine if their child is dealing with anxiety and what to do if they are dealing with anxiety. You can also use the guidelines for depression too. I have provided an outline to the APA guidelines below:
The American Psychological Association (APA) offers the following tips to recognize if children may be experiencing stress or anxiety:
• Withdrawal from things the child usually enjoys
• Trouble falling or staying asleep
• Unexpected abdominal pain or headaches
• Extreme mood swings
• Development of a nervous habit, such as nail-biting
Parents can actively help kids and adolescents manage stress by:
• Start the conversation to let kids know you care about what’s happening in their lives.
• Notice times when kids are most likely to talk – for example, in the car or before bed.
• Stop what you’re doing and listen carefully when a child begins to open up about their feelings or thoughts.
• Let kids complete their point before you respond.
• Listen to their point of view even if it’s difficult to hear.
• Resist arguing about who is right. Instead say “I know you disagree with me, but this is what I think.”
• Express your opinion without minimizing theirs – acknowledge that it’s healthy to disagree sometimes.
• Focus on kids’ feelings rather than your own during conversation.
• Soften strong reactions, as kids will tune you out if you appear angry, defensive or judgmental.
• Word swap.
o Say ‘and’ instead of ‘but’
o Say ‘could’ instead of ‘should’
o Say ‘aren’t going to’ instead of ‘can’t’
o Say ‘sometimes’ instead of ‘never’ or ‘always’
• Model the behavior you want children to follow in how they manage anger, solve problems and work through difficult feelings. Kids learn by watching their parents.
• Don’t feel you have to step in each time kids make what you may consider a bad decision, unless the consequences may be dangerous. Kids learn from making their own choices.
• Pay attention to how children play, the words they use or the activities they engage in. Young children may express their feelings of stress during play time when they feel free to be themselves.
• It is important to explain difficult topics in sentences and even individual words kids will understand. For little kids it might mean saying simple things like, “We love you and we are here to keep you safe.” For adolescents, it’s important to be honest and up front about difficult topics and then give them a little space to process the information and ask questions when they’re ready.
Call a psychotherapist who specializes in treating children and teenagers, if stress begins to interfere with your child’s daily activities for several days in a row. It is very important that you contact a mental health clinician so you get an accurate diagnosis and an appropriate treatment plan for your child.
You can find additional helpful information about kids and stress by visiting the Centers for Disease Control and Prevention’s Helping Children Cope webpage at https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/for-parents.html.
Dr. Michael Rubino is a psychotherapist with over 25 years experience treating children and teenagers. For more information about Dr. Rubino’s work visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple or on Audible.