PUTTING ATTENTION ON ANXIETY
BY ELIZABETH SNYDER AND JOY LAUERER
The COVID-19 pandemic continues to impact many children and families. In 2021 many schools transitioned back to in-person classes for children, but with waxing and waning cases, some students may find themselves in hybrid formats doing some work at home. Children spending more time at home can lead to social isolation, eating disorders, social restrictions for activities and exercise, and increased social media use.
One of the biggest concerns for families has been children’s expressions of anxiety over the course of the pandemic. Children, like adults, experience stress and anxiety but most have not yet developed the necessary skills and understanding to effectively communicate these emotions.
Thankfully, most children’s anxiety can be managed through gentle interventions that help them process their feelings of fear, anxiety, and stress.
Here are some effective techniques that may help: Caregivers/parents should first start by actively monitoring their own anxiety. Children can be little sponges and often notice even the most subtle changes in the household.
Your own response to stimuli is heavily influential in how children observing you will behave in turn. Learn to calm yourself first so that what your children see when they look at you is the behavior and mindset you want them to emulate.
Simple breathing techniques help calm the mind and focus attention. To teach this to children, an illustrative prompt is most effective. Try “Sniff the flower and blow out the birthday candle” to cue for inhaling through the nose and exhaling through the mouth to calm breathing. Practice this with your child and then encourage them to continue their own — give positive feedback to reinforce their efforts.
Monitor screen time and create a plan. Literature shows too much screen time can worsen anxiety in some kids. Screens are an essential part of our lives now, and healthy habits are essential to managing their effects. For more tips and information on healthy screen use, visit this resource by the American Academy of Child and Adolescent Psychiatry.
Redirection is the most effective way to reduce a negative stress reaction. Physical activity, interactive games, reading a favorite book or even a new one — just a few minutes of diversion can help children feel better and make space to deal with their apprehension later, when they and you are in a better frame of mind.
Normalize stress. Negative feelings can be overwhelming and disorienting. Letting kids know that everyone has these same feelings from time to time, and that it’s OK can help to reassure them. Teach them to seek help from an adult, ideally their parents or primary caregivers, when they are feeling especially worried or anxious before it affects their school or daily activities. When they do, try to exude calm and assurance, as you gently explore what could be precipitating their fear or worry.
Share your own experiences. Acknowledge your feelings to your kids — attempting to hide or deny these feelings can be confusing and may promote feelings of guilt or shame when your children experience these emotions themselves.
You might say, “I’m feeling scared right now, but I know it’s not that likely that the thing I’m scared of will actually happen. I’m going to call my sister/spouse/best friend for advice.”
Self-care when parenting is important, as is passing on the practice to your kids. And remember — you have to put your own oxygen mask on first in the event of an emergency.
If your child’s anxiety seems to be worsening or interfering with daily activities, talk to your child’s pediatrician or seek the support from a mental health professional.
Tips and resources for improving health of children: The Centers for Disease Control recommends all children and adults who meet the current criteria for vaccination get vaccinated to slow the spread of the virus that causes COVID-19. In areas of high transmission everyone 2 years of age and older should wear properly fitting masks indoors in public places regardless of vaccination status. Because social isolation can lead to depression, caregivers should monitor for signs of depression such as lack of desire for normal activities, withdrawing from social situations, irritability, changes in eating or sleep patterns, and low attention span.
- The Society for Adolescent Health and Medicine website includes many resources for parents and teens. www.adolescenthealth.org/Resources/ Clinical-Care-Resources/Mental-Health/Mental- Health-Resources-For-Parents-of-Adolescents.aspx.
- In Beaufort County, the Hands on Health South Carolina website links several mental health and advocacy services for all ages. www.handsonhealthsc. org/golocal.
- If parents suspect an eating disorder, the South Carolina Department of Mental Health website includes links to resources and referral sites. www. state.sc.us/dmh/anorexia/resources.htm.
- Some signs to monitor include changes in eating patterns, skipping meals, frequent dieting, and extreme concern with body shape and size to name a few. The National Eating Disorders organization offers a helpline for resources as well. www. nationaleatingdisorders.org/warning-signs-andsymptoms.
For children especially, physical activity plays a fundamental role in psychological health and can be helpful improving other health issues associated with COVID-19. One tip is to encourage activities where adequate social distancing can be maintained such as walking, running, or other individual sports.
Increased use of social media by children can expose them to cyberbullying, depression, anxiety. The American Academy of Pediatrics indicates adolescents and teens who spend too much time on social media may exhibit changes to their health.
A tip is to create a social media plan and clearly indicate what is appropriate use, posting, and influences of the use.
COVID-19 has impacted so many health issues in addition to the obvious respiratory conditions. Recognition of the impact on mental health and resources for parents is key to ensuring a health balance for health and wellness.
Always seek advice from your health care provider if you are concerned with depression, eating disorders, anxiety, or any other mental health issues that may impact you and your children’s health.
Elizabeth Snyder, DNP, FNP-BC is a Family Nurse Practitioner in Hilton Head, a clinical instructor with the Medical University of South Carolina, and a board member with Mental Health America Beaufort Jasper/Island House.
Dr. Joy Lauerer is a MUSC college of nursing faculty and a nationally recognized child and adolescent psychiatric advance practice nurse. Joy specializes in the treatment of ADHD, mood and anxiety disorders in children. She practices in a telehealth-school-based mental health clinic in Charleston.