With the closure of schools and the restrictions of our movements by COVID-19, kids and teens may be in a state of confusion and need to communicate with their parents about their worries. More importantly is how COVID-19 affects a teen or child’s ability to get treatment for their ongoing mental health issues.

Mental illness or addictive behaviors don’t take a break for anything – even a deadly virus. With all the upheaval and worry, kids with mental health issues or behavioral disorders may find their symptoms worsening, may see their anxiety peaking, or could develop new symptoms they never experienced before.

During this time of crisis, it is essential that your child know that you are doing everything in your power to provide a safe space amidst COVID-19 concerns, like monitoring their symptoms, keeping their medications current, setting up tele-med therapy appointments, giving them time to communicate their fears to you, and discussing any new or worsening symptoms.

Monitor Symptoms

The most common of child and teen mental health issues are anxiety and depression. With the constant news reports about COVID-19 and the urging of government officials to increase social distancing and flatten the curve, anxieties are high for everyone in America.

As a reminder, here is a list of the symptoms common in children with anxiety:

Physical Symptoms:

• Rapid breathing or Hard to catch breath
• Stomach aches or head aches
• Rapid heart rate
• Shaking, dizziness, tingling
• Fatigue
• Sweating

Emotional symptoms:

• Ongoing worry about their friends, education, or missing activities
• Worrying about things before they happen
• Constant thoughts and fears about safety
• A need for everything to be “perfect”
• Reluctance to do schoolwork
• “Clingy” behavior, especially with parents or grandparents
• Inability to focus
• Irritable or unable to calm down
• Insomnia

While your child may already display many of these symptoms, it’s important to re-familiarize yourself with other symptoms that could begin to pop up as your child’s anxiety level begins to rise. Given the current situation with COVID-19, it is not a matter of “if” there are new symptoms, but rather “when” the new symptoms show up.

When your child is dealing with depression, there is another constellation of symptoms that can occur. Your child may be currently showing some of these symptoms, but you need to keep an eye out for new, developing symptoms:

• excessive guilt
• persistent sadness
• feeling hopeless or helpless
• low self-esteem
• feeling inadequate
• loss of interest in usual activities
• difficulty relating to others
• sleeping too much or having insomnia
• changes in appetite
• gaining or losing weight
• decreased energy
• difficulty focusing
• cannot make decisions
• suicidal ideation
• frequent physical complaints
• threats of running away from home
• hypersensitivity to failure or rejection
• irritability, hostility, aggression

The tricky part about determining whether or not your child is experience new or worsening symptoms of depression is that many of the symptoms on the list are simply normal reactions to a crisis situation. Many people have difficulty sleeping, gain or lose weight, have trouble focusing, or feel helpless during crises. It’s essential that you, as the parent, are able to tell if this is a worsening depression, or simply a normal, human reaction to a crisis situation like COVID-19.

Whether your child suffers from anxiety, depression, or other mental health issues, review the symptoms, keep them in mind, and check in with your kids. It is also crucial that kids diagnosed with these issues have consistency with their medications.

Keep Meds Current

Once a child has been diagnosed and treated for mental health issues, it becomes part of their daily routine. With the news of closing businesses and shortages of supplies due to COVID-19, children and teens may become concerned that they can’t get their meds – something they have come to rely on for their positive recovery and maintaining good mental health.

Doctor’s offices, psychologist’s offices, and pharmacies are all open for business. You may not be able to get in to see your doctor or therapist, but you can schedule for a tele-med appointment. Often, if all you need for your child is a refill, you need only speak with the nurse or you can call the pharmacy directly.

If your child’s prescription has run out or expired, you will need to call your doctor or psychologist’s office directly. They may require a tele-med visit to assess your child’s current condition, consult with you on any new or worsening symptoms, and determine if the current course of treatment will suffice for the remainder of the COVID-19 crisis.

One of the main reasons to keep your child’s medication schedule intact is that their moods and behaviors can devolve without the medications to level out their brain chemistry. Depending on the medication, quitting abruptly can cause a variety of bad reactions, “ranging from mild to moderate early discontinuation symptoms with antidepressants, rapid return of the illness being treated, or even potentially life-threatening seizures with a high dose of benzodiazepines.”

Whatever the case may be, stay in touch with your child or teen’s doctors to maintain therapeutic levels of their medications within the brain. It’s also a good idea to keep therapy appointments via tele-med.

Tele-Med Therapy

Since the majority of family therapists are not taking in-office appointments due to COVID-19, it’s essential that you arrange for tele-med therapy appointments for your child, teen, and/or family. All you need is access to Wi-Fi, and you can have a full appointment with a therapist. Some young kids and teens might even like this because being online is like being in their element!

Many therapists will need your consent, as the parent, to conduct such sessions because the chances of privacy being violated are high. Even if both your child and the therapist are using Wi-Fi networks with high levels of security, hackers can still break into a live conversation between two people. Your child also needs to understand this risk.

Children, and teens especially, don’t seem to have an understanding that everything on the internet is able to be seen. While the therapist and parents can make every effort to secure a private therapy conversation, there is always a risk that it can be pirated. Some children may find this distressing as they may not have disclosed their condition to anyone in their immediate circle or the school environment. Make sure your child is involved in the conversation regarding security.

Once a tele-med appointment has been set up, make sure your child or teen has total privacy, in a room with a door, so they can feel as safe as they do at the therapist’s office. The therapy appointment will not be productive if the child does not feel confident in his or her ability to be absolutely honest and truthful.

The open communication your child or teen has with a therapist is not just something that is good for therapy – in this challenging time of COVID-19, open communication within the family is also crucial for everyone’s mental health.

Open Communication

When there is a global crisis like COVID-19, constant exposure to the news is not good for anyone’s health, but most especially for children who suffer from mental health issues. If ever there was a time your kids need open communication with their parents, it’s now.

Your children and teens need to know that they can come to you for clarifications, to ask questions, or even to voice their concerns. Parents need to provide correct information as they know it, answer questions directly, and address a child’s concerns appropriately. Don’t try to brush off their questions with a generic, “Oh, everything’s gonna be fine.” The child or teen will feel dismissed and their feelings devalued.

Even young children need to have their voices heard and needs addressed. As a parent, do yourself a favor and treat your children like the young adults they are. You needn’t get graphic with them, but be honest. Children know when parents are whitewashing the truth, so there is no point in lying about the real concerns regarding COVID-19.

Discussing New or Worsening Symptoms

When either you or your child notices new symptoms, or their existing symptoms intensify, the first thing you can do to calm their nerves is be proactive. Sit with your child and talk about what they are feeling and how the situation in the world with COVID-19 is making them feel.

Then, ask them what’s different – what new feelings or symptoms are troubling your child? Is there an increase in an existing symptom or are there new, uncomfortable symptoms you child does not know how to deal with? Write down what your child says and keep track of their symptoms on a private calendar.

Regardless of what you discover, it is essential to report your child’s condition to his or her therapist or psychologist immediately. Report the dates of incidents or changes (after reviewing your calendar) and ask your therapist about the best course of action. Your child may require additional therapy sessions via tele-med or an adjustment to his or her medications.

Conclusion

It is an uncertain time in America and all over the world right now as the COVID-19 virus spreads. People are frightened, secluded, and feel smothered. Children are especially vulnerable to the anxieties and pressures involved with home schooling and the indefinite stay at home orders by government officials.

You can keep your kids safe, even in troubling times. While travel to an in-patient facility like Hillcrest may be difficult in these times of social distancing and trying to flatten the curve, we’re happy to be here for phone consultations!