Helping Children Manage Anxiety & Depression During Covid

As we all well know, families have been under an extraordinary amount of stress since 2020, and – sadly – that has seeped its way into our children’s lives and psyches in unimaginable and unprecedented ways.

The childhood anxiety and depression that began with Covid – and, for many kiddos, still persists – is very real (just ask any child psychotherapist). 

To be clear, kids are resilient, and they prove their adaptability every single day. But they are also not immune to the challenges and big emotions that come with the pandemic (i.e. lack of in-person socialization, inability to read social cues due to wearing masks, fear of getting sick, etc.) and every other hardship we’ve faced since 2020 (and before). In fact, they hear and see more than we know, and feel things more deeply than we realize.

If you’ve noticed anxiety and depression in your child(ren) since the start of the pandemic, you’re not alone. 

Perhaps you have a kiddo who has always struggled with anxiety and/or depression (or other mental health concerns) and the pandemic exacerbated his or her symptoms, or maybe you have a child who has never struggled before, but over the last couple of months or years has started showing signs of sadness or distress. 

Either way, we’re here to help.

My Story

Up until Thanksgiving of 2020, our then 8-year-old daughter seemed to handle the many changes that came along with the pandemic with so much resilience and flexibility. When she started at a new school in the fall, she wore her mask without complaints, and she even managed to make friends despite all the social distancing and other pandemic measures. But right around Thanksgiving, our school shifted back to remote learning due to the high COVID case count in our community. 

Though she first seemed to manage her daily zoom class schedule well and independently, I noticed a discernible change as the weeks dragged on. Her normally boisterous energy levels dropped significantly, until I could hardly recognize our normally happy, sociable, easygoing daughter. Some days, she felt too tired to get from her bed to her desk, and she even refused to leave the house to go play.

I was worried, but I chalked it up to the difficulty of remote learning, and also staring at a screen for 7 hours a day. When our school announced we’d be heading back into the classroom in January, we were all so excited! I figured being in class and around peers, as opposed to on a screen, would cheer her up. 

But after one day back in class, she came home from school early with a “tummy ache,” which turned out to be anxiety from her overwhelming feelings of worry, grief and sadness. She burst into tears and finally let it out to me: she missed her old school, her old friends… her old life. Too much had changed, and she just wanted things to go back to normal. She told me that it’s like her brain has all these blue dots on it, and the dots are all her worries and sad feelings, and she doesn’t know how to make them go away. 

Hearing these words from my daughter broke my heart — and felt all too familiar. I too struggle with anxiety, and I too have a lot of blue dots floating in my brain. I too miss my old life. So I can relate more than she knows, besides feeling her sadness and loss so very deeply.

As I thought a bit more about what she told me, I realized that her old school represented her pre-pandemic life. Up until March of 2020, when the world shut down, she was a normal kid who could intermingle with her entire class, eat in the lunchroom with friends, play freely on the playground with pals at recess, go on field trips, attend school assemblies, and so on. Her new school, which she started in the midst of the pandemic, was a clear representation of Covid-life: where she wears a mask, has her temperature checked every day, eats lunch at her desk (alone), and so many other restrictions that have taken all the fun out of her daily life.  

As I began thinking about how to address this properly and work through these feelings with my own daughter, I realized that this is a huge problem for families everywhere. Kids all over are struggling with this strange, new and restrictive life that’s also filled with new worries. Their little minds and bodies may be overrun by so many big feelings that they don’t know how to process, express or solve. 

I know my family isn’t alone in this struggle; my hope with this article is to help you and your child breathe a little easier today.  

A Child’s Pandemic Experience 

As we’ve discussed, no matter how old your children are right now, just like you, they too may still be overcoming the trauma of the loss of socialization they’ve experienced during this time period, even if things are getting back to normal(ish). 

As a result of intermittent school closures, bouts of remote learning, fear of catching or spreading germs, and physical distancing, our children missed so many of their regular opportunities for social development and growth.

Devoid of playdates, family visits, and in-person school for so long, preschool and elementary school-aged children have been less able to practice important, developmentally-appropriate skills like sharing, taking turns, working through differences with peers, etc.; and older kids who thrive off their social interactions have been feeling increasingly lonely and isolated, which was starting to become a huge problem for teens even before this pandemic.

Add to all this the lack of time with extended family and support systems (grandparents, cousins, etc.), the stress of absorbing caregivers’ feelings about changes to everyday life, and you’ve got yourself the perfect recipe for our children to experience actual trauma (of course, trauma is on a spectrum, and some children’s traumas will be more severe than others. Some kids may have lost a loved one to COVID or have a parent who’s lost a job; others are experiencing food or housing insecurity or are in abusive or otherwise unhealthy homes, etc.). 

All this said, there are things we can do — both for ourselves and our children — to prevent long-lasting anxiety, depression and overarching negative feelings.

First, let’s discuss the signs and symptoms you should look for to determine if your child might be struggling with mental health concerns.

Signs and Symptoms of Anxiety and Depression in Children by Age — Overview 

Though your younger kiddos may not be truly aware of the pandemic and what’s going on in the world, they could still be displaying signs of anxiety due to changes in routine, absorbing caregivers’ stress and anxiety, and/or the overall mood in the household.   

For example, my friend’s kids overheard her talking on the phone to a friend whose dad had just died of Covid. They later asked her questions about death, who was about to die, when will they die, and so on. These things are hard to hide from our kids — they hear and absorb so much more than we think!

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Anxiety Symptoms in Toddlers

• Changes in eating, sleeping and “normal” (for your child) behavioral patterns;
• Increased fussiness;
• More difficult to console;
• Separation anxiety when caregivers leave the house or when being dropped off at daycare, preschool, etc.;
• Potty accidents (for those who are potty trained);
• More aggressive behavior than usual.

For a more extensive list of recognizing anxiety in toddlers, check out this resource from Parents.com, as well as this article from PsychCentral.

Anxiety Symptoms in School-aged Children

• Changes in social behavior — i.e. kids who have always enjoyed being social no longer wanting to see friends or leave the house;
• Children not wanting to come out of their rooms or engage with caregivers, siblings, etc.;
• Excess worrying; 
• Feeling sad, irritable, helpless or hopeless;
• Changes in energy level — suddenly sluggish, tired all the time, low energy;
• Loss of interest in previously enjoyed activities;
• Loss of interest in school and schoolwork; 
• Falling behind in school; 
• Hard time falling or staying asleep;
• Unexplained tummy aches, headaches, or other physical problems;
• Feelings of worthlessness;
• Changes in appetite.

For a more extensive list of the signs of depression in children, take a look at The Signs of Depression During the Pandemic from the Child Mind Institute. 

According to Child Mind Institute, if any of these symptoms persist for more than two weeks, they definitely need to be addressed (suggestions on ways to do this below). However, if the symptoms are more fleeting in nature — present for a day or two, say, and then gone — it may be less of a concern, and more momentary or situational.

Here’s a good rule of thumb, according to Child Mind Institute and clinical psychologist Dr. Mark Reinecke, PhD: “If you see them, take note. If they last, take action.” 

Ways to Help

If you’ve determined that your child is struggling with anxiety, depression, or other mental health concerns, what should you do?

First of all, take a deep breath. Yes, you. If your child is struggling, chances are pretty high that you are too. 

Second, you can feel reassured by the fact that, according to this article in USA Today, “…unless a child is experiencing toxic stress [toxic stress, which can be experienced at any time, not just during the pandemic, is defined as “…severe in its strength and chronic in its duration and happens without a buffering relationship…”], they probably will recover well and may even build resiliency that will serve them in the long run.”

The simple act of reading this article means that you care and you likely serve as that “buffering relationship,” which is so imperative to your child’s mental health and wellbeing. 

Here are several other specific ways you can support your child:

Keep Things Consistent

• Maintain household consistency, routines and familiarity as much as possible. There is so much uncertainty in the world right now, but keeping things as predictable and consistent as possible at home will go a long way in creating a sense of safety and normalcy for your child. For example, keep a morning routine, where everyone wakes up, eats breakfast, brushes their teeth, gets dressed, etc. — even if you have nothing to get dressed for.
  
• Set a time and create a safe space at home for you and your child to check in with each other regularly (daily, if possible) — without distractions (phones, email, siblings, etc.). Just that 1:1 time will help your child know she is supported, cared for and loved — this alone will help (this is also part of creating and strengthening that protective “buffering relationship” mentioned above). These check-ins can be as long or short as your child needs them to be — even a quick 3-minute conversation is better than nothing. 

Be a Sounding Board 

• Listen without judgement and take your child’s feelings seriously.
• Validate your child’s feelings without trying to “fix” their problems for them. 
• Similarly, resist the urge to say “it’s OK.” It sounds good, yes, but in reality, things don’t feel OK for your child right now. Saying “it’s OK” may sound like you’re diminishing your child’s feelings and experience. Instead, you can offer a warm hug, an empathetic nod and something along the lines of, “I hear what you’re saying. I know what you’re going through is really hard. I’m always here for you. I love you.” 

Physical Activity and Fun

• Encourage your child to stay physically active, even if s/he doesn’t feel like it. If your child plays soccer, try your best to keep her going to practices and games. Or just take your child outside to kick the ball around. If they enjoy a good dance party, lower the lights, blast the music, and get grooving together!
• Go outside at any opportunity you can. Yes, you can (and should) still stay active outside on the coldest of days.
• Don’t forget to HAVE FUN! Sometimes, our mood is so serious and we totally forget to loosen up a bit. Having fun together as a family does wonders for everyone’s moods. Whether it’s the aforementioned dance party, taking the afternoon to go sledding and drink hot chocolate or playing a fun game together like Pictionary or charades, making time for silliness and fun will create warm, positive feelings and memories, which we all need right about now.

Mindfulness and Gratitude 

• Practicing mindfulness can help, and here are some great ways to implement that into your children’s routine. In addition, there are so many great apps out there, like Calm and Headspace, that can help kids learn how to breathe deeply, stay in the moment, and accept and tolerate feelings of uncertainty.
• Adopt an attitude of gratitude. One idea is at the beginning or end of each day, have your family go around and name 3 things they feel grateful for. Research shows that focusing on what we’re grateful for, rather than what we’re unhappy about, can actually help improve our mood and overall health and wellbeing. 

Understanding and Combating Worry

• Help your children understand how worrying works. Lynn Lyons, LICSW offers really useful tips (and tons of other things related to children and anxiety) on her website and in her podcast, Flusterclux. When kids understand why their symptoms are occurring (i.e. tummy aches, headaches, low energy, etc.), they tend to feel less anxious about them and more powerful and in control of their bodies.
• Have your children name their worry or depression… and then yell at it whenever it shows up. My daughter’s worry is called “Mr. Mean Pants,” and she has my full permission to yell and scream at him whenever he appears. Doing this externalizes the feelings of worry and depression — they are NOT a part of your children — and helps kids understand that THEY are the bosses of their brains and bodies… not their worries, intrusive thoughts, and/or depression. 
• Help your kids challenge their negative or self-destructive thoughts. For some amazing tips on how to do this, check out Social Emotional Workshop and Mindful Little Minds. 

Be a Good Role Model

• Be aware of how you discuss the pandemic and your own anxieties and frustrations in front of your kids. Children are sponges, and no matter how hard we try to shield our own feelings of fear, anxiety and depression from them, they pick up on everything. This isn’t necessarily bad, as long as we share our feelings with them in a constructive way. 
  
  According to the National Association of School Psychologists, “It is very important to remember that children look to adults for guidance on how to react to stressful events. (…) This is also a tremendous opportunity for adults to model for children problem-solving, flexibility, and compassion as we all work through adjusting daily schedules (…) and connecting and supporting friends and family members in new ways.” 

Reach Out for Help

• Always reach out to your pediatrician with any questions or concerns you may have about your child’s physical and mental health. 
• Find a children’s therapist for your child — every kid (and adult!) can benefit from having someone to talk to and acquiring tools and tricks to work through struggles and painful feelings and experiences.

For more guidance on how to support your children during this challenging time, check out this guide for helping kids’ manage Covid anxiety, as well as this helpful report from Child Trends entitled, Resources for Supporting Children’s Emotional Well-being during the COVID-19 Pandemic

Bottom Line

If you think your child’s mental health may be suffering due to the pandemic, you’re not imagining it, and you’re definitely not alone.

Our children’s lives have been completely uprooted, and all the “normal” ways in which kids traditionally learn, gain independence, engage with peers and develop helpful coping mechanisms and overall life skills have wildly shifted as well.  

But (!!!), with our awareness and support, we can help our kids manage (and even thrive) during this very difficult time (and any difficult times to come). According to this article in USA Today, “Experts underscore a child’s best buffer during the pandemic is a supportive parent.” 

Parents, it is also incredibly important that you take good care of yourselves, too; you must put on your own oxygen mask before you can assist others. And remember, this is temporary. As I reminded my own daughter just last night, this too shall pass. I don’t know exactly when or how, but it will. And we will all be together (perhaps even hugging?) on the other side when it does.

Helpful Resources about Childhood Anxiety and Depression During Covid

• Lynn Lyons, LICSW — podcast Flusterclux

• Child Mind Institute

• Child Mind Institute — Coping With the Coronavirus Crisis: Supporting Your Kids

• HealthyChildren.org

• Mayo Clinic

• USA TODAY — Experts say this is what children need to survive the COVID-19 pandemic

• How COVID-19 Could Affect Kids’ Long-Term Social Development

• Will the Pandemic Socially Stunt My Kid?

• Toddlers to Teens: How to Help Kids Cope with Stress from Covid-19