Commentary: Talk with your kids about this extraordinary time

How does a parent handle their child’s anxiety, and their own?

A novel happening, particularly one with the potential for illness and lifestyle disruption like Covid-19 has done, is a sure source of anxiety.

It’s also an opportunity for families to come together to decrease that anxiety and its effects, especially on children and adolescents. 

As we follow CDC and Delaware guidelines to help decrease virus exposure and monitor for physical symptoms of COVID-19, it is important to monitor for anxiety and emotional signs connected to the fear of COVID-19 as well.

Mark Borer, MD

Parents will be simultaneously dealing with the upset and anxiety expressed by their children as they seek reliable sources of information regarding COVID-19, and concerns they themselves have regarding the risks and changes to the parent, including worry of illness, separation from the community, and access to food and income during these times of shutdown in public restaurants, gatherings, and workplaces.

Put your own oxygen mask on first

We have a saying in medicine that when a physical crisis occurs in a patient, the first thing to do is to take one’s own pulse. 

This advice for doctors is equally important to those with children during this challenge. 

It means that one should first take stock of their own situation.

This means to alleviate your own anxiety over things such as making sure there is sufficient food and water at home, that job situations are addressed (such as being able to work from home when possible).

It also means if parents have work required away from home, to do that work with some extra social distance and wipe-downs of hard surfaces.

HED Talk to the kids in your life

It is important to take time to talk to children — as a family, and as needed, one-on-one. Talk in words the child understands and with a calm, supportive tone.

Acknowledge the child’s fears. Minimizing or denying the serious nature of the virus and the changes it is causing will not calm their fears and will interfere with the child’s trust in the parent and their honesty. 

Answering questions as honestly as possible for the child’s age level, while showing healthy ways to look at anxiety, can help build trust.  Children pay attention to the parent’s response and composure, and will pick up on worry. 

Yet, as parents admit concerns, they can emphasize ways they are responding and planning to help the family and to protect their children. 

You can pick a specific time of day to talk with the child, and bedtime can often be that special time.  Reading bedtime stories to children that involve heroism and helping others to overcome a foe can be helpful to set the tone for current challenges to COVID-19. 

Educating about the virus, and exploring past challenges to our country and how these were overcome may be helpful for discussions with teens.

Children may show their anxiety through physical complaints, such as stomach aches or headaches.  Anxiety can manifest as rapid breathing or shortness of breath, which may mimic one symptom of the COVID-19 virus, so it is important to also check for a fever and cough. 

Stay calm, stay engaged

It is essential that parents minimize inappropriate responses such as yelling, turning to drugs and alcohol, or withdrawing from the child and family. Such responses will be remembered by the child, who may later model these behaviors when they hit their own future crises.

When the parent engages the family and the child, calm can prevail. 

Young children may express fears and distorted views of the way viruses work.  Helping them to understand that this virus is like a cold virus, only “meaner” to some people — usually not to children — may help them to create an image of this small invisible organism. 

Teaching the child about healthy hand washing to wash the virus away, using disinfectant wipes on hard surfaces, and covering coughs and sneezes, are all ways children can feel some sense of autonomy and effectiveness in combating the virus and making it weak.

Having altered routines can be challenging for children. Show them that on-line learning and setting new study periods at home are ways to continue their education. These can help to increase their sense that there can be learning even when school is out. 

Parent supervised YouTube can teach children about a wide variety of topics and projects that can be helpful to their learning for the future. 

For those without internet access, exploring books and magazines can foster education. Doing simple projects together helps build parent-child relationships and fun together. Outdoor family activities that don’t involve contact with crowds can pass time and teach about outdoor skills and physical outlets. 

These all reinforce distance from and distraction from the virus, while increasing interest and decreasing boredom. 

Reaffirming time for family togetherness, affirming their faith and sense of hope for a positive future as this virus eventually subsides, will serve to increase confidence and decrease fear.

The reality is that parents may need some time to perform activities for their employers, while their children pursue some individual study or game time.  Finding the balance in each family is likely to lead to more satisfaction.

Include teens in the conversation

Teens may alternate between being supportive with suggestions and being frustrated and argumentative.  Outlets such as online time with friends and having some games and projects may help. 

While keeping informed of updates is important, excess time spent on news and social media can be counterproductive and an anxiety aggravator for everyone.

Prolonged social isolation is also unhealthy, so clever ideas include reasonable access to on-line meetings, church and community activities, and blogs.

Evaluation by a mental health professional may be needed for children who become unable to divert their minds from the fears of the virus. Signs may include being excessively withdrawn; showing signs of depression or trauma, such as sleep disturbances, appetite and energy changes; and persistent loss of enjoyment or hopeless feelings. 

For those able to adjust gradually to the “new normal” for now, no mental health professional support may be needed.

If you do need access to counseling or therapy, as you call local professionals, ask if they can do their session by phone or by telehealth to your phone or computer. If not, ask what safe health standards they have in place at their offices. 

For additional information contact AACAP.org and AAP.org.

Together our Delaware community will weather this challenge and build additional safeguards to help us in the future. 

For now, be with each other and be well!

Mark S. Borer, MD, DLFAPA, DFAACAP is a board-certified child and adolescent and general psychiatrist.  His office, Psychiatric Access for Central Delaware, is located in Dover. Dr. Borer is currently taking part in a grant to help primary care practices access child psychiatry support for their patients.