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Published on January 12, 2021

Helping your child cope with COVID-19 isolation

COVID Teen Health

As the coronavirus pandemic continues, the mental health and well-being of an increasing number of children and adolescents is being affected. They are having to deal with new routines, a loss of their normal social life, and missed holiday traditions with extended family. Some children are also facing housing and food insecurity, as parents who have lost jobs are struggling to survive.

On November 13, 2020 the CDC reported that since April the proportion of children’s mental health-related visits to Emergency Departments increased by approximately 24 percent for children ages 5 through 11, and 31 percent for adolescents ages 12 to 17. Local kids are no exception, according to psychiatrist Bart Main, MD at the Centers for Behavioral Health of Cape Cod Healthcare, who specializes in the treatment of adolescents. 

“Our whole clinic is bustling over with people who are really, really uncomfortable right now,” he said. “In psychiatry there’s a term called ambiguous grief. Ambiguous grief relates to the idea that there is not a specific event. It’s an ongoing process where there is no termination in sight. It’s indeterminate and that is extremely anxiety-provoking and depressing for people.”

It’s important to recognize that different children will process the current events differently, depending on their temperament. There are a lot of different levels of susceptibility to depression and anxiety.

“For some kids who are more socially connected, and the existential meaning in their life is related to their social peer group and friendship networks, this is devastating,” Dr. Main said. “There are other people who are much more introverted, whose best friend is a good novel and it’s not so hard for them.”

Masks create an additional barrier that makes things harder for most children because children are still learning social cues. They do so primarily by reading faces. When you cover up half of the face, the child is missing critical data, especially since in our culture we read the messages from a smile or frown more readily than we read eyes. Dr. Main compared it to a common symbol people use when texting or sending an email.

Almost everyone knows that a colon followed by a close parenthesis :) stands for a smiling face. Modern computers will even automatically create a little smiley emoji if you type those symbols. But imagine if you just type a colon and don’t include the close parenthesis, which is essentially what a mask does to a face. It becomes impossible to decipher the same meaning, he said.

What Parents Can Do

But there are some things parents can do, he added. Parents should be alert for any signs their children are particularly struggling. If parents are worried, they should contact their child’s pediatrician. Pediatricians can screen for depression and anxiety and make a referral to a mental health counselor if needed.

Signs your child might need professional help (from the American Academy of Pediatrics):

  • Changes in mood that are not typical for your child such as feelings of hopelessness or rage.
  • Changes in behavior.
  • A loss of interest in things that were previously enjoyed.
  • Changes in sleep – either too much or too little.
  • Changes in appetite – either a larger or smaller appetite.
  • Changes in appearance, such as a lack of personal hygiene.
  • Risky behaviors, such as using drugs or alcohol.
  • Thoughts or talk about death or suicide.

Extra Support

Not all children will need professional help, Dr. Main said. Most just need extra support from their parents to get through this difficult time. He offered some practical tips and strategies that will be helpful for most kids and adolescents.

His first suggestion is mindfulness meditation. This isn’t as big of a stretch as it might seem. All public-school students on the Cape, with the exception of Barnstable, have taken part in a mindfulness training called Calmer Choice, so mindfulness is a concept they can relate to. That training included taking belly breaths and inhaling and exhaling while tracing the outline of your hand, which can be very calming.

“For a parent to remind the kids about mindfulness and the technique of using that to reduce stress is very important,” Dr. Main said.

One of the best things for children to do is some type of meaningful work, especially if that work helps others. Older kids can offer to rake their elderly neighbor’s yard or help a younger sibling with schoolwork. Children of all ages can send mail to elderly family or church members. A hand-drawn card or picture with a little note is very meaningful to an elderly person who can keep it and savor it more than once. Parents can help by providing stamped and addressed envelopes.

Another excellent way to combat stress and anxiety is dancing, Dr. Main said. Dance involves music, which has its own benefits and body movement and exercise have proven to be beneficial to mental health. Plus, it is just a joyful thing to do. Parents can plan family dance parties or encourage children who are more outgoing to create TikTok videos to share with friends and family.

Creativity of any kind is good for children’s mood. Writing, drawing, making music, baking, painting or playing with clay are all good choices. Painting Kindness Rocks to leave on nature paths is another excellent idea because it combines the benefit of art with giving back.

Gardening is another great activity for kids and even though it is too cold to grow things outdoors, Dr. Main said planting an amaryllis bulb indoors can be a very fun project. Creating a terrarium or cactus garden are also possible this time of year.

“Different people have different talents and different interests in those areas,” Dr. Main said. “But some sort of creativity can be so great, especially if it’s something that other people will value. If it’s something they can share and somebody else says, ‘Wow, that’s cool,’ that makes all the difference. So, parents can support and validate their kids and that will go a long way.”

Getting outdoors is beneficial in every way. Fresh air and exercise are invigorating and studies show that forest bathing is good for both mental and physical health, Dr. Main said. Forest bathing is the Japanese technique of taking in the forest with all five senses. Listen to the rustling of leaves, brush your fingers through a white pine branch and smell the fresh scent. Take a deep breath and taste the air. A walk on the beach can have the same benefits. The trick is to be mindful of your senses while you are doing it.

Finally, try to incorporate play and laughter into each day.

“The bottom line is the more playful we can be the more we can allow ourselves to be playful – creative in a silly way, the better,” Dr. Main said. “It’s important and good to lighten up and laugh. It’s lifesaving.”