How to help children with anxiety in the pandemic

Anxiety is among the most common health disorders in children and adolescents and was exacerbated by the pandemic. When to consult and how it is treated.

Yes, this is an anxious time, and yes, everyone is anxious, but it is particularly difficult to be an anxious child in an anxious time. Anxiety disorders are the most common mental health disorders in children and adolescents (and this was the case before the pandemic), and they can be related to other problems, particularly depression.

Anxiety can lead children to emergency consultations and psychiatric hospitalizations; And in a time of increased stress and anxiety in general, parents of anxious children find themselves especially concerned, wondering how to talk to them about the complexities of life in 2020, and trying to assess when it is necessary. seek professional help.

At Boston Children’s Hospital, during the first months of the pandemic and isolation, the number of children and adolescents who went to the emergency room with mental health problems decreased, said Patricia Ibeziako, associate chief of clinical services for the department of hospital psychiatry and behavioral sciences.

Stress and anxiety can manifest as poor health, especially for children with underlying medical conditions.

“The largest number of children treated during the pandemic, who present in hospitals with mental health problems are those with suicidal ideation and suicide attempts – many also have anxiety, sometimes underlying anxiety disorders. Teens who arrive with eating disorders often have anxiety. Children with developmental disabilities have come with agitation and disruptive behaviors that reflect anxiety, as the pandemic has disrupted their routines, “said Ibeziako.

Even in a time of anxiety, anxiety is treatable. “The first-line treatment for anxiety is therapy,” he said. And he added that cognitive-behavioral therapy is used for children and adolescents. It involves understanding the thought process of anxiety, he explained, and how it affects emotions and behaviors, and helping the child to reframe or change troublesome thoughts.

Some children, depending on the severity of their symptoms, may also need medication. Severely affected children may need therapy in a day program or in a hospital, at least to begin with, while others will do well with a weekly session.

Ideally, however, they should receive therapy and medication, if necessary, before anxiety becomes so intense or debilitating that parents consider a visit to the emergency room. “It would be really great if parents could reach out to a pediatrician or primary care provider and try to connect with a counselor or therapist and start address this in time“Ibeziako said.

During this difficult time, some families think that “help is for the people who really need it, but not for my son,” said Rachel Busman, senior director of the Center for Anxiety Disorders at the Institute of the Children’s Mind of New York. who cares for many young children in his clinical practice. And he added that the expansion of virtual attention in the pandemic, the availability of mental health services for children increased.

Carolina Zerrate, an adjunct professor of psychiatry at Columbia who also works in a school mental health program, said that while these are stressful times for all families, “Black and Latino families have been most affected by the virus.” He noted that “some families were already in a situation of stress.”

Zerrate suggested that parents model how to express your emotions and ask for help and support, that they do check-ups by asking open-ended questions, such as “How do you feel? Why do you feel that way?” Don’t dismiss their concerns, he advised, or tell them they’re too young to worry. “You are opening a space to communicate, it’s okay to talk about your feelings, it’s okay to share with your family.”

Help should be sought, Zerrate noted, if patterns are observed that significantly interfere with a child’s daily functioning, or if he appears to be distressed over time and worsens, and of course, if he says something about hurt yourself or suicide.

Rebecca Berry, a clinical psychologist at New York University Hassenfeld Children’s Hospital in Langone, said parents often knew that a child was prone to anxiety, and that they might have separation problems around the age of 4 or 5. He described anxious children as having “what I call a worried brain, who worries about ‘When is the second wave going to come?’

“There are so many things a parent can do to model behavior brave, not anxious and resistant“Busman said. Parents tend to want to rush and protect their children from distress, he said, and may inadvertently send the message that yes, the child is in danger and needs protection.

Before the pandemic, Ibeziako said, school-related anxiety was a common problem, but what you are seeing now is “tinged with pandemic implications“reflecting the changes in the school year and the general uncertainty about how long this will continue.

The routines and structure They are important, and they can help us manage anxiety – they are important for young children, for school-age children, for teens, and for adults too.

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