Here we are, almost 3 years post the COVID-19 virus pandemic that shut down our world instantly and provided new perspective about many of the parts of life that we took for granted. We temporarily lost the freedom to leave our home without protection or worry, to freely interact with others, and to move around our community and environment without worrying about catching a virus that had the potential to be deadly. We experienced a large scale and collective level of nervousness and worry about the present, the future, our health, and the health of others. We also worried about the availability of basics such as food and toilet paper.
Let’s start with the definition of a pandemic. The World Health Organization (WHO) definition is “a worldwide spread of a disease” with the COVID-19 pandemic being our 21st pandemic (Pitlik, 2020). Due to both its virulence and the speed of the spread of the virus, the general consensus of governments around the world was to shut down and create isolation in order to confine its spread. Humans are social creatures and in need of interaction with others on a consistent basis. The rise of a “virtual” world allowed for many to keep their jobs, and for education to seemingly continue. However, the short-term and long-term effects of isolation have impacted our mental health.
During this time, anxiety set in for many. Dictionary.com defines anxiety as the following: “an abnormal and overwhelming sense of apprehension and fear marked by physical signs (such as tension, sweating and increased pulse rate), by doubt concerning the reality and nature of the threat, and by self-doubt of one’s capacity to cope with it.” It is also defined as an “apprehensive uneasiness or nervousness usually over an impending or anticipated ill.” Anxiety is at an all-time high, leaving mental health providers with waitlists.
How is Anxiety Manifesting Itself Presently?
Avoidance
Many of our children, teens, and young adults are still avoiding school, social situations, or participating as members of a team for a sport or activity. What can be heartbreaking for parents is that our children may have actively participated in these arenas pre-pandemic and did not know how to “re-enter,” so many didn’t. They once had many interests, but for some children those interests seem to be fewer. Many of our kids have found a strong interest in video games because they don’t require face-to-face interaction and there is escape and submersion in a virtual and highly engaging electronic world. I have heard way too often from parents in my practice that their child or teen has very few “real” friends and friends from the video game domain; however, these friends don’t live locally making their interactions exist only in the virtual world.
Many of our kids found interest in more sedentary activities that have had the negative consequence of weight gain. Dr. Johnson, of the Johnson Center for Health, indicated that the quarantine change in lifestyle created weight gain; however, the long-term effect of the virus may have resulted in physiologically-based excessive hunger and increased appetite. This may have also created new, unhealthy habits where our kids ate due to boredom rather than due to hunger. In the long run, the change in eating habits has created a change in appearance and ease of movement that has further created avoidance for some children and teens to participate in school, socialization, sports, and activities.
For many of our teens and young adults, their friendships changed over the pandemic. There were varying levels of comfort in attending school or socializing, which altered social groups and friendships. Many of our teens have had to create new friendships; however, when their peer group was small to begin with, some children have struggled to find other children with whom to create new friendships.
Hanging in High Mode
Many anxious people start their day with a high residual level of anxiety that runs in the background. As the day goes on, that level of anxiety continues to peak and wane as different situations are encountered that result in a feeling of “I can’t handle this,” or “This isn’t safe.” For a student in school, thoughts such as the following can heighten anxiety over the course of the day:
- I can’t solve these math problems.
- Everyone must think I’m so stupid for that answer I just gave.
- I can’t read this.
- I don’t know the answer to this test question.
- This is so much work – I can’t finish it.
- I should have done better on this quiz.
- I hope the teacher doesn’t call on me.
- She thinks my hair looks stupid.
And even when our children and teens have a moment or two where things in life are cruising along smoothly, they often sit with a high level of anxiety for fear of what’s to come. Many fear that if they let their guard down, they will be blindsided by the next “disaster.” I’ve heard this phrase too often, “I’m waiting for the other shoe to drop” and “I need to be ready for whatever may come my way.” Anxiety can lead to anticipation of the next “bad” thing that may happen and having a moment of respite is often not enjoyed.
Hold this mantra instead: the other shoe will drop and holding that high level of anticipatory anxiety, it won’t lessen the surprise or the hurt. Whatever it is, you will deal with it at the moment.
Unreasonably High Self-Standards
Many children, teens, and adults often hold themselves to high self-standards at a very young age and can be intolerant of making mistakes. That may look like a meltdown when a child colors outside of the line or doesn’t know the answer to a math problem. Anxiety often comes with the standard of perfection or nothing at all, with little in between. It’s either good or bad, pass or fail. Errors and mistakes or anything lower than a high set standard is equated with shame, guilt, or feeling incompetent or unintelligent. Not achieving 100% or being 100% accurate holds the fear of letting others down and not being “perfect.”
With education managing the pandemic as best as it could, our kids lost time and skills. Many children’s learning disabilities went unnoticed and undiagnosed as teachers could not see the student’s work directly. In my practice, I have been evaluating and diagnosing children with learning disabilities and other disabilities that likely would have been diagnosed two to three years ago. At nobody’s or no institution’s fault, our children are missing academic skills for their present age and grade level, thus certain academic classes are difficult. However, our kids aren’t necessarily aware of this reason for their struggle in reading, writing or math, and instead, are anxious about going to school and blame themselves for experiencing this struggle. I hear again and again, “I SHOULD be able to do this work, but I can’t so I’m stupid.”
Now What?
Relate, Engage and Move
Our children are emotionally starved and are trying to make up for the lost time. Their self-esteem has suffered. As parents, create family time and time with friends and extended family. Many of us as parents used to have an active social calendar and the onset of the pandemic decreased that zest to reach out and set the dates on the calendar. For younger children, create playdates at least one time per week. If during the week is difficult, try to set one playdate per weekend at a minimum. If possible, create plans to do social things with other families and their children to create those bonds and memories that our children can build on. Although our children say they have friends in school, the amount of time spent socializing during class is minimal and friendships will be formed and strengthened outside of school, for the most part.
Just yesterday, a 9-year-old little girl said to me, “You know, since COVID, I don’t play soccer anymore. I used to but now I don’t.” I asked her why she doesn’t play soccer anymore and she said, “I just got used to not playing soccer.” This one short sentence summed up for me how our children lost their interests during and after shut down and are struggling to return to the sports and activities they enjoyed or are struggling to find new ones.
Parents: talk to your children about finding an activity or sport that they think they may enjoy. Find local classes or teams and join for a trial class or session. Part of the hesitation is not knowing how to be a part of a team anymore, which – particularly for younger children – may feel like a distant memory. There may be hesitation in holding accountability as a team or group member. If your child struggles to be on a competitive team, find an activity or sport where they are competing against themselves such as track.
Our bodies are not meant to be this sedentary and our children sat in front of a computer instead of walking through the hallways, participating in their physical education class, or playing on the playground. The natural inclination to move may have been quieted and we all need to awaken that instinct once again. Encourage your kids (of any age) to go outside (even if it’s cold) and take a walk by themselves, with a friend, or walk the dog. Take a bike ride, ride a scooter, play on the playground, go for a hike, find indoor swimming (during the winter), join a gym, or create a home gym – anything that keeps the body moving and pumps endorphins.
Engage Your Child’s Teachers
If you notice that your child is struggling in any one or more subjects, reach out to your child’s teachers and ask for a meeting with one teacher or their entire team of teachers. Ask them if they are noticing what you may be noticing in terms of struggle with anxiety, reading, writing or math. Ask the questions:
- Is my child finishing assignments in class?
- How well is my child able to express herself in writing?
- Do you notice significant spelling, grammatical or punctuation struggles?
- Is my child able to understand what he has read to himself?
- Is my child able to answer questions verbally in class?
- Is my child a multi-sensory learner or a child who learns best through hands-on, demonstration or doing?
- How well is my child able to make inferences and make connections between concepts?
If there is suspicion of a learning disability, reach out to the school’s Child Study Team or seek a private psycho-educational evaluation. If you don’t suspect a learning disability, perhaps your child needs a tutor to build more foundational skills in math, reading, or writing. There are often students at the high school level who are available as peer tutors or are seeking service hours.
Just as there is documentation about long-COVID, which is a physiological manifestation of the effects of the virus, we may be facing the long-term emotional and social impact of the pandemic on our children. Ask questions and seek support and resources for you and your child.
Pitlik S.D. COVID-19 compared to other pandemic diseases. Rambam Maimonides Med J. 2020;11(3)
Dictionary.com, Definition of Anxiety: https://www.merriam-webster.com/dictionary/anxiety
Johnson, Barbara. Why You Gained Weight After COVID-19, https://www.drbarbarajohnson.com/blog/why-you-gained-weight-after-covid-19
