The Long Arc of Misery

By Stephen Gray Wallace.

Why resiliency is key for kids during, and after, the pandemic

These days, it seems that every time we are about to turn a corner on COVID-19, we somehow miss the intersection. Such is the long, slow, agonizing slog that is the pandemic.

By now, most people are familiar with the short-term challenges posed by the virus to people young and old. What we may not have yet factored into our calculus of the total toll are the longer-term effects. With the Centers for Disease Control (CDC) out of alignment with a growing number of states going maskless, it’s hard to even conceptualize “an end” to this most pernicious of diseases. One thing, however, is clear: learning loss, social isolation, and a vast, vague sense of the future won’t suddenly disappear once (and if) the mutating cells cease to do so.

Mountains of data suggest the present holds considerable risk for young people, perhaps especially for teenagers. The passage from childhood to adolescence was already marked by self-doubt and uncertainty. COVID-19, with its school-prescribed isolation, only amplified the angst.

Indeed, a warning from the CDC noted that mental-health-related emergency room visits for children aged 12 to 17 increased by 31 percent from April through October 2020 (Leeb et al, 2020). These included reports of increased anxiety, depression, schizophrenia, self-harm, and substance abuse (SOS Illinois, 2021).

Of course, the kids are not alone. Physicians for Human Rights reported, “In January 2021, four out of ten adults in the United States reported symptoms of anxiety and depression, a 400 percent increase from January 2019” (Flores, 2021).

But back to the kids.

America Rafanelli of Direct Relief, a humanitarian aid organization active in all 50 states and more than 80 countries, described the pandemic’s effects on children’s development: “While Covid-19 is typically benign in children, the pandemic could have long-lasting impacts on society’s youngest members. With childcare programs closed and social distancing measures in place, many children are missing out on opportunities for development.”

She spoke with Dr. Michelle Aguilar, the head of pediatrics at Venice Family Clinic in Los Angeles, who offered, “‘Children are not getting the cognitive and social stimulation that they would normally get outside their home.’” Rafanelli continued, “Providers have noted delays in speech and language as well as trouble sharing and being in groups.

“But for children, a delay in social skills may not be the only consequence of the pandemic. With many parents undergoing financial stress, children face higher rates of housing and food insecurity. And others are subject to rising rates of neglect and household dysfunction – all of which can affect a child’s trajectory into adulthood” (Rafanelli, 2021).

What many clinicians fear the most is the prospect of the pandemic inciting a rise in youth suicides, already a leading cause of death for teens. A Baylor College of Medicine article, “COVID-19 and the Rise of Teenage Suicide,” reports, “The pandemic uniquely impacted adolescents. Social isolation, constant uncertainty, stress, and fear have plagued their lives. According to the CDC, teenage emergency room visits for suicide attempts increased significantly during the pandemic, with a 50% rise in cases in females and almost 4% increase in males” (Rosenbaum, 2021).

Thus, as we crawl our way across the arc of misery that is COVID, it is critical that parents and all caring adults pay special attention to the emotional state of the children in their care.

One of the most important steps in helping to prevent suicide is being able to recognize the warning signs of suicidal ideation (planning or having thoughts about suicide). Teens, known for sleeping late and having mood swings as part of just being a teen, can be good at masking their feelings. But extreme mood swings and changes in sleeping habits (more or less sleep) are only some of the signs of suicidal ideation. Drug and/or alcohol use might start or worsen, and withdrawal from friends and family should also raise a red flag.

So, what can worried parents and loved ones do?

Ask their teen directly about suicide. Contrary to what they might fear, asking about suicide or suicidal thoughts will not “suggest” the idea to a depressed young person. Heed any discussion of hopelessness, and talk of suicide or plans for suicide should be taken very seriously. When someone is having suicidal ideation, their risk of actually having a suicide attempt is much higher (Reinach Wolf, 2022).

The #BeThe1To campaign, created by the National Suicide Prevention Hotline, asks family and friends to “be the one to help save a life.” Starting a conversation and listening without judging is vital. Learn what to say, and what not to say. Be sure not to make promises that cannot be kept, such as promising not to tell anyone else, since the teen may require assistance from those trained in helping suicidal individuals.

And if a young person seems close to suicidal, first ensure the teen’s safety and then call 911 or go to the emergency room.

Teens need to know they are not alone, help is available and they will be supported. Check-in regularly and offer to help set up appointments with professionals.

Each day it becomes clearer that we will likely transition not to the end of COVID-19 but from a pandemic status to an endemic one. A recent Monmouth University poll reported that “Fully 7 in 10 Americans (70%) agree with the sentiment that ‘it’s time we accept that Covid is here to stay and we just need to get on with our lives …’” (Monmouth University, 2022).

Given that inevitable reality, one of the best things we can do for our kids is to help them build resilience, which will help them to cope with the everlasting landscape of the disease.

The article “10 Steps for Raising Resilient Kids” by Maria Tratakovsky offers insight from Lynn Lyons, LICSW, a psychotherapist who specializes in treating anxious families: “‘We have become a culture of trying to make sure our kids are comfortable. We as parents are trying to stay one step ahead of everything our kids are going to run into.’ The problem? ‘Life doesn’t work that way.’”

Lyons continues, “However, a parent’s job isn’t to be there all the time for their kids … It’s to teach them to handle uncertainty and to problem-solve.” She suggests the following tips.

1. Don’t accommodate every need.
2. Avoid eliminating all risks.
3. Teach them to problem-solve.
4. Teach your kids concrete skills.
5. Avoid “why” questions.
6. Don’t provide all the answers.
7. Avoid talking in catastrophic terms.
8. Let your kids make mistakes.
9. Help them manage their emotions.
10. Model resiliency.

The outcome? “Resiliency helps kids navigate the inevitable trials, triumphs and tribulations of childhood and adolescence. Resilient kids also become resilient adults, able to survive and thrive in the face of life’s unavoidable stressors” (Tratakovsky, 2016).

Resiliency has the benefit of also lowering suicide risks as children learn they have the skills and support to overcome obstacles, during and after the pandemic.

Stephen Gray Wallace, M.S. Ed., is a doctoral candidate in the Institute for Ethical Leadership at St. Thomas University in Miami, Florida. He is also an associate research professor and president and director of the Center for Adolescent Research and Education (CARE). Stephen has broad experience as a school psychologist and adolescent/family counselor. He is a member of the professional development faculties at the American Academy of Family Physicians and American Camp Association and a parenting expert at kidsinthehouse.com, NBC News Learn, and WebMD. He is also an expert partner at RANE (Risk Assistance Network & Exchange) and was national chairman and chief executive officer at SADD for 16 years. Stephen is an award-winning writer and author of the books Reality Gap and IMPACT. Additional information about Stephen’s work can be found at StephenGrayWallace.com.

REFERENCES

Flores, A. (2021). Pandemic burnout: the toll of COVID-19 on health care workers and children. Physicians for Human Rights. May 21, 2021. https://phr.org/our-work/resources/pandemic-burnout-the-toll-of-covid-19-on-health-care-workers-and-children/ (21 Feb. 2022).

Leeb, R., Bitsko, R., Radhakrishnan, L., Martinez, P., Njai, R. and K. Holland. (2020). Mental Health–Related Emergency Department Visits Among Children Aged <18 Years During the COVID-19 Pandemic —January 1–October 17, 2020. MMWR Morbidity and Mortality Weekly Report 2020. https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a3.htm (21 Feb. 2022).

Monmouth University. (2022). Time to accept COVID and move on? January 31, 2022. https://www.monmouth.edu/polling-institute/reports/monmouthpoll_us_013122/(21 Feb. 2022).

Rafanelli, A. (2021). Growing up in a pandemic: how Covid is affecting children’s development. Direct Relief. January 19, 2021. https://www.directrelief.org/2021/01/growing-up-in-the-midst-of-a-pandemic-how-covid-is-affecting-childrens-development/ (21 Feb. 2022).

Reinach Wolf, C. (2022). Family members can play a role in suicide prevention. Psychology Today. February 7, 2022. https://www.psychologytoday.com/us/blog/the-desk-the-mental-health-lawyer/202202/family-members-can-play-role-in-suicide-prevention (23 Feb. 2022).

Rosenbaum, T. (2021). COVID-19 and the rise of teenage suicide. Baylor College of Medicine. November 17, 2021. https://blogs.bcm.edu/2021/11/17/covid-19-and-the-rise-of-teenage-suicide/ (21 Feb. 2022).

#BeThe1To. (2022). Be the one to help save a life. National Suicide Prevention Lifeline. https://www.bethe1to.com/ (21 Feb. 2022).

SOS Illinois. (2021). Teen mental health: a vulnerable stage of life. SOS Children’s Villages Illinois. https://www.sosillinois.org/teen-mental-health-a-vulnerable-stage-of-life/ (9 Feb. 2022).