A Brave New World

Amid warnings of a new, and potentially more contagious, strain of COVID-19 (Delta Plus) lurks an unrelenting optimism of life returning to normal. Nonetheless, reentry may be anxiety-provoking, perhaps especially for children and teens.

It’s one more hit in a decades-long spiral of youth mental health. Loneliness, anxiety, and depression have been well-cataloged among pandemic-era students. A study issued by Challenge Success and NBC News in February 2021 yielded three key findings.

1. KEY FINDING 1: Students, especially females and students of color, continue to experience high levels of stress and pressure.
2. KEY FINDING 2: Students’ engagement with learning, which is always a challenge, is especially low now.
3. KEY FINDING 3: Students’ relationships with adults and peers are strong, yet appear strained in recent times.

Similar data from Total Brain, also released in February of this year, concludes, “The COVID pandemic is having a dramatic impact on U.S. students’ mental health which, in turn, is affecting precious cognitive capacities like memory, focus, and planning.” Other findings include the following.

• 48% of high school and college students are at risk of general anxiety
• 45% are at risk of social anxiety
• 39% are at risk of PTSD
• Risk of common mental health conditions is 19% to 41% higher for females than males

Earlier reporting by the Centers for Disease Control and Prevention noted that during a ten-year period (2007-2017) the suicide rate among persons aged 10-24 increased 56% and the suicide rate for persons aged 10-14 declined from 2000 to 2007 but then nearly tripled from 2007 to 2017.

So, while these problems are not new, COVID-19 didn’t help.

A Children’s Health report from the University of Michigan reveals, “For teens, pandemic restrictions may have meant months of virtual school, less time with friends and canceling activities like sports, band concerts, and prom.

“And for young people who rely heavily on social connections for emotional support, these adjustments may have taken a heavy toll on their mental health, a new national poll suggests.

“Forty-six percent of parents say their teen has shown signs of a new or worsening mental health condition since the start of the pandemic in March 2020, according to the C.S. Mott Children’s Hospital National Poll on Children’s Health at Michigan Medicine. Parents of teen girls were more likely to say their child had a new onset or worsening of depressive symptoms and anxiety than parents of teen boys.”

Poll co-director and pediatrician Gary L. Freed, M.D., M.P.H., points out that while teens are biologically calibrated to seek independence from their families, pandemic precautions kept them at home.

Another problem associated with COVID-19 is a sharp increase in screen time, according to a study from Morgan Stanley and the Child Mind Institute. Their report in March says, “Many children are benefiting from virtual schooling and socializing during the pandemic, including some who have anxiety or have struggled to connect with other kids in person. However, excessive internet use can also trigger unhealthy behavior, including loss of sleep and interest in relationships or activities, neglecting schoolwork, going online to avoid unpleasant feelings, and acting out when internet time is limited.”

Nick Mancusi, a 19-year-old student at Macalester College in Minnesota, told me in an email, “Life going back to normal is definitely not as easy as I thought it would be. Socially, lots of my anxieties are back, like doubting myself and not being confident in myself. Life is normal, but at the same time very overwhelming. I feel as though I should feel normal, but I don’t.”

After more than a year of caution, Nick’s anxiety is understandable.

In her New York Times article “The Nervous Person’s Guide to Re-Enter Society,” Christina Caron shares some tips for the transition back to normal.

• If you don’t want to jump into the pool, dip your toe in first.
• Don’t wait for the anxiety to go away.
• You do not have to replicate what you did in the ‘before times.’
• Let go of resentment.
• Prioritize activities that help reduce anxiety.

For her part, Phyllis L. Fagell, a licensed clinical professional counselor, in her Washington Post article “6 Ways to Help Kids Regain a Sense of Purpose,” advises, “Although some children will dive into school and activities with enthusiasm as the pandemic lets up … others will be more guarded.” She quotes Suniya Luthar, a professor emerita at Teachers College at Columbia University: “‘We’re wanting a child to run, but in my view, children almost need to walk again in terms of negotiating life … We need to ensure they’re not unhappy, distressed or nervous about meeting friends before we can expect them to get passionate about the saxophone again.’”

Fagell goes on to offer some parenting tips for these difficult times.

• Create a realistic plan for transitioning.
• Give them something to hold onto with certainty.
• Address social awkwardness and insecurity.
• Prioritize fun, humor, play and connection.
• Help them practice self-compassion.

Teens in particular may not always share how they are really feeling, so we need to look for subtle clues about their overall mental health. Experts at Newport Academy, a series of evidence-based healing centers for adolescents and families struggling with mental health issues, eating disorders, and substance abuse, warn parents about a specific and dangerous form of depression, saying, “Smiling depression is what’s known as an oxymoron—two words that don’t seem to make sense together. Unfortunately, smiling depression is real. It’s a form of depression in which a person appears to be happy and even thriving on the outside while suffering on the inside. A teen with smiling depression may get good grades, do lots of extracurricular activities, and have a large circle of friends, all while hiding their true feelings even from those who are closest to them.

“While putting on a happy face for the world, teens with this disorder usually feel very different inside. They are exhausted by the effort of hiding their depression day in and day out, and constantly afraid of being discovered. In addition, they may experience any or all of the following depression symptoms:

• Overwhelming sadness and hopelessness
• Lack of self-confidence and self-worth
• Anxiety
• Mood swings
• Difficulty concentrating and making decisions
• Suicidal thoughts
• Feeling ‘too fast’ or ‘too slow’
• Not taking pleasure from activities they used to enjoy, despite pretending to.
• Sleeping too much or too little, including long naps during the day
• Significant changes in appetite or weight
• A feeling of heaviness in the arms and legs
• Body aches
• Headaches
• Irritability and restlessness
• Substance abuse
• Extreme reactions to what they see as criticism or rejection.”

In the end, most young people will find their way through the vagaries of transition and find success. According to a recent article in Inc. magazine, parents can aid that process in five ways.

• Be a role model (but not their only role model).
• Teach them to love the outdoors.
• Teach them to prioritize kindness.
• Praise them the right way (effort not their gifts).
• Be there for them, and then some.

Also helpful is recognizing their resilience and courage while learning to excel in a brave new world.