Children's Mental Health Responses During COVID-19

One of the biggest topics in my virtual office these past few weeks has been normalizing children’s stress response to COVID-19. Families I work with range from seeing restrictions as an annoyance to full on panic, but nearly all of them realize that this is something new and uncharted for children, our nation, and the world. Even the healthiest and most well-regulated children and families are feeling the impact.

Okay – brace yourself – 99.9% of children in the world today, in this moment, live with some form of pandemic related movement restriction. For many families this comes with an increase difficulty in getting nutritional, education, financial, and safety needs met among others. 

Past research has shown us that during times of health emergencies leading to closing of schools and other social services resources, children are at heightened risk for exploitation, violence, and abuse.  And additionally, those young people who needed the support of a strong special education team to meet their needs are left without crucial services and at high risk for falling behind or further behind.  All of this is an additional to the anxiety, fears, and rumination about the pandemic in general – especially for children who have parents that are essential workers or work in the medical field and need to leave the home or who love and care about someone who would be at high risk for infection.  Let’s face it – that definition encompasses most children.

So here is the other thing –although we know children will be impacted by the pandemic, we can’t assume that all children will have a trauma response.  Although we can agree that COVID-19 and the global impact of this pandemic is traumatic – it depends on children’s perceptions if a trauma response will develop. The child that thinks “Everyone I love will die” will likely have a different reaction than the child that thinks “I know we are doing everything we can to keep safe”.  The child who has had one or more family members pass away from COVID-19 in a community with a high infection rate such as New York is likely to have a different response than a child from a rural community that has had low rates of infection.

Every child will react a slightly different way to COVID-19. The good news is there are no right or wrong ways to feel – all feelings and behaviors are the bodies way trying to make sense, process, and regulate as well as meet our needs. While some choice may be unhelpful – all behavior is purposeful – an attempt to get to a regulated and safe state.  It is through this lens that we can gain an increased understanding of what is driving the behaviors so we can problem solve alternatives.      

To be honest, some children may LOVE the fact that they get more time with their parents and the decrease in transitions from home to school and activities. They might enjoy the fact that they don’t have to go to a school where they get bullied or have significant separation anxiety.  Young people may also like the fact that everyone else can’t go out without them, and they don’t have to see social media pictures of hangouts, movies, or birthday parties they weren’t invited to.  For those with social anxiety, it is a welcome break to engage with others from behind a screen and not having the pressure of being called on in class.

For other children these feelings of positivity and relief will definitely not be the case.  They may be angry, tantrums may increase, or irritability may come out.  Toys may be broken, names called, and art work ripped up.   Children may hyper-focus on the small things in an attempt to gain some form of control.  All of a sudden it becomes really important to have a certain brand of cereal or they HAVE to wear their favorite shirt even thought it is in the laundry. If it doesn’t go their way, it may seem like their anger comes out of nowhere, big and explosive. Also, in an attempt to gain control, there might be a spike in noncompliance of expected tasks.  The simplest thing may turn into an all-out battle. 

Some kids have hyper focus on anxiety triggers and will spin out and ruminate on minor triggers.  One of my favorite Deb Dana quotes is “story follows state” – meaning that our brains will create stories or reasons WHY our nervous system is dysregulated.  Oh – that math assignment you didn’t turn in last year?  The cookie you took from the grocery store at age 7?  When you said something mean about your friend on the playground earlier this year? YES! That is why you are anxious!  And sometimes our brain feels like if we can just solve this problem in front of us everything will be better! 

For me this week it was trying to find a note I had written on an index card leading me to tear apart up and down my home “office”.  Where did I find this note?  Not at all on an index card, but actually on a post-it turned upside down on my desk.  Spoiler alert – finding the note didn’t regulate my nervous system.

Other times anxiety can take over in an attempt to gain control by becoming very focused on routine, structure, or placement. Sometimes children (and adults too) convince themselves that they will regulate if their routine doesn’t change, their books are in the right place, or when nobody switches chairs at the dining room table.  There can be sadness, meltdowns, and tears if things are out of place. 

There can also just be sadness in general. A down mood, feeling slowed down, and concentration can be difficult.  You might give a child instructions 3 to a zillion times and they might not be able to focus enough to finish a task.  Other kids might get jumpy, have a flight energy, and be constantly moving their bodies. 

Kids also might feel flooded or overwhelmed by the range of feelings and just want to check out or disconnect and numb from their body.  This could look like binge watching TV shows, getting sucked into video games, or even the child that is re-reading the whole series or Harry Potter again barely coming out of their room to eat. You might also hear that kids are bored or there is “nothing to do”.  Nothing brings joy or excitement.

Also, because most of our nervous systems are on high alert and likely pumping out large amounts of cortisol and adrenaline children can get tired, lethargic, and oversleep.  A lot of young people are pushing bed times to later at night and sleeping in later in the day.  Other kids may put all of their effort and energy into SOMETHING like organizing their rooms or planning their fairy garden for the summer.

Other young people may have regressive behaviors.  This is when emotional or physical responses regress or "go backwards" to an earlier age.  This might mean talking in a way that is younger than their age, clinging to safety objects like a blanket, sucking thumbs again, waking up in the middle of the night, having bathroom accidents, or being unable to sleep on their own. 

Whatever the response, and let's be honest - the range is wide,  the hope is we can have compassion for all the ways we are trying to make sense of these times.  Hope that we can meet children where they are at and help create a felt sense of safety and co-regulation.

I SO want to keep the ball rolling on this conversation - leave a comment about what other responses have you seen within yourself, your family, or the children you work with!

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