Supporting Your Child's Mental Health

In recent weeks, merely watching the news has felt dangerous to our mental health—especially if we are parents. The horrors of the school shooting in Uvalde, Texas, have been playing and replaying on our own inner TV screens, creating unthinkable levels of shock and anxiety. And our children are just as susceptible to these destabilizing emotions as we are.

We can use all the help we can get to help our children process it all, on top of everything else they have been processing since the coronavirus arrived on our shores more than two years ago.

But well before then, mental health issues among children and adolescents had been on the rise in the U.S. Depression, anxiety, self-harm and suicidal thoughts—especially among adolescents—have plagued American families for years, but the COVID-19 pandemic has eroded child mental health in unprecedented ways. And parents and mental health professionals alike have been working overtime to help children and teens cope and heal.

At an earlier stage in the pandemic, the virus caused major disruptions in our day-to-day lives. “Families were coping with fears of an unknown virus and the stress of isolation and loss,” says Dr. Corinne Catarozoli, a clinical psychologist at the Weill Cornell Specialty Center and Assistant Professor of Psychology in Pediatrics at Weill Cornell Medicine. “Parents struggled to create and maintain routines while juggling child care and working from home.

“Now, children and families are facing different types of stressors,” she continues. “The return to in-person learning and socializing has created anxiety for many children, having been separated from their peers for almost 2 years. While some youth experienced a reprieve from social anxiety during earlier stages of the pandemic, it has come roaring back with the reopening of schools and other public spaces.”

Read on for additional insights and advice from Dr. Catarozoli in response to our questions.

What are the signs of depression and anxiety in children and teens? How can parents learn to assess their children’s mental health?

Common signs of anxiety in children include:

• Excessive worry
• Avoidance of feared places or situations such as school and social gatherings
• A need for constant reassurance
• Abdominal pain, headaches, nausea or chest pain
• Changes in sleep patterns or appetite

In young children, also look for signs of behavioral regression, in which a child may retreat to an earlier developmental stage. These signs may include sleep disruption, separation anxiety or tantrums.

Among teenagers, parents should pay attention to mood changes that last for longer-than-usual periods of time. Unlike the more usual adolescent “moodiness,” these changes can be so intense that they disrupt the ability to function. If your teenager remains withdrawn from friends, family and formerly rewarding activities, that may be a sign of depression or anxiety.

How can parents or caregivers help children cope with the uncertainty surrounding the pandemic and the prospect of a post-pandemic future?

Tolerating uncertainty can be extremely difficult for children and adults alike. Parents can help their child focus on what they can control as opposed to what they can’t. Try to shrink down their “worry period” to the current day, week or month, rather than focusing on months or years down the line. Use coping thoughts like “that’s a worry for another day.”

Please share some strategies for helping children stay calm and reversing the “anxiety spiral.”

Deep breathing, progressive muscle relaxation and guided imagery are all great techniques for staying calm. Teach your child to call anxiety by its name and say, “that’s my anxiety talking,” or “that’s my worry brain again.” That labeling can help create distance between the child and potentially overwhelming thoughts and feelings. Children can also challenge their anxiety by examining evidence and facts and incorporating these into their thinking.

Parents may use a gradual, step-by-step approach to help children practice facing their fears. Taking small steps towards scary situations teaches children how to tolerate their anxious feelings.

What are the pros and cons of digital technology and social media, especially during the long months of the pandemic?

Let’s focus on social media. On the “pro” side, it has been an extremely useful tool that has helped teens stay connected during an otherwise isolating time.

While research on the connection between social media use and mental health is mixed and complex, many agree that it’s the way someone uses social media that is critical to its impact. Passively consuming social media—i.e., scrolling and observing but not engaging—may be more linked to depression and anxiety than more active use—directly engaging with other users. One more downside is sleep disruption, especially for teens who keep their phone in their room or on their bed.

While social media can have benefits, it is not a replacement for in-person interactions.

How important is self-care for parents? What are the best ways for the adults in the family to take care of themselves?

Given the unprecedented nature of the coronavirus pandemic, it’s natural for parents to feel anxious and overwhelmed. But it’s important for the adults in the room to model remaining calm and stable, because kids tend to look to their parents to gauge how worried they should be. Parents can prioritize their own mental health by practicing relaxation techniques, getting regular exercise, limiting excessive news-watching and connecting with others.

To combat catastrophic thinking, say to yourself, “this is temporary; we are doing what we can to stay safe.” If your stress is impairing your ability to parent or function, reach out to a mental health professional for support.

Is it possible to foresee the longer-term effects of the pandemic on children’s mental health?

We don’t yet have the data to guide such predictions. However, we have effective treatments for many of the mental health issues children and teens are facing, including cognitive behavioral therapy, an evidence-based treatment that has been shown to reduce child anxiety in numerous clinical trials.

Gaining access to these treatments can be extremely difficult right now, due to increased demand. Lack of access to mental health services is particularly concerning for marginalized populations who have been disproportionally affected by the pandemic.

What we do know is that youth are resilient in many ways. Even low-income, disadvantaged families have options, especially in a city like New York, with its wealth of resources.

To make an appointment with a mental health professional at Weill Cornell Medicine, go to https://weillcornell.org/services/psychiatry or call (646) 962-2820.