Anxiety, Fear, Loneliness may lead into depression, varied psychological disturbances
While parents are fighting the Pandemic…..Is Children Suffering Silently?
Children must be taught to face Pandemic by parents
Fear is the oldest and strongest emotion of Mankind, Most significant fear being the fear of unknown. Fear is a most protective instinct for humans as long as it doesn’t disable and itself ruin them.
Lot has been talked about COVID-19 and its effect on physical health. What about mental health particularly in Children? While adults are lost in sorting themselves out trying to figure out how to protect themselves and their family, their finances and all; unknowingly they are modeling responses for the kid and setting a precedent. That means the anxiety and depression in the parent evokes similar responses in the kids too.
Types of Stress and Anxiety that impacts children
There are multiple types of stress and anxiety that is creating psychological impact on children and adolescents….
- Fear of the disease and its impact on self accenterated by media.
- Fear of losing near and dear to the disease.
- Lack of routine and lack of information about possible return to school and friends.
- Social isolation due to lack of peer interaction leading to depression.
- Lack of Physical exercise and no hobbies, disrupting moods thus creating sleep disruption.
- Exposure to domestic violence, violence among parents on each other and violence over kids at home.
- Worry about financial instability often discussed by adults at home, oblivious to its effects on kids.
- In low income groups, loss of school meal and hence poor nutrition leading to psychological disturbances.
- Biggest danger of unlimited exposure to online content particularly adult content and predators online.
- Boredom leading to rise in alcohol and substance abuse, both in parents and teenagers.
- Online classes and challenges posed by new form of education
- Most government school children with working parents loosing a year of education, sometimes landing them in child marriages and hence school dropouts with far reaching consequences.
According to Dr. K Sharmila, senior consultant Pediatrician & Neonatologist , Apollo Cradle & Children Hospital, Hyderabad “during this period younger kids might manifest by getting clingy, crying episodes, tantrums, being irritable, new onset bet wetting, yelling at every one or with draw and become silent and minimal”. She also explains that these kids might either start eating a lot or become anorexic and not eat much. When it comes to adolescents in addition to all of the above, there might shut themselves away from family or start getting addicted to screens or substances (Tobacco, Alcohol or drugs), She adds with a word of caution. If this is not properly understood and a right remedy is not found then they might end up with suicidal ideation too.
In addition to the normal kids exposed to abnormal circumstances reacting as described, we have small proportion of kids (with special needs who get very difficult to manage at home. They end up being violent and destructive and sometime being punished by violent means by desperate parents.
Apart from psychological issues, and symptoms, anxiety, depression might lead to pain, headache, sleep disturbances with sleeping long hours, or most of the day and disruption of night sleep disrupting the next day. Lack of Schedule compounds this. Identifying the problem is first and most important step to reach a solution
Need for a proper schedule
The single important intervention needed is to reestablish a routine, albeit not written in a stone, a negotiable routine made by sitting with the kid given the chance to setup a routine and follow it, says Dr. K. Sharmila, senior consultant Pediatrics & Neonatologist , Apollo Cradle & Children Hospital, Hyderabad. Routine should include time to spend time with friends over phone, in the family at home in addition to online classes, study and other activities, she advises. She also cautions about a set of the “worrying well” parents, those with no disease but afraid of contracting it while passing on the anxiety to the children by repeatedly insisting on following instructions, which are unreasonable and over the top. The three major health care interventions which are hand washing, masking and physical distancing are important enough to stay safe, she adds.
Just as physical health is influenced largely by mental health, physical exercise of any kind definitely creates happy hormones and is known to keep children happy and healthy. Ensuring nutritious food with fruit, nuts and veggies endures both physical and mental health as micro nutrient deficiencies effect mood. Being strict and ensuring adequate sleep and maintaining bed time will sort out mental health in a big way.
Young Kids will love spending time with parents but making it mandatory for older kids and adolescents too and communicate by keeping conversation going will help pick up mood disturbances early and attend to them. Just make family time, part of non negotiable routine particularly with adolescents.
Losing friends and Family Members
Another much missed out aspect is insisting on being in touch with friends over phone and video call. This will help kids particularly teenagers a lot. In underprivileged homes, teachers and school provide respite from abusive harsh environment, so getting them to connect with teachers help maintain sanity. Online counseling helps and more importantly all general practitioners should double up as counselors and make parents aware of these issues.
A happy parent only can nurture a kid into a happy one. So parental anxieties, depression need immediate help. Loss of a dear one, separation of parent in isolation or in hospital has to be explained well and the child reassured of return to normalcy by teaching coping strategies.
As children tends to spend most of their time on digital devises and internet, Dr. K Sharmila, senior consultant Pediatrics & Neonatologist , Apollo Cradle & Children Hospital, Hyderabad advises the parents need to regularly monitor Online content and also advises them to discuss perils of social media like trolling, bullying, cheating and predators who groom children sexually should be warned against, particularly with adolescents.
At the End:
Is it all that gloomy – no. Lockdown actually provides a much needed break from gruelling routines and super competitive racing for children. Most children breathe easy, get creative and bond with parents, better still for socially awkward kids who find it relaxing though this is temporary and many a child is motivated towards social service looking at the parents involved in same.
At the end every cloud has a silver lining, COVID 19 definitely brought families more close than ever hoping all is well that ends well. It definitely well :}}
Article prepared by –
Dr. K.Sharmila, senior consultant Pediatrics & Neonatologist, Apollo Cradle & Children’s Hospital, Jubilee Hills, Hyderabad, completed MBBS, MD (Pediatrics) from Osmania Medical College. She Worked as Honorary associate professor, Macquarie university( Australia); Ex Assistant professor pediatrics, Apollo medical college and is having 17 years experience in managing newborns and pediatric patients in emergency and outpatient care. She also received multiple health care awards, vaidyavibhushan being the latest. During this pandemic, Dr Sharmila has treated COVID children ranging from 2 month old baby to 20 year old adolescent.