Managing the long-term effects of the pandemic on your child's mental health

The COVID-19 pandemic has been an especially difficult time for children. Much more of their lives have been taken up by the pandemic in comparison to adults and the loss of in-person learning and favorite activities with friends has been devastating. As we look to a world beyond the COVID-19 pandemic, leaving fear and uncertainty behind will prove to be a difficult task for many adults and children alike.

We spoke with expert adolescent psychologist, best-selling author, regular New York Times contributor and mother of two Dr. Lisa Damour about how you can support and guide your child as they navigate life beyond the COVID-19 pandemic.

In what ways has the pandemic impacted children’s development?

The universal experience for children in the pandemic has been missing normal developmental opportunities. So much of what helps young people grow and learn comes from enjoying the company of a wide range of caring adults, spending time with a variety of peers and getting to engage in new and interesting experiences. Whatever else children and adolescents have lost in the pandemic, they all lost that. Their lives necessarily became very narrow and close to home. And while that may have kept them safe from COVID-19, it — without question — robbed them of the variety and complexity of life that is a needed and healthy part of development.

How have children’s social skills been affected by the pandemic?

In terms of social skills, kids are out of practice. Part of how they learn how to get along with others is by spending time with people, making friends, and also by being with people they wouldn't necessarily choose to be around. It's with practice that children and adults get better at doing all of those things. So we are definitely seeing signs of developmental lag in some children’s social skills. This is to be expected, but it can also be addressed.

The most important thing you can do is to be very explicit with children about how you want them to handle the challenges they run into. For example, if a child grabs a toy from another child, you can say, “Of course you want the toy. But here’s how you handle this: You say ‘when you are done with that can I have a turn?’”. Don't get frustrated with children for not always knowing the developmentally appropriate ways to interact. We shouldn't expect that they can figure it out on their own. We may need to provide children with more coaching and explicit instruction than we have had to provide in the past.

How have you seen the pandemic impacting children’s mental health?

Without question, the pandemic has caused tremendous distress for children and their families. Children are very sad, very anxious or even very angry about all they've been through. What we're likely to see in the immediate term are children who are just a bit more emotionally fragile than they would be normally. We can help children with that by being patient with them, helping them put their feelings into words or even find other ways to express themselves, such as through art, and offering them comfort and empathy.

In terms of mental health, I think one of the best things we can do is to not confuse being in psychological distress with having a mental health problem. The pandemic caused distress for everyone and, in fact, feeling upset by the pandemic and the conditions it brought about is a natural response. We only become concerned that there's a mental health problem when the child is unable to handle those feelings in ways that are adaptive, that help them feel better and that do no harm.

So when children are tearful about all they've missed out on, they are having the right feeling at the right time. They're handling that feeling effectively by expressing it through tears, and hopefully taking comfort from loving adults. If, however, a child is sad about all that has happened and is unable to receive or find ways to help themselves feel better, is doing things that are harmful to others or harmful to themselves, or is so sad that the sadness starts to interfere with the ability to enjoy anything or feel hopeful, then we want to treat that as a mental health concern and make sure that child gets the needed support.

What can a parent do if they are concerned about their child’s reaction to difficult feelings?

I think the first thing that you always want to do is to validate that they are suffering: “Your feelings make sense. You're having the right feeling at the right time. This has been an incredibly difficult period historically, and you've lived through it.”

The second step is to make the distinction between the feeling being the problem and the expression of the feeling being a problem. You can say, “of course you are upset, but the way you're letting us know how you feel – whether it's being unkind to everyone around you or being unable to get out of bed – is getting in your way or is harming others and we need to get help so that you can find healthy ways to get relief from this feeling."

>> Read: How to recognize signs of distress in children 

Are there any long-term mental health effects you anticipate seeing in children coming out of this pandemic? What can parents do to mitigate them?

I think the outcomes we want to try to prevent are children who become extremely cautious as a result of the pandemic. Their lives were hemmed in by the pandemic and I wouldn't want to see children continue to lead highly constrained lives when that is no longer necessary, because it will deprive them of all of the variety that will help them to thrive and flourish.

The other outcome we want to watch for is children who missed a step academically. That needs to be addressed and lost learning needs to be made up. I worry that there are children whose academic lives have been knocked off their trajectory and who need and deserve academic, as well as social and emotional support, to get their learning back on track at a reasonable pace.

The way we prevent these outcomes is first to continue to urge children to spread their wings when it's safe. If they're feeling really nervous about moving back into the world we can remind them that they don't have to do everything all at once. They can take small steps. We want to remember that, over time, avoidance feeds anxiety. Children have needed to avoid many things in the name of physical health. But in the name of mental health, once it becomes safe to be back in the world, it's important that they start to return to the normal activities that go with childhood and adolescence.

As for the academic challenges, there's a very big job to be done to understand what each child did and did not get at school, because the range of what was mastered — even in a single classroom — is enormous. Many children had a really difficult time learning during the pandemic, even those who had good access to online learning, which many did not. So the work ahead is to discern what children learned and what they didn't, and to find ways to fill in the gaps so that having missed content during the pandemic doesn’t go on to undermine their education going forward.

How can parents find support if they are feeling anxious about letting their children spread their wings?

I think we need to acknowledge that parents missed developmental steps too. Under normal conditions, our children branch out into the world gradually. For parents, that gradual process is part of what makes it more comfortable for us to encourage our children to exercise their independence. One thing I think a lot of parents are struggling with right now is they have had their children and teenagers very close to home for a few years. And so it's not easy as a parent to go from having your child very close to home to helping them gain the kind of independence that might be age-appropriate now. What I would encourage parents to do is to both help their children spread their wings, but also get support for how hard it can be to watch your child leave the nest.

One thing that can help is to talk with parents who raised children the same age as your child before the pandemic. Get reassurance from those parents about what 10-year-olds, 13-year-olds and 16-year-olds can be expected to do independently. Because when parents feel confident that a child can manage independently, it helps to build confidence in children that they can do things on their own.

>> Read: How to support your child through reopening