The Battle with COVID-19: Children & Their Mental Health

Written By Esa Mohammed on December 24, 2022

For the past three years, the globe has been ravaged by a virus known as COVID-19, a respiratory illness caused by the coronavirus SARS-CoV-2. It was first identified in Wuhan, China in December 2019 and has since become a global pandemic. The virus spreads from person to person through respiratory droplets produced when an infected person breathes, coughs, or sneezes. It can also be transmitted by touching a surface or object contaminated with the virus and then touching the mouth, nose, or eyes. Symptoms of COVID-19 can range from mild to severe and may include fever, cough, difficulty breathing, body aches, fatigue, and loss of taste or smell. Some people may have no symptoms at all, while others may develop severe illnesses and require hospitalization. There is currently no specific treatment for the disease, but many people recover on their own with supportive care. Several vaccines have been developed to prevent infection, inducing an immune response that protects against the virus. Currently, several vaccines have been authorized for emergency use and are being distributed and administered globally. These vaccines have been shown to be effective at reducing the risk of infection and severe illness from COVID-19.

This disease has taken its toll on many, impacting various groups and economic climates. Consequently, the pandemic harmed the mental health of children through factors of isolation and anxiety. Many children have experienced changes in their daily routines and activities, including disruptions to their schooling and social interactions. The stress and anxiety of the pandemic, as well as the loss of loved ones or changes in family circumstances, can all contribute to mental health challenges in children. Increased mental health problems among children and adolescents have been observed during the outbreak, leading to significant healthcare concerns. Survey studies provided unique opportunities for research during this pandemic, however, there were not many systematic reviews with children as the main focus for health professionals. The pandemic has had a significant and wide-ranging effect on children’s and teenagers' mental health. 

According to various survey studies conducted on child and adolescent mental health throughout the pandemic, most children and adolescents that were infected with COVID-19 seem to have had mild to moderate symptoms and low mortality rates. Yet the main symptoms associated with mental health include anxiety, stress, depression, panic, irritation, impulsivity, somatization, sleep problems, emotional lability, post-traumatic stress disorder, and tendencies of suicidal behavior. To enhance the physical safety of children, we must reduce the earlier precautions of transmission (e.g. quarantine, social distancing, virtual school) as these are determined as the factors contributing to all the following symptoms. Nowadays, in a post-pandemic world, everything is relatively open, but we are still paying the price for those 3 years, especially when it comes to our health. Countries asked their citizens to practice health precautions like social distancing, wearing masks, and sanitization, leading to the closing of educational institutions and transitioning to online exams and coursework. This is of great focus as young children may sense and observe their parent's stress and display their behavior under a disguise which can be interpreted as defiant behavior leading to more aggressive behavior and thus an increase in parental self-doubt and feelings of insufficiency, difficulty understanding and empathizing, depression and lack of self-control which in the end could lead to a sense of withdrawal which may end up triggering trauma or a specific stress response. Older children and adolescents may have been unable to attend birthdays, school shows, hang with friends, extracurricular activities, as well as visiting family. Psychologist Erik Erikson's model of psychosocial development is a theory that describes how individuals progress through eight stages of development throughout their lifetimes. According to Erikson, each stage is marked by a specific psychosocial crisis that the individual must resolve to move on to the next stage. Throughout the 8 stages of psychosocial development, Stage 5 (Identity vs Role Confusion) which takes place between ages 12 to 19, social relations are vital. Teens and college students possess certain traits like high energy, motivation, curiosity, and passion, which makes social relations and activities vital to them, and with COVID-19 we have seen increased stress levels as opposed to said traits. Children with special needs are especially vulnerable to the negative psychological impacts of school closures; children with autism spectrum disorder and neurocognitive disability can begin to become frustrated due to disruptions as their basic therapy sessions are removed, leading to problematic behaviors such as irritability, aggression, and social withdrawal whereas for children with pre-existing mental illnesses, it has been observed that those suffering from depression and anxiety disorders may feel overwhelmed with the news of death and disease. In a recent study conducted, it was found that negative psychological impact from quarantine can be found after months and potentially years. There is a four-times increase in mean post-traumatic stress scores in quarantined children vs non-quarantined children. This indicates that a high percentage of these children may fulfill the requirements for PTSD.

The overall understanding of COVID-19 has spread throughout the world, but we are still yet to see the long-term mental health impacts on children as they are too complex to estimate with our current research. Overall, measures to prevent the virus from spreading and handling uncertain situations pose big risks to the psychological well-being of children which is why it is the responsibility of the guardians and caregivers to consistently use open communication and counseling to address the specific stressors. If we want to attain positive results then we must consider the thought of implementing positive coping mechanisms which may help play a factor in familial and social support for these affected children. Following these five steps as a guideline could yield positive results:

1.) Maintain a sense of structure and routine: Children often thrive on structure and routine, and the disruptions caused by the pandemic can be unsettling. Maintaining a consistent daily routine, including regular meal times, bedtimes, and structured activities can help provide a sense of stability and normalcy. 

2.) Encourage open communication: Encourage children to express their feelings and concerns about the pandemic, and provide a safe and supportive environment for them to do so. Listening to their concerns and answering their questions honestly and age-appropriately can help alleviate their stress and anxiety. 

3.) Stay connected: The isolation and lack of social interaction caused by the pandemic can lead to feelings of loneliness and isolation. Encourage children to stay connected with friends and family through phone calls, video chats, and other virtual means.

4.) Engagement in activities: Encourage children to engage in activities that they enjoy, such as hobbies, creative pursuits, and physical activity. These activities can provide a sense of accomplishment and help alleviate stress and anxiety.

5.) Seek help if needed: If you are concerned about your child's mental health, it is important to seek help from a mental health professional. This can include speaking with a school counselor, a pediatrician, or a mental health provider.

It is also important to take care of mental health as a parent or caregiver, as this can have a positive impact on your child's mental well-being. Taking breaks, engaging in self-care activities, and seeking support from others can help you manage stress and better support your child. All in all, the pandemic has caused significant stress and disruption to people's lives, and it is important to find ways to cope with these challenges. Some of these coping mechanisms may be applicable and beneficial to child patients with other health conditions as they may feel alienated from the concept of a healthy childhood. One of the most impactful diseases that can impact both the mental and physical health of youth is cancer. It can be a traumatic experience, and patients may experience a range of emotional challenges, such as fear, anxiety, and depression. Due to the unpredictability and uncertainty of the course of illness and prognosis, a child may need to try various techniques to improve their mental health and recover. The battle with COVID-19 may be near its end, however, with the research phase taking off, it is important to discover and study how the problems and solutions to the children’s mental health crisis can be impactful to global health on a larger scale.

References:

Leeb, Rebecca T, et al. “Mental Health-Related Emergency Department Visits among Children Aged <18 Years during the COVID-19 Pandemic - United States, January 1-October 17, 2020.” MMWR. Morbidity and Mortality Weekly Report, U.S. National Library of Medicine, 13 Nov. 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660659/. 

Shah, Kaushal, et al. “Impact of Covid-19 on the Mental Health of Children and Adolescents.” Cureus, 26 Aug. 2020, https://www.cureus.com/articles/38703-impact-of-covid-19-on-the-.

Theberath, Monique, et al. “Effects of Covid-19 Pandemic on Mental Health of Children and Adolescents: A Systematic Review of Survey Studies.” SAGE Open Medicine, U.S. National Library of Medicine, 30 Mar. 2022, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8972920/.