As a pediatrician working in the ER, I have been fighting COVID on the frontlines for the past few weeks. And although children aren’t suffering as much physically from the virus, there still remains a huge threat to kids while the virus is around. The already taboo topic of emotional and mental health isn’t often top-of-mind when it comes to fighting the novel coronavirus. But the emotional toll of COVID on kids may be just as dangerous as the physical symptoms.

With the exception of a few cases, we have been so lucky that the virus causes more mild symptoms in the pediatric population. Children are not often getting the same severe respiratory complications that are so concerning in the older population.

However, we are missing a huge piece of the puzzle – emotional well-being. I have treated panic attacks, drug abuse, and depression.

COVID-19 has changed lives in unimaginable ways. Whether your child was preparing to start kindergarten next year or graduate from high school in the coming months, their entire world has been turned upside down.

Structure is gone. Routine is gone. There’s only endless uncertainty.

Organized sports, playdates, and birthday parties are all a distant memory. Our children are quickly learning new concepts, such as social distancing and death tolls. They watch us leave the house in masks and gloves. This imagery can be incredibly scary and provoke extreme anxiety.

Coping with the Emotional Toll of COVID on Kids

As we all navigate our new normal, it’s important for us to stay in tune with the emotional needs of our children. We must provide the support they need to process what is happening. So how do we do that?

1. Turn off the news when you are with your children.

This advice is extra difficult for parents who now have kids home all day. We know kids are “biological supercomputers.” They constantly scan their environment and soak in information. When they have incomplete information, they fill in the blanks to make life seem orderly and predictable. While their “kid logic” is always cute, and usually funny, it rarely leads to accurate conclusions.

Although the news is an important tool to stay educated, it consists of imagery and language that can provoke fear and anxiety for children. They may not be able to process the information depending upon their age. And the images alone can provoke fear and feelings of sadness.

Try to limit the amount of time you watch the news in front of your children. If your child appears to see something upsetting, refocus and introduce images that illustrate human kindness and love.

2. Point out the good in all the chaos.

In every stressful time, there are dedicated and beautiful people who sacrifice their own safety to help others. “Look for the helpers,” as Mr. Rogers would say. Find a nurse helping a patient or citizens volunteering. End the day with positive images to ease anxieties and fear.

I have never felt so honored to be a part of the field of medicine and surrounded by people who are tirelessly working to help others. It is important to highlight these acts of kindness to your children. Whether you have your child create a sign to support the members of the frontline or write letters to the local nursing home, create opportunities for children to feel good about themselves and help others. Most importantly, praise your child for the fact that by staying home they are doing their part to stop this virus. They are helping keep people safe and healthy.

Challenge: Before going to bed, have your child tell you their highest moment of the day. Help to point out the positive aspects of being home and staying safe. From quality time with family to doing fun activities with you, it’s important to point out the positives.

3. Be developmentally appropriate when discussing the facts.

It is only normal that children will have questions about the virus as they try to understand why they can’t go to school or see friends and even some family. It is important to understand where your child is developmentally and answer their questions appropriately. Don’t volunteer too much information, as it may be overwhelming.

Instead, try to answer your child’s specific questions. Invite your child to tell you anything they may have heard about the virus and how it makes them feel. Reassure your kids that things will eventually go back to normal while being honest about the fact that you don’t know when exactly “eventually” will happen.

Also, give your kids space to talk about their negative feelings. Help them identify these feelings (anxiety, frustration, boredom) and then work through their emotions. Remember, children express stress in different ways. Some children become more clingy and anxious while others might become more withdrawn and agitated. It is important to make sure your child feels supported and loved during this time.

4. Maintain a schedule or routine.

Children thrive on structure. This need for structure becomes especially apparent and important if you are suddenly homeschooling your children. Make sure you create routines your family can follow so kids can have some sense of predictability.

Start the day by having your child make their bed and get out of their PJs. Getting dressed sets the tone for the day and helps them get into the mindset of going to school.

Additional routine tips:

• Keep the same schedule every day to provide consistency.
• Break up the work with playtime.
• Make sure to incorporate outdoor play and exercise.
• Allow kids to make some choices, even if it’s only what assignment they want to tackle first.

5. Lead by example when coping with the emotional toll of COVID-19.

Try to project calm and confidence. Children are sponges and absorb the energy we put out. If we are positive and calm, they will feel secure and supported.

Most importantly, be mindful of what your kids overhear in your conversations with other adults. Your coping mechanisms for the emotional toll of COVID may be completely safe for an adult, but kids don’t always see adult matters so clearly.

Remember that “kid logic” we mentioned before? They will inevitably fill in the gaps between what they know and what they hear.

We are all under a lot of stress. And our children will observe the coping mechanisms we use. Our thoughts on coping with these new stressors becomes particularly important when dealing with alcohol.

Parents are the leading influence on a child’s decision to drink – or not drink – alcohol.

Many parents may turn to a glass of wine to unwind and help relax at the end of the day. But we must always be mindful of how we present this idea in front of kids.

Enjoying a glass of wine or cocktail with dinner or while out in the open with friends while socially distancing demonstrates a positive mindset. This imagery is a powerful distinction from using alcohol to cope with the stress of your day. That mindset often feels negative; the language is negative; the role modeling suggests alcohol is the coping strategy.

Avoid saying things like, “Ugh! I need a glass of wine,” or, “Mommy needs a glass of wine to feel better.”

Instead, focus on wants versus needs. Do you WANT a glass of wine or NEED a glass of wine? The language you use really does matter.

April is Alcohol Responsibility Month. It’s never too early to start a conversation with your kids about safe and responsible alcohol consumption. When conversations about alcohol between parents and kids go up, underage drinking goes down – conversations really do work!

And the talk doesn’t have to be complicated! By keeping things simple and age appropriate, you can have real and honest conversations with your children starting early.

Final Thoughts on the Emotional Toll of COVID on Kids

I encourage all parents to be role models for your children when it comes to how you handle the stresses of COVID-19. They watch you, they admire you, they emulate you, they adore you, and they want to be like you.

Here are the main takeaways:

Do:

• Be careful of what your kids overhear in your conversations with other adults.
• Create routines your family can follow, so kids can have some sense of predictability.
• Create opportunities to let each member of the family choose things you do, so they have a greater sense of control.
• Take time for adequate self-care so you can bring your “A” game to the start of each day.

Don’t:

• Joke about the seriousness of this situation. Even sophisticated kids will suspect there is a grain of truth to humorous, sarcastic, or hyperbolic comments about “Armageddon” or the “apocalypse.”
• Make promises or give reassurances for things that are out of your ability to control or foresee.
• Model negative coping strategies as you manage your own emotional reaction to this crisis.

When it comes to coping with the emotional toll of COVID on kids, it is completely possible to avoid harmful anxieties. Continue to show your kids how you are finding time for self-care and being kind to yourself. Your attitude during this time will greatly affects theirs, so hang in there!

Stay home! Stay safe!

~Dr. Katie