Is COVID-19 Affecting Your Teen’s Mental Health?

Disrupted routines. Separation from their friends. Worry about world events. For teens and tweens, the coronavirus pandemic adds new pressure to their already tumultuous world.

These stressors can intensify existing mental health issues in teens, says Ellen Rome, MD, MPH, a pediatrician and head of the Center for Adolescent Medicine.

“We’re likely to see lots of acting-out behavior during this pandemic,” she says.

Parents and health care professionals should be on the lookout for warning signs of depression and anxiety in teens.

Different teens, different reactions

Surprisingly, for anxious or introverted teens, current events may actually bring about a sense of calm or relief. “The world is experiencing some of the baseline anxiety that they live with day-to-day, so for some kids, that’s actually reassuring,” Dr. Rome says. “The world gets them more.”

But many adolescents are struggling.

“The extroverts who tend to recharge with people are devastated by quarantine, and many of them will do everything they can — including participating in risk-taking behaviors or not socially distancing — to get around it, which can potentially put their families and loved ones at risk,” she says.

These steps may help minimize those behaviors:

• Plan safe ways for teens to engage socially. “That may mean a bike ride where everyone can’t be that close to each other, or a socially distant bonfire where the parent places the chairs where they need to be,” Dr. Rome says.
• Help them understand. Parents can talk with teens and tweens about the spread of the coronavirus and their risk — but it’s important to do so in a way that’s appropriate for their age, says Dr. Rome.
• Engage them in the solution. If your teen sneaks out of the house to meet friends or engages in other risky behaviors, Dr. Rome suggests asking them to suggest their own punishment. This way, they’re more likely to think about the consequences of their actions. Ask them for other ways that have less impact on the household, extended family and community.

Screen time, sleep + social media

For some families, staying home means everyone’s spending more time in front of the TV or online. Excessive screen time and news consumption can stress teens out. It can also worsen anxiety and depression — especially if they aren’t following a schedule or aren’t getting enough sleep.

Work with your teen to set reasonable expectations for screen time and ensure they get enough sleep (at least 9 to 9.5 hours a night). Make sure cell phones are put away an hour before bedtime.

Teens may feel especially frustrated if they observe their friends or other families who aren’t being as strict about social distancing. Encourage teens to share these frustrations with you, and acknowledge that things are hard. In some cases, teens might have mixed feelings that result in an apparent cognitive dissonance.

Depression: Not all warning signs are obvious

It’s important for parents and pediatricians to be on the lookout for signs of depression in teens, including:

• Emotional changes, such as feelings of hopelessness or emptiness.
• Trouble thinking or concentrating.
• Changes in eating habits or weight.
• Changes in sleep patterns.
• Sudden contact with a friend who’s a known troublemaker.

Isolation can be a potential warning sign, but a teen hiding in their room isn’t always cause for alarm.

“This is a hard one, because in crowded households where everyone is doing their thing from home, a bedroom may become a sanctuary,” Dr. Rome says. “Yet, if you have a depressed child, is the bedroom a dangerous place? Is it a place for self-harm? Is it a place where the kid is stuck in their own head with things getting worse?”

If a teen begins isolating to the point that they’re taking all their meals alone, that can be a sign of disordered eating, or that the family dynamic has become toxic.

If your child makes any mention of suicide, take those words seriously and take action immediately. “If kids use the magic words ‘I want to kill myself,’ that’s time for a psychiatrist and a therapist,” Dr. Rome says.

Seeking help from a professional therapist may also be warranted for teens whose anxiety is serious and affects their daily life. If your teen is hesitant to talk to a professional, Dr. Rome suggests framing it as strength-building or coaching, rather than fixing something that’s broken.

“You can say, hey if you want to be an NBA all-star, you’d seek out a coach to build your skills,” she says. “If you want to be resilient in times of stress and crisis, we all could use a really good coach to help us be at our best.”