For youths, COVID brings mental health challenges

Parents and children are facing major life disruptions as COVID-19 upends life with school closures, physical distancing and the myriad other changes to life’s routine.

But the mental health effects are a little bit more elusive when routines, a fundamental part of human nature bookended by simple impositions like regular waking-up and sleeping times, are turned upside-down.

“The problem arises when the routines, which we set up for ourselves, are not healthy, for example staying up at night while sleeping during daytime,” a spokesperson for the Malta Association for Child and Adolescent Mental Health (ACAMH) told MaltaToday.

“The current situation has brought on us a sudden change; no one was prepared for it and our previous lifestyle was very different from the one we had to adopt recently. This has created a period of adjustment for all of us,” they added.

ACAMH has warned that the more children and youths have now lost the structure that school and extra-curricular activities provided. “As expected, they have reacted differently to this situation, with some feeling relieved that they have more free time and less academic pressure.”

Age is an important factor to consider. Younger children usually have more unstructured time to play and learn by experimentation. For this reason, they might miss their friends and teachers, however still enjoy spending time with their parents.

On the other hand, teens are likely to have days filled with activities including academic, social and recreational past-times, which during this period may not be replaced in a way that fully accommodates their needs.

“For example, social needs may be acquired through digital means, but some might still feel isolated and lonely. Sporting activities, which could have been used as a strategy to regulate emotions, may be limited now,” the ACAMH said.

A WHO study on adolescent behaviour during the pandemic found that most were experiencing positive and supportive social relationships and good overall health and well-being, while eating habits had improved and substance abuse was on the decline.

However, the rapid increase of social media had led to problematic usage among some adolescents, affecting their relationship with friends and family. And physical activity levels remain worryingly low, with increasing numbers of youth reporting issues that affected their mental health, including feeling low and difficulties with sleep.

ACAMH said it was important to take up activities that could be done in the home, such as a new hobby, decluttering, cooking activities, and reaching out to neighbours and nurturing neglected relationships. “Families who are less privileged and already struggling before COVID-19 may find the necessary adjustments all the more challenging. For example, there is currently a strong reliance on technology to access services, like schools, social services and mental health professionals.”

Children and young people may need a private space at home during online learning sessions – which may not be possible for low-income families, putting them at a disadvantage and exacerbating their struggles.

“Children and young people’s mental health cannot be separated from that of the rest of the household. If a parent is struggling to adjust or for example, has been made redundant, the other members of the family are bound to be negatively impacted. This possibly is exacerbated when we are all spending most of our time at home, close to the rest of the family. Tense and conflictual relationships may start to take a toll on everyone,” the association said.

The toll on children with conditions

Kids with certain conditions like autism spectrum disorders (ASD) and attention deficit hyperactivity disorders (ADHD) may find this sudden shift in lifestyle harder than others.  “People with ASD generally find change very difficult, even minor disruptions to their routine may create intense emotions of anxiety, fear, and confusion. Many thrive in highly structured and predictable environments. In the current unprecedented events, receiving definite answers to their questions is highly unlikely,” ACAMH said.

The risk that they may develop novel interests and obsessions related to COVID-19 – statistics on positive cases and deaths – could heighten fear and anxiety, making it harder for them to resume their previous lifestyle when the lockdown is over.  “Children and young people with ADHD have possibly experienced increased difficulty to maintain focus. Usual coping strategies may be limited or impossible, for example doing tasks in quiet environments because of siblings being around them. They may also become easily bored inside and require more efforts from parents to keep them entertained.”

Letting go of expectations

ACAMH says parents have to acknowledge the difficult situation and permit themselves to adapt their parenting expectations.

“Families are trying to cope in the best way they can, with the resources that they have. Letting go of some expectations may be a wise decision at this point in time. Rather than focusing on strict rules, attention can be redirected to nurturing relationships, by doing things together and enjoying spending time with each other.”

Many parents may also be working from home and need their private time and space to focus – this means that children need to be encouraged to occupy themselves safely.  “Fortunately, there are many ideas online to help children keep occupied in a fun way, such as arts and crafts projects, online storytelling activities and physical activity videos.”

ACAMH also encourages families to get some natural light, in order to not go stir-crazy. “For children and young people, as well as adults, getting some natural light is important for general physical and mental wellbeing. Spending too much time in unnaturally lit environments can hurt our mental health, including disruptions in the waking/sleeping pattern. Therefore, now is the time to make use of all the spaces that we have available in our homes that receive natural light.”

The association said that evidence showed exercise improved physical and mental health, suggesting that families go out for a run around the block or a walk in the countryside as long as social distancing is strictly adhered too according to public health recommendations.