Pediatric Anxiety/Depression Amidst the Coronavirus

An interview with Carrie Baker, CPNP

With school canceled and children learning from home, children’s lives have changed suddenly and drastically. With so many fears regarding the coronavirus, children with anxiety/depression may find themselves having difficulty coping, or children not previously diagnosed may be acting noticeably different.

Your child is not alone. As of 2019, there are more than 6 million children (ages 3-17) in the United States who struggle with anxiety/depression. With the current pandemic, it is important that parents are able to recognize the signs and symptoms of anxiety/depression and are able to help their child move forward.

Carrie Baker, CPNP of Maumee Bay Pediatrics, an affiliate of The Toledo Clinic, specializes in pediatric anxiety and depression. With over a decade of experience, she has the most current, science-based knowledge to help parents during this difficult time.

What are some signs or symptoms of anxiety/depression disorders in children? 

Children do experience different symptoms [of depression compared to adults] depending on their developmental age, and the situation with the coronavirus may bring these symptoms to surface more now than ever.

Ages 5-8: Symptoms often manifest as sleep issues, including refusing to sleep, nightmares, and frequent night-waking. Children in this age group will often display unrealistic fear as well, often based around the fear of something happening to their parents. 

Ages 9-12: Anxiety/depression may present itself as separation anxiety within this age group. The child may react very negatively to being separated from a parent or significant caretaker and may cling to parents excessively. Parents may notice their child is less willing to branch out and try new things. Instead, they may try to stick with what is familiar.

Ages 13+: It is within this age group that anxiety/depression begins to have similar symptoms as adult anxiety/depression. Now that the child is more cognitively developed, they are able to express worry and concern. Parents may notice their child isolating themselves in their room or keeping to themselves, as well as displaying sadness.

Children may also have physical symptoms associated with their anxiety/depression, including frequent headaches, nausea, stomach aches, and/or trouble breathing.

If parents suspect their child is displaying symptoms of anxiety or depression, what is the best way to talk about it with them? 

There are two very important parts to this, and the first is to listen. Being present and allowing the child to express their feelings in a safe place is critical. The next part is the response. Respond with compassion. Reassure and support them by letting them know that you are there to protect them. 

Do not ridicule or judge the child for what they are going through, and do not convince them that their concerns and emotions are irrational. Feelings are not right or wrong. Children tend to shut down when they do not feel safe talking about and/or expressing their feelings, which would not improve the situation.

Parents should also make sure that any other significant caretakers or parental figures in the child’s life respond in the same manner. Many children speak openly about their feelings with people they trust. Having a consistent support system will build trust and a feeling of safety for the child.

Should parents involve their primary care provider? 

Yes. If parents have concerns, then a professional should be involved. Anxiety and depression are not just “in your head;” it is a chemical imbalance in the brain, which requires a proper diagnosis. A trained professional should educate parents on what is really happening with their child so that a well-informed decision can be made when moving forward with a plan for treatment. I strongly recommend seeing someone who specializes in mental health issues so that they can provide the best education and plan moving forward. Once the issue is identified, it’s not fixed overnight. It takes a lot of work and patience from both the child and the parents.

Other mental health issues can mimic anxiety/depression, including ADD and ADHD. This is something only a trained medical professional can accurately diagnose. Seeing a professional will get the child the help they need before things get worse.

With the coronavirus keeping people indoors, should parents wait to schedule an appointment?

No. It is imperative now more than ever to get children struggling with anxiety/depression the help they need. The implications of anxiety/depression are bad enough without the added stress and fear of a national pandemic. A child’s symptoms may be exacerbated in this situation.

For parents wondering if it’s safe to go to their primary care provider’s office, the answer is likely yes. Doctors’ offices are safer than most public places. Health providers understand how to keep their facilities safe and properly sanitized, all while using PPE appropriately.

If your primary care office is not open, Maumee Bay Pediatrics can provide care to any child, regardless if they are a regular patient or not. We will happily send any notes to the child’s regular primary care provider once they reopen.

Does anxiety/depression have an effect on other components of a child’s health, both mental and physical?

Anxiety/depression absolutely has an effect on physical health. Oftentimes it is through sleep, whether it is too much or too little. Unhealthy sleep habits inhibit a child’s ability to focus on tasks and be productive. Sleep can also affect the immune system, which can potentially open up the possibility of countless other physical ailments. 

Additional mental health issues can certainly be happening in conjunction with anxiety/depression, and ultimately if left untreated, children can run the risk of becoming suicidal. Again, these issues are serious and require a trained medical professional to appropriately diagnose. Children deserve to get the help they need, and parents really need to make the first move in seeing a specialist.

Should parents be careful about what information they allow their children to hear about the coronavirus? 

There is a lot of information out there, and some of it has the potential to evoke fear, anxiety, stress, etcetera. Children who are at different cognitive stages will react differently to this information, so it’s best to monitor the information they are listening to based on their cognitive maturity. 

The situation with the coronavirus has the potential to increase the speed of development for clinical anxiety/depression in some children, so parents may want to consider limiting their information sources, such as TV, social media, etc. If you are unsure of what information your child can handle, speak with your primary care provider.

To learn more and access more health information resources, visit ToledoClinic.com.

To learn more about Carrie, Dr. Wexler or the team at Maumee Bay Pediatrics, visit MaumeeBayPediatrics.com.