January 20, 2021

Adolescents and COVID-19: What I’ve Noticed

FILED IN: COVID-19

Adolescent wearing mask and doing homework on laptop during COVID-19 pandemic

Let’s chat about what I have seen in my patients. I have to tell you between being cooped up at home and online school, adolescents are going stir crazy. Screen time is at an all-time high and social media intensity has risen. Is there any way to get around it? What has it led to?

The American Academy of Pediatrics (AAP) has put out multiple statements suggesting families create a family media plan to lay out the dos and don’ts about screen time and media use. It is clear that each families’ needs may be different based on the circumstance. Ideally, we would want there to be less screen time but how can this be accomplished in the time of COVID-19? School and connecting with friends & family are all online, so how do we talk restrictions or limitations? School is a given or a must, but can decreasing screen time after school ends actually be feasible? There are lots more questions than answers. Even after school dismisses for the day, adolescents have homework that requires more time spent on electronics. They turn their homework in online, they check assignments online, they do everything about school online. It is overwhelming for the adolescent, so we can imagine the parental burden on top of that. Honestly, everyone should cut themselves some slack. COVID-19 changed what is normal! Parents should start to think about what they would like to happen with the amount of time spent watching screens and work your way up to that goal. A gradual progression is fine, no one is perfectly doing it ‘right’, whatever that means.  Keep in mind, online work does allow parents the ability to get creative in using electronics to their advantage to connect with their teens, help them with their homework, and spend time doing what they love to do. Sit down as a family, have frank conversations, and work together to develop a plan.

For example, if you have a family of four — two working parents, a 12-year-old daughter (your social butterfly), and a 15-year-old son (your video gamer) — everyone uses electronics and that includes parents for work and to connect with their friends. Your daughter likes to be on facetime or google duo with her friends; sometimes they are doing work together, but typically just gossiping. Your son likes to be online playing Call of Duty with his friends. Options for your media plan might be a time to turn off all electronics (or at least silence them), maybe around 7pm. Put restrictions on where media/electronics will not be used – dinner table, bathroom, family gathering, and bedroom after 10pm (or earlier based on child’s age). These are some ideas that can be included in your plan. See resources below for the Media Use Plan suggested by the AAP.

Now that we have sorted through the inevitable use of media/electronics during this time of quarantine, you might ask yourself what else should we be worried about with our adolescents? With the decrease in connectedness with others, you may start to see adolescents becoming withdrawn, worried about outcomes, concerned about theirs & your well-being, or difficulty falling asleep – just to name a few. This pandemic is affecting adolescents’ social, emotional, and mental well-being. Social distancing is challenging in a group that relies on the social interaction with peers. Young people are losing out on celebration after celebration, a lack of excitement over achieving milestones. These changes to our ‘new normal’ signify a loss, leading to symptoms of grief in some circumstances.

Grief isn’t the only drawback, depression and anxiety are increasing as well. This stress can lead to increased substance use, irregular eating habits, and sleep disturbances; all of which impact their ability to function. Just to provide context, over the last 6 months, 80% of the adolescents I have seen in clinic report new onset use of alcohol or marijuana. Although not abusing, use is still a concern as this can place them in vulnerable situations. It is important to discuss the fears around isolation and monitor what your adolescent may or may not be doing. This is the time to re-establish those relationships and ensure your adolescent knows you are there for them. Ask questions, try not to pass judgement, and allow them to open up to you.

Diagnosis of anxiety and depression in adolescents has increased in clinical settings over the last few months. Personally, I have seen more new patients for anxiety and depression than I had at this time one year ago. Many of my previously stable patients are also presenting with acute exacerbations of symptoms. Some symptoms that may be harder to pinpoint as symptoms of anxiety and depression include irritability, anger, short-temperament, insomnia, headaches, abdominal pain, fatigue, and decreased interest in spending time with others. Although there are many more symptoms that could be present, these are just a few to look out for as a parent, guardian, or friend. These adolescents need care, need to feel supported, and need an outlet for their feelings. Being able to talk to someone may be the only thing they need to keep them from cutting and/or attempting suicide because of the perceived uncontrollable distress. In my opinion, this is the area we can make the most impact. From parents to teachers to physicians, see the signs and get the adolescent into care. Early assessment leads to early diagnosis and improved future outcomes. If you are in Las Vegas, feel free to send these kids my way!

Here are a few tips and tricks to encourage your families and adolescents to do, or try it out for yourself:

1. Decrease your media/electronic use by 2 hours

Set up the media plan using the AAPs handy tool at the first link under the resources section. Use this to continue making changes and stay present in family needs. Put a hard stop point on use to wind down your day. This can be challenging, especially if you are finding yourself working late into the night or feeling overwhelmed with the many changes that are occurring at once. Don’t worry, you are not alone. Take a deep breath and think about what would be ideal. Then work backwards to figure out how to get there. Also, all media/electronic use isn’t bad, so find a happy medium.

2. Connect with your kids in other ways – board games, movie nights, cooking, story-telling

Remember that there are other things to do besides being on our phones. Connect within your family, really get to know one another. COVID-19 is giving you this opportunity. COVID-19 is allowing us to spend more time at home, often with our significant other or other family members. So, spend some time doing something together every day, preferably not on social media or electronics unless it is TikTok and you are dancing!

3. Exercise is key

Get outside and move, even if it is a gentle stroll around the block. Put on an exercise tape, do it as a family! Exercise has been shown to decrease stress. It has also been shown to be an effective coping mechanism. Aside from its mental health benefits, it impacts your physical health as well. It can decrease risks associated with obesity, improve heart health, and improve the management of your blood sugar/insulin levels. It can be hard to do regularly but set an alarm and create a routine, put you first. Exercise can be anything from dancing in your living room to weightlifting at the gym or in the garage. Think about different forms of exercise you can engage in. Take an hour a day and get moving! You can even use exercise apps with friends and share in working out together. Fitbit, FitOn, Nike, and so many more!

4. Establish good sleep hygiene

If you are unable to do anything else, at least do this. Sleep impacts many of our systems, specifically our mental health. Just think, when you sleep at least 8 hours (amount of sleep needed varies by age) you are less cranky and irritable and are able to be more efficient and focused during the day. There are multiple studies that have discussed the cycle between amount of restful sleep and anxiety, let alone other physical health factors in an adolescent’s growth and development. This is one item that by itself can impact your adolescent’s functioning during school hours, so make it a priority. Set yourself and your adolescent up for success!

5. Get your kids in to see the doctor – stay up on vaccines

This one is just my shameless plug to get back in to see your friendly pediatrician. Staying up to date on your check-ups are crucial as an adolescent. You should be seeing the doctor yearly or more regularly if you have any chronic conditions. Assessments and evaluations are done at these visits for early detection and intervention of both medical and physical health problems. These visits will allow you to address the changes you might see through the stages of adolescence and have an open conversation about how to manage them. Stay up to date with vaccines, they will be required for school, college, or the military depending on what your adolescent decides to do in the future. Think about the long-term protection you are providing your adolescent.

6. Mental health problems are REAL

Stop negating how your adolescents are feeling. Their feelings are real and need to be acknowledged. Every adolescent won’t require medications. If it is up to me and it can be avoided, other avenues of treatment will be pursued. Therapy is crucial in helping your adolescent manage and develop coping mechanisms to utilize when acute changes or concerns occur. Some will need medication, but it doesn’t mean they will be on it for the rest of their life. There are no guarantees for how long they might need it but trust me if they do, it will benefit them in the end to be medicated. Ask all the questions you need around these medications because you deserve to. All I ask is that you keep an open mind if your physician is suggesting use.

COVID-19 has led us into unprecedented times, changed how we interact with the world, revitalized media/electronic use, and had some negative consequences on our youth. Reach out to the adolescents out there, mentor them, support them and their feelings, and help them remain on the right track.

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