Back in March, when Covid-19 fears were first rising and states across the country began enacting shutdown measures, no one really knew how long that might last. Many parents likely hoped controlling the virus would be a short-term endeavor, allowing their children to return to school and normalcy as soon as possible.
Unfortunately, the opposite has proven true. Eight months later, schools are still shut down, social distancing is still a buzzword, and kids and adults alike are experiencing isolation, economic frustration, and fears about what the future may hold.
Pandemic stressors have experts worried about the mental health of adolescents, especially, with a recent Centers for Disease Control (CDC) report finding that 25 percent have considered suicide this year alone.
For parents worried about their teen’s mental health in the midst of this worldwide crisis, adolescent mental health clinicians have advice for identifying, and treating, the struggles you may be witnessing firsthand.
The Pandemic’s Impact on Teenagers
“As a clinician working with many teens each week, they continue to express increased feelings of isolation and frustration with the ongoing restrictions and inability to engage in life activities in ‘normal’ ways,” licensed psychologist Nicole Beurkens, PhD, CNS, of Horizons Developmental Resource Center recently said.
She explained that these teenagers are working through the disappointment of not being able to experience things in the ways they were hoping and expecting. The start of their senior year of high school or their freshman year of college now looks very different from how it should have. They are missing special events like graduation and homecoming. They aren’t able to attend football games with their friends. Nothing is as they’ve spent their entire childhoods anticipating it would be.
These teens, Beurkens said, are stressed and anxious about having to navigate things like virtual schooling, visiting colleges solely online, and what the admissions process will look like for them. Not to mention whether family members and friends will stay healthy.
The result has been many teenagers feeling thrown off their developmental course—and not having in-person access to their peer groups to help them work through that.
All of this has led to what the CDC report identified as higher rates of anxiety and depression among teenagers right now, even more so than adults. These struggles may be especially pronounced for teenagers with pre-existing anxiety or depression, according to Beurkens.
“While they may have previously been able to manage low-grade depression or anxiety on their own, they may need the help of medication and/or psychotherapy to help manage the pressure of Covid,” she explained.
Knowing the Signs
Sherry Skyler Kelly, PhD, is a Licensed Clinical Psychologist and Clinical Neuropsychologist who has worked with teens for over 25 years. She said the following can be signs a teenager may be struggling mentally and in need of outside help:
- Change in habits – such as sleeping, eating, bathing, exercise
- Sleeping a lot more or sleeping very little
- Change in academic performance – falling behind, not completing work
- Change in social life – not talking to friends
- Not talking to you
- Change in mood – crying, angry, easy to get upset, or lack of affect and withdrawing from activities that used to bring them some happiness
If you suspect your child may be experiencing depression or anxiety, Kelly said it is a good idea to take stock of the stressors in your life that may be impacting your child. Have you lost your job or business? Are you experiencing financial stress? Illness? Other issues related to having everyone at home?
Going into that conversation aware of the factors at play may help you to have a more honest and open conversation with your teen.
“Determine—in advance—what you expect out of this discussion,” Kelly said. “What do you want to get out of it and what do you want to change? Be purpose driven in this endeavor.”
In other words, know what you hope to accomplish. Is it to get your child to talk to you? Is it for them to change their behaviors? Is it to bring them to counseling or medical care?
“This will also prepare you for the common teen response ‘Ugh—What do you want from me?’” Kelly said.
She encouraged parents to focus on feelings, rather than behaviors, in having this conversation. And to ask both yourself and your child, “What would better look like?”
“It’s a strange way to ask it, but it’s open ended and provides a good place to start.”
If, during the course of this conversation, your teenager expresses thoughts of hurting themselves, it’s time to seek immediate help—contact your child’s pediatrician, or consider taking your child to the emergency room if the threat feels imminent.
Kelly further identified these behaviors as reasons to ask for outside help as soon as possible:
- Drug or alcohol use.
- Any suicidal ideation, talk of suicide.
- Any self-harm behaviors (cutting), making themselves vomit
- Gaming behaviors that seem addictive—they can’t disengage or spend too much time
- Significant changes in mood and behaviors
- Not sleeping
“Parents might first reach out to their trusted pediatrician, who is a wealth of information and support,” Beurkens said of your next steps following talking to your teen.
“In an emergency, you can go to your local emergency room or text TALK to the crisis text line at 741-741,” she explained.
If you’re looking for a specialist, Kelly said your state psychological association should have a referral list for specialists in adolescent psychology. And she added that many states have implemented crisis lines for low cost or free mental health support through their Department of Public Health.
“When a teenager’s daily functioning is severely impacted by their anxiety or depression, medication may be indicated,” Beurkens said. “If they are no longer able to find joy in experiences that used to bring them joy, or they are experiencing panic attacks and debilitating anxiety, or unable to get out of bed and begin the day, medication may be able to help.”
Both Kelly and Beurkens agreed that therapy should accompany pharmaceutical treatment, however.
“It’s important to provide support for patients, not just medication. Medication won’t solve the real issues underneath the surface of behaviors,” Kelly explained.
Beurkens said this is especially true for teenagers.
“While medication can help balance the chemistry in our brains to stabilize our ability to function in the world, therapy can help us better understand how to operate in the world, from a social, emotional, and spiritual perspective,” Beurkens explained.
She said therapy can help teenagers better understand their place within the family’s dynamic, while also providing them with tools to best navigate challenges as they arise.
While all teenagers struggling with anxiety or depression can benefit from therapy, both experts agreed medication should be determined on a case-by-case basis.
“Medication can absolutely be helpful, even for teenagers who have never experienced mental health struggles prior to the pandemic,” Beurkens said. “The best person to make a decision about medication is an experienced psychiatrist, particularly one whose practice focuses on children and teenagers. Parents can also seek the guidance of their pediatrician.”
Plenty of teenagers and adults find relief from symptoms of anxiety and depression with therapy alone—but there is no shame in adding medication if doing so is indicated by your child’s symptoms and state of distress.
Helping a Teenager Who Doesn’t Want to be Helped
Teenagers are, of course, notorious for their own stubbornness. If your teen refuses to get help, Kelly suggested trying to get them to explain why they are resistant. “Maybe it’s the type of help, or misconceptions of care?”
Talking things through with your teen may help you to come to a compromise. Of couse, Kelly said there are some situations that require medical attention even if your child refuses—to include threats of suicide and self-harm.
Barring that, Beurkens said it’s important to continue talking to your child, letting them know you are there to support and love them unconditionally, even if they refuse help. Hopefully, by keeping the lines of communication open, they will eventually come around.
“If you as a parent are struggling with your teenager’s depression and anxiety, I highly recommend seeking therapeutic services for yourself,” she suggested.
This is also a great way to model what getting help looks like for your teenager.
As we transition into the winter months, with less daylight and less sunshine, increased mental strain is possible for everyone. Beurkens wanted to encourage all families to spend time outdoors, even as the weather becomes colder.
“We must help teens remember that they are powerful, and they have the power to shape the life they want to live,” Beurkens said. “Therapy, sometimes with the support of the right medication, and the loving presence of family and friends, can help us navigate these stormy waters together, so that our teenage clients and children can begin to find a sense of calm within once again.”