As families have been maneuvering through the COVID-19 pandemic, the social isolation of staying home may also be leading to strain on the mental health of children and adolescents.

Dr. Sarah Martin, child and adolescent division chief at Texas Tech Physicians of El Paso, said it is too early to tell if there will be long-term mental health impacts from the pandemic for children at various stages of development.

“It’s really hard to predict how those kids’ social skills will be different than if they had never gone through this period of social isolation,” Martin said.

Martin said the children who have struggled the most during the pandemic have been those with an autism spectrum disorder.

“The core of autism is being very rigid and they don’t like change, so for them it’s been extremely hard,” Martin said. “Especially for kids who when they get frustrated, a lot of times autistic kids cannot express their emotions that well verbally, so they act out.”

Martin said kids with autism have a hard time adjusting to anything new and are sensitive to changes in their schedules. In her own practice, she has found that adjustments to treatment plans and medication have been helpful.

Teenagers are also likely having a difficult time adjusting to the prolonged distance from their peers.

“Overall for development, I think that it’s harder on teenagers because they are at the stage of life where they don’t want to stay at home,” Martin said.

Martin said that although studies have shown the harm of social media to child development, social media during the pandemic likely has mitigated negative impacts of isolation for teenagers because they can still interact with their friends.

Warning signs

Martin said children have a range of emotional responses during the pandemic, from a normal temper tantrum to more serious long-term issues.

She said parents should be alert to changes such as increased isolation, arguing, crying more easily, irritability and the lack of joy in basic activities .

Martin said the most common warning sign is going to be irritability. It may present itself differently based on the age of the child. She said the younger the children are, the more they will be throwing classic temper tantrums, but they may be having more of them or they may be lasting longer than before.

“Irritability and temper tantrums can be a sign of many different problems, but some of the most common problems we see in kids of all ages are anxiety and depression and that is a symptom of both,” Martin said.

Another symptom that can be typical of depression and anxiety is anhedonia, or the inability to experience pleasure from activities usually found enjoyable.

“So that’s something that parents can look out for — they don’t enjoy anything anymore, they don’t enjoy the most fun parts of being a kid that they still have access to,” Martin said.

Martin said a question she would always ask parents is whether the child enjoys the things children their age like to do. She said it is a way to tell whether it is a normal phase of life.

“(Is) this kid just in a bad mood today or is it something where they really are having enough problems where they are limiting the happiness of their childhood?” Martin said.

Simple solutions

Martin said if parents think their child’s behavior changes are being caused by the prolonged seclusion from friends, they should expand their child’s social life a little bit. 

She said some families are allowing one friend to visit, or small groups of five or less can get together at a park.

“Don’t limit them just to their own siblings or just to an adult. It’s common to have only children these days, so I really wouldn’t limit it to just the immediate family at this point,” Martin said. “I would recommend that people expand if they think that this is directly related to loneliness that the child might be feeling.”

Martin said it is also important to make sure that children are spending time outside and getting sunlight. She said she recommends parents try to work time outside into the daily schedule.

Sunlight improves mood, creates Vitamin D and helps reduce stress among other benefits, she said.

“You are going to be killing two birds with one stone — you will be improving their physical health and their mental health,” Martin said.

Martin said pets that like to bond, like dogs, also are beneficial to children, especially if there is only one child in the family.

“If you are an only child, you don’t want to go outside and play by yourself,” Martin said, adding that dogs like to play and can motivate children to be more active. “A dog is going to be a pet that can improve the health of the child.”

Catching the signs early

Martin said if parents feel their children are having more serious mental health issues, help is available.

She said things to watch out for are if children start to say they don’t want to live anymore or make comments that they would be better off dead, or begin hurting themselves on purpose.

In extreme cases, parents can call 911 for emergency help, but psychiatric hospitals also have areas where children can be evaluated.

Martin said El Paso County has a lot of therapists who are doing online treatment and are flexible to families’ needs.

“Therapy is always a good place to start,” Martin said.

Although El Paso has a shortage of child psychiatrists, Martin said Texas Tech University Health Sciences Center El Paso’s psychiatry department launched a telephone hotline in May as part of the new Child Psychiatry Access Network.

Parents concerned about their child’s mental health can go to their primary care practitioners, who can call the hotline to get advice about child and adolescent patients with psychiatric symptoms.

“This approach is important because the earlier you get treatment for a psychiatric problem, the more likely they are to get back to there they were before,” Martin said. “The earlier we can catch it, the less ill that person will be for their entire life.”

Cover photo: A man and a girl exercise together in Album Park on Thursday evening. Psychiatrists say parents should schedule daily outdoor activities for their children during the pandemic. (Corrie Boudreaux/El Paso Matters)