ONCE UPON A GENE - EPISODE 023 - Mental Health and Coping During Covid-19
I hope you're all as safe and healthy as you can be right now. Dr. Laura Black is a Childhood Adolescent Psychiatry Fellow and she's providing tips to us on talking to your kids about COVID-19 and managing your heightened stress and anxiety. She also leads us through a mindfulness exercise, so be sure to take a few minutes for yourself at the end of this episode and share it with a friend or family member who can benefit.
EPISODE HIGHLIGHTS
What is your background?
I'm a Childhood Adolescent Psychiatry Fellow, trained in psychiatry in adults, children and teenagers. I'm trained in medication and psychotherapy and I've been working in mental health for a number of years.
How do we explain to kids what COVID-19 is and why they can't go anywhere?
This is particularly related to your audience with kids that are medically complex. You are the pros at making developmentally appropriate explanations of medically complicated stuff, so don't forget that you have been doing this for your kid's whole life. This is something you know how to do and you may even be able to support some of your parents friends. Be proactive and sit down and have a conversation with your kids about what's going on. One way of putting it would be to say that "COVID-19 is a new virus that's happening in the world and doctors and scientists are still learning about it and studying it. A lot of people have gotten sick recently. Doctors think that most people will be okay, but some people are going to get pretty sick." Emphasize that doctors and nurses are working really hard to help people stay healthy. End on a positive note and talk about what role they can have in flattening the curve by saying "If we can share less germs, more people can stay healthy. The proactive things we can do include cleaning our home, washing our hands and staying in touch with people in ways that aren't in person."
How do we help reduce our kid's stress and anxiety levels?
It can be really helpful to have routines around mental health and it's one more way that families and kids can learn to take care of themselves.If you already working with a therapist or mental health professional, continue to do that via video or phone and maintain the routine of those regular visits if you have a way of doing so remotely. Finding a way to validate anxiety without magnifying it is really key. Acknowledge fear or worry without escalating it. One way of doing that is by thinking of positive coping thoughts. If worries keep recurring, write them on an index card or put them on a bulletin board to visualize them regularly. With us all being stuck at home, it can be helpful to have scheduled worry time and a scheduled worry spot. Choose a spot in the house that can serve as the worry spot and schedule time in your day that you think about worries and if worries come up outside of that time, put it out of your mind for the moment. For younger kids, it may be helpful to do the worry time with them and help contain it to a certain time and location.
How do we explain the concept of the current situation in a realistic way that doesn't spark more fear?
This can be hard if the kid has trouble understanding that this isn't their fault. Try to emphasize that we're all in this together, and not because we're in trouble, but because we're trying to help each other and we're all doing our best. Try to reassure as much as possible that this is something we're all doing together and no one is at fault.
What are some ways to manage tempers escalating?
Parents and teenagers need to have compassion for themselves when that happens. If patience becomes short or we're a little more on edge than we normally would be, to remember we're all going through a lot right now and we're having a shorter fuse because we're under more pressure than usual. Try to take a breath and forgive yourself when that happens. When it comes to dealing tempers at home or kids struggling with their emotions, think about your prevention strategies. How do you set up your home for success? You can increase the way you're structuring time at home together, like school stations and who is doing tasks when, thinking about minimizing conflict and being flexible. Be mindful that some of your house rules may require an adjustment, but I wouldn't let go of them completely. When emotions come up, one framework that may be helpful is to think about the zones of regulation- green (good-to-go), yellow (things are ramping up) and red (negative emotion explosion). Use the language around the zones to suggest breaks and if kids begin to recognize those feelings within themselves, reward that using whatever system you use to encourage self-awareness and regulation.
How do we all adapt to the changes in our routines?
Anxiety can cause people to get rigid and that's true for kids and adults. Have a daily schedule on a board that's visible and schedule daily activities similar to the typical school schedule. Visual schedules are especially helpful for kids with ASD or developmental disabilities. If you're having difficulty with transitioning between preferred and non-preferred activities, having a simple first-then visual can help. It's important to talk about flexibility at home and as a parent you can model that and recognize your kid's flexibility as a specific behavioral target.
When kids are bored and not wanting to do social distancing, what can we do?
As we've seen from the recommendations, it's so important that we buckle down right now. With kids, this is tough. Explain in the most developmentally appropriate way that why this is going on, that this is how we're keeping people healthy and that this is a way kids can contribute and do something good. Have a structured day with fun stuff within the structure built in. Play family games on the TV and facetime with family and friends to stay connected in a way that keeps our distance. With teens, it's a little more complicated because they have the natural desire to rebel and not follow rules. Some teens may still be at the stage of joking about the virus, which is a form of denial. Usually under denial is fear that a person doesn't want to feel, so be aware of your emotions that might arise when you see teens acting that way. Bring it back to finding a way that speaks to them to acknowledge the importance of what's happening.
Families now have this extra strain of losing their jobs, paying their bills and keeping everyone healthy. How much of an impact can this have on kids on top of everything else they're dealing with and how can we be extra cautious?
Kids do respond to your emotional cues and that's both the words you say and the tone you say it in. They can feel the emotions and pick up on vibes, so it's important to make sure they feel safe with you with everything going on right now. My intention is not to add another layer of parental guilt, but it's more to reframe and emphasize that your ability to care for yourself is really important right now. Put the oxygen mask on yourself before you help others. This is an important time for you to take care of yourself to the point that you can be emotionally present for your child as you go through this experience together so you can meet their emotional needs. Have compassion for yourself right now because this is a legitimately tough time and you're going to be stressed. Your experience will be better and your kid's experience will be better if you do what you need to do to care for yourself.
As a parent of a medically complex kid or having a family member with a compromised immune system, how would you suggest coping with feelings of anger towards others who aren't following social distancing guidelines?
It's natural to feel upset by that. I've seen the filter people are using on their Facebook photos that says "your only is my everything" and it's pure truth. This is not a joke, it's real life. It can be hard to know how to respond to people not taking the situation seriously. As far as your own feelings or resentment or anger toward those people, give yourself permission to feel that because you have every right to feel upset about what's going on and the impact it may have. Try to find some empathy for what would bring a person to have that perspective, like denial. What's under the denial or the joking is a fear that they aren't able to face. As far as communicating with people who aren't taking this seriously, it's two sided- speak your truth and pick your battles. If there's a conversation to be had, keep it simple and don't demonize the other person. Pick your battles and be thoughtful about your interactions.
What do you want to leave us with amidst all of the stress going on right now?
I want to recognize all of the parents out there who are dealing with this, especially having medically complex kids. I have so much respect for you and I'm sending you so much love and support. Take care of yourself right now. Take a moment for a mindfulness, love and kindness exercise and come back to it as often as needed.
LINKS AND RESOURCES MENTIONED
Visual Schedule Printables - Google
Ten Percent Happier Meditation
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