Guide adolescents into post-COVID world

Now that we are easing out of the height of the pandemic and people are beginning to unmask, how is this impacting adolescents?

As a nurse practitioner and licensed clinical social worker, we have noticed adolescents are more anxious, more socially awkward, more overstimulated and feeling more insecure as they resume their role in society. The pandemic continues to be a historic life event for all, but re-entry for adolescents, post virtual living, is even more complex. Social, physical and emotional reintegration has had an overwhelming effect on adolescents. Learning how to restructure responsibility of managing home, peers and school, after two years of stunted development has created a much larger learning curve as children become young adults. Many find these steps intimidating. We are here to let them know they are not alone. Everyone, world over, is going through this simultaneously.

Adolescents are experiencing social awkwardness as they are seeing peers without masks for the first time in two years, as mask mandates are lifted. This creates an unfamiliarity with a previous comfortable acquaintance.

Over the past years, children have been taught to physically hide from their peers, staying online, keeping masked to stay safe. We are not debating the efficacy of these steps, only noting that unmasking leaves them more vulnerable, during a period when physical looks and socialization matter most. Learning how to keep oneself safe while trying to manage the challenges of talking to a peer without a mask brings new dilemmas raising social anxiety levels. To reduce anxiety for adolescents, we suggest supporting those who chose to continue to wear masks; encourage resumption of sports/activities for group socialization; and be aware that digital technology can be used positively among anxious youth who choose to interact without being seen.

Physical health, including nutrition, sleep and immunity are also a new challenge. Adolescents must consider meal planning once again, as they are no longer home with the kitchen readily available to them. Many are returning to school hungry due to skipped breakfast. Staying after school for sports/activities has reintroduced eating a one meal/day routine. Vitamin D was on the decline while kids remained indoors away from sunlight, now Iron levels are once again being affected by poor food choices.

Encourage Iron-fortified breakfast foods, protein bars and snacks for school if they do not want to eat the provided meals. Taking a daily multivitamin can provide a source of Vitamin D, Calcium, Iron and other vital nutrients necessary for healthy bone growth and brain development, as well as immunity. Redeveloping a sleep schedule, after two years of flexibility, is important for emotional and physical well being. Good handwashing skills learned should be continued to lessen germs.

Resuming a high level of participation in activities (school, sports, work, play) has also led to periods of over-stimulation. The pandemic forced us to quarantine as a society, giving families the opportunity to slow down. Less multi-tasking and more time spent doing hobbies, eating together, cooking and playing together as families occurred during our time indoors. There is something to be said for this and how it impacts our overall well being. Adolescents should reinstate self-imposed “quarantines.” This can be a day spent with family, an hour alone, 30 minutes with a friend, or 10 minutes of meditation time. This act of “time out” from life’s overstimulation, whether physical or digital, can serve as a time to attend to one’s wellbeing. In turn this can alleviate some of the psychological symptoms that may have been precipitated by the pandemic shutdown.

For adolescents with more severe symptoms, screening for anxiety and depression is a must. The U.S. Preventive Services Task Force (USPSTF) is now recommending screening for major depressive disorder in adolescents aged 12-18 years and anxiety screening for all children aged 8 to 18 years, not just those experiencing anxious and depressive symptoms. Youth found to meet criteria for diagnosis of anxiety and depression should seek professional counseling.

For those not connected with mental health providers, please reach out to your primary care provider, school counselors, school-based health centers, or neighborhood programs for more information.

Stay well.