Experts: Child anxiety, depression heightened during pandemic

COVID-19 has put extra stress on everyone, and experts said children are not immune to feeling the strain of the pandemic.

“Kids hear their parents talking about all these things, and everybody is wearing masks and looks different,” said Dr. Margaret McClure, an associate professor and chairwoman of the psychology department at Fairfield University.

With so much uncertainty, McClure said, it’s understandable that children might be feeling anxiety or depression.

“Anxiety is an adaptive, healthy, completely normal experience and so are changes in mood,” she said.

But how can a parent tell if a child’s tension and mood swings are a healthy reaction to what’s happening in the world, or something different? And what additional strain could the pandemic put on a child already battling clinical depression or anxiety disorder?

Even before the pandemic, many children were already coping with these issues, said Dr. Eli Lebowitz, director of the Program for Anxiety Disorders at the Child Study Center at the Yale University School of Medicine.

“Many children are going to have (an anxiety disorder) at some point in their lives,” he said, adding that nearly 30 percent of children develop some form of anxiety.

Lebowitz spoke Wednesday at Yale New Haven Health’s 43rd annual Maxwell Bogin Lectures in Pediatrics. The lecture series is held annually and each year it focuses on a different topic. This year, the conference was held virtually for the first time and focused on childhood anxiety and depression.

Though most speakers did not directly address the effects of COVID-19, new school restrictions and other fallout from the pandemic on children’s anxiety and depression, the youth impact is evident, Dr. Yann Poncin, one of the speakers, said following the lecture.

“We are seeing more kids for mental health concerns in the pediatric (emergency department) and on our inpatient unit,” said Poncin, an assistant professor of clinical child psychiatry at the Yale School of Medicine.

“Those who live in homes where preexisting acrimony was present were the earliest to show up.”

During his talk, Lebowitz said there are many types of anxiety, ranging from phobias to panic disorders to social anxiety and generalized anxiety. All can be troubling in their own ways, even when not severe, he said. Take panic attacks, for example.

“Panic attacks, while they themselves are not dangerous ... are extremely uncomfortable and unpleasant,” he said.

Depression was also discussed during the lecture, and speaker Dr. Paola Ayora said roughly 3.2 percent of children aged 3 to 17 have been diagnosed with depression.

Ayora, an assistant professor of clinical child psychiatry at the Yale School of Medicine, said part of the process of screening children for depression is assessing what else is happening in their lives, and to see if any change in mood has been triggered by something specific, as opposed to clinical depression.

“It’s OK to have a period of increased sadness in response to something,” she said.

McClure echoed those thoughts and said there are two clear ways to tell if a child is dealing with a deeper issue. “(One) differentiator is when (shifts in mood) start to cause problems for kids, such as difficulties at home, in relationships or at school,” she said.

Another indicator of a serious problem is if children have severe changes in mood for two or more weeks.

Determining the impact of pandemic-related stress on a child with preexisting depression or anxiety is a little more complicated, McClure said. One of her concerns was children who were receiving treatment might have skipped sessions due to the pandemic, and could have had a relapse in symptoms.

But, McClure said, one upside is that children who are already getting help for mood disorders have likely learned coping mechanisms that they can use to help manage additional issues caused by the pandemic.

“Those skills can translate really well into coping with other issues,” she said.