When kids test positive for Covid-19, they typically don’t get as sick as adults do, and often don’t show any symptoms. Unfortunately, they are far from immune to the pandemic-related stress that’s hitting so many adults.

“As many as 1 in 5 elementary and middle school-aged children are afraid to leave their homes and are worried there will not be enough food to eat during the course of the pandemic,” says Anthony Rostain, MD, chair of the department of psychiatry at Cooper University Health Care.

Even before the pandemic swept through South Jersey, kids’ mental health was raising alarms. Experts were calling out a higher prevalence of anxiety and depression in kids today compared to past generations – noting that social isolation caused by too much screen time was playing a role. The pandemic has added more fuel, says Rostain. More and more kids have been diagnosed with adjustment disorders since the quarantine. With school and life routines still in upheaval, it’s far too early to know the lasting effect, he notes.

Anthony Rostain, MD

“Younger children worry about catching the infection, fear infecting others, and are anxious about missing school work,” he says. “Older children worry more about their families, friends and relatives than about themselves.”

With few outlets to relieve their stress, some kids act out by lashing out at their families, Rostain says. Common reactions are increased clinginess, distraction, irritability, anxiety, depression and reduced appetite. It’s been particularly hard on kids who live part time with one parent and part time with the other.

“For children who spend time in multiple households with a stream of relatives, prolonged social distancing will mean profound separation from people who provide care,” he says. “They miss help from aunts, uncles, grandmothers, gym coaches and others.”

Nicole Schwartz, director of mental health services at Bancroft Children’s Services, says pandemic stress has been a tipping point for many children who were already struggling with mental health issues, including anxiety, depression, ADHD and behavioral disorders like impulsivity.

“The pandemic has heightened these issues,” Schwartz says.

But it can be hard for parents to tell if the way their child is acting is typical adolescent behavior – especially with teens – or if what they’re experiencing is something more worrisome, she says.

Nicole Schwartz

“Often, if kids are battling mental health issues you might see some increased irritability, they might withdraw or they might stop doing things they once enjoyed,” she says. “You would see changes in sleep and appetite and maybe more arguing over very simple things that were never problematic before.”

At the first sign that your child is having a hard time, encourage them to discuss their feelings, and let them know it’s ok to ask questions.

“Opening the lines of communication is key,” she says. “Respond as honestly as you can, remembering their age and developmental levels so you don’t give them too much information and make them stress out more.”

There can be a fine line between being honest and adding to their worries, but keep in mind that kids often know more than they let on. If you tell them everything is fine, and they look around and see that clearly everything isn’t fine, that their daily life has changed drastically, then they simply aren’t going to believe you, she warns.

“School-aged kids don’t need to know about the finances,” she says. “But you can talk about what is happening in the world and how that affects their lives at home.”

And parents, don’t forget about your own mental health. How you care for yourself and manage your own anxieties influences how your child reacts to this unprecedented situation, she says.

“Children get a sense of how parents are feeling, so if you’re really anxious, constantly watching the news and talking about it, that’s going to affect your children,” Schwartz says. “If parents remain calm and try to limit how much they talk about uncertain things in front of their kids, that can really help.”

You can be honest and acknowledge that the virus is dangerous, Schwartz advises, but focus on spelling out the ways you’re going to get through it as opposed to wallowing in it.

“It’s about keeping things as normal as possible for your child, even if things aren’t normal,” she says.

She suggests creating a day-to-day schedule and sticking to it. Wake up, get dressed, have breakfast and prepare for the day, just as they would if they were going to school in person.

“We all struggle when there are changes to our typical routine,” she says. “Kids really try to seek out structure and routine.”

Along those lines, Rostain notes, now more than ever, it’s important to live a healthy lifestyle.

“Try to lay a solid foundation for your mental health and well-being by prioritizing sleep, eating well and exercising regularly,” he says.

Parents who are looking for additional resources can start by reaching out to their child’s school and guidance counselor for advice or additional resources.

“We’re all going through something really difficult, and the effects are going to stay with us for a long time,” says Schwartz. “It’s important to be on the lookout for possible issues that may get worse over time. Even just making sure your child knows that you’re here for them, that it’s hard for you too and that you’ll get through it together can go a long way.”