After It’s Over: The Pandemic’s Secondary Effects on Mental Health

Dan Shapiro

 Attention Magazine June 2020

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During this pandemic, I have listened to parents and children share many common concerns:

  • What about the health and safety of my family, my friends, and myself?
  • How do I balance working and schooling from home?
  • Will my business and family take too big a financial hit?
  • How do I keep up with schoolwork?
  • I miss seeing my friends and having my routines.
  • I get anxious about all of this change and uncertainty.
  • Living and working under one roof, we are driving each other crazy.
  • When will this shutdown finally end?

Much has been written about how to support and communicate with children during these challenging times. But there is another important side to the COVID-19 pandemic: When the shutdown finally ends, how will we return to normal?

During this time of crisis, children with developmental difficulties may be having more trouble—or less. Even as parents feel more stressed, many children seem much more relaxed. In fact, since this plague forced us all to hunker down, some children have never been happier. The shutdown allows children an opportunity to avoid previous sources of anxiety and distress. Parents and teachers have been advised to lower their expectations. For children with academic challenges, the pandemic has granted a reprieve. There is less work to do and more time for screens. Rules and routines have been relaxed.

Children who struggled with social complexity are now able to stay contentedly within a much narrower comfort zone. Some rarely leave their homes, let alone their own bedrooms. Those with anxieties about going to school, departing their house, coming into contact with germs, socializing, and performing are more comfortable practicing avoidance than problem-solving. Ironically, then, as much of humanity confronts unprecedented death and disease, some children are experiencing a time of extraordinary comfort.

When the pandemic finally ends, most of us will breathe an exhausted sign of relief. But for many children, all their old problems will come roaring back with a vengeance. Many will not want to go back to school, do their work, perform, deal with social anxiety, or face their fears about illness. They will miss the odd freedom of quarantine. I am not advocating premature abandonment of school shutdown and social distancing. These interventions remain crucial in our fight against COVID-19. The disease is absolutely worse than the treatment. But the prescription has possible side effects.

Even as we are still fighting this plague, how do we prevent a secondary wave of school refusal? How do we teach children to face fears during an era of mandatory avoidance? And, of course, there will be the thousands of children who have fared worse during the pandemic. How do we plan for the inevitable spike in post-traumatic stress and other mental health problems brought out during this time of historic disruption and loss?

As Rahm Emmanuel said, “A crisis is a terrible thing to waste.” Now is the time to prepare for the future. We can give our children the skills they will need to confront the challenges ahead. This means more attention to teaching problem-solving skills and building resilience. More than ever, children need to be taught how to:

  • Control what we can and accept what we can’t
  • Avoid pessimistic generalizations
  • State problems in specific and solvable terms
  • Take a solutions-oriented and collaborative approach to dealing with adversity
  • Rely on science and objective analysis to make decisions
  • Experiment with different possible solutions
  • Not get discouraged if we need to go back to the drawing board
  • Tell stories and experience adult models of bravery, courage, heroism, and perseverance
  • Adopt a mindset of growth and change
  • Explore the arts and nature
  • Nurture relationships and practice social connection
  • Keep old routines, create new ones
  • Develop good self-care habits; including healthy sleep, nutrition, and exercise
  • Practice mindfulness and meditation
  • Help others, perform daily acts of kindness
  • Count blessings, keep hopeful, find joy, have humor

During a pandemic and beyond, all of this isn’t easy. But even as we race to find a vaccine against COVID-19, we need to immunize our children—and ourselves—against its secondary effects on mental health.

Dan Shapiro, MD, is a developmental-behavioral pediatrician in Rockville, Maryland. He is the author of Parent Child Journey: An Individualized Approach to Raising Your Challenging Child and Parent Child Excursions: ADHD, Anxiety, and Autism. He developed the parent group-training program.
Watch Dr. Shapiro’s video seminar,  Supporting Children during the COVID-19 Pandemic and Beyond.