The Pandemic: Q&A and Tips

I was asked some questions, so I wanted to share my thoughts.


WHY HAS THE PANDEMIC MADE IT MORE DIFFICULT WITH CHILDREN WHO HAVE ADHD?

Children with ADHD typically thrive with routine and predictable structure, which allows for them to understand and be aware of their daily expectations in a consistent manner. With this pandemic came a huge, sudden change in structure, pushing most children into online learning and upending their general routine.

The pandemic has significantly limited physical activities in which children can participate. Exercise is a great way for children to “burn off some energy” and temper some hyperactive behaviors. In addition, exercise increases dopamine and norepinephrine neurotransmitters, which are the chemicals that stimulant medications target; helps to regulate the amygdala, which contributes to healthier emotional responses; and increases prefrontal cortex volume, which is responsible for executive functioning tasks, planning, and judgement. So with limited physical activity, these protective factors are diminished.

ADHD is highly heritable, which means that many children who have ADHD may have a parent who struggles with similar issues. Many parents with ADHD have struggled with organization, multitasking, their own changes in their routines, etc.

Given that many parents have been working from home and/or have little experience with online learning, many are unable to provide a consistent, structured, non-stimulating environment to mimic what their child may have been receiving while at school. As a result, there tend to be more distractions with online learning– screens, noise in the environment, other children who may be engaging in other tasks, etc.

It is fairly common to see children with ADHD also struggle with anxiety and/or depression. As a result of the unpredictability and uncertainty that is inherent within this pandemic, many have experienced an exacerbation of these symptoms, which ultimately affects their ADHD symptoms. 

I further discuss all about how ADHD symptoms, for many children, have worsened during the pandemic. I talk about the reasons for this, what kids with ADHD need, and how parents can help in Verywell Family’s recent article on the topic. Read more about Verywell Family’s “Study Reveals ADHD Symptoms Worsening During COVID Pandemic” here.


HOW CAN I DEAL WITH ANXIETY DURING THE PANDEMIC?

im·age·ry
/ˈimij(ə)rē/
noun 
an anti-anxiety technique where you imagine the sights, sounds, tastes, feel, and smell of a place that you find comforting or relaxing; take a deep breath, close your eyes, and transport yourself   
there. how do you feel?

This is a great technique to work through any anxiety you may experience. Give it a try and let me know what you think!


HOW DOES COVID-19 IMPACT MENTAL HEALTH IN AMERICA?

As a psychiatrist, I have to tell you I am scared about the devastating mental health crisis that we seem to be on path to experience (and in some places are already living). This pandemic is not like other mental health disasters, and as a nation we are not doing enough to address its mental health effects. Anxiety, depression, grief, trauma, loss, abuse, substance use, etc. These are just some of the mental health concerns that have really surged since this pandemic began.

I recently read an article by Jacob Stern that really resonated with me. He said, “already, a third of Americans are feeling severe anxiety, according to Census Bureau data, and nearly a quarter show signs of depression. A recent poll by the Kaiser Family Foundation found that the pandemic had negatively affected the mental health of 56 percent of adults. In April, texts to a federal emergency mental-health line were up 1,000 percent from the year before. The situation is particularly dire for certain vulnerable groups—health-care workers, COVID-19 patients with severe cases, people who have lost loved ones—who face a significant risk of post-traumatic stress disorder. In overburdened intensive-care units, delirious patients are seeing chilling hallucinations. At least two overwhelmed emergency medical workers have taken their own life.”


SHOULD SCHOOLS REOPEN IN THE FALL?

This has been such a hot topic of debate recently, as this decision to reopen schools in the fall is a very important and impactful one.Earlier this week in Orange County, California, where I’m from, the Board of Education voted to return students back to school in the fall without requiring social distancing or masks.

As a physician, I was completely shocked by this recommendation! It is extremely reckless, and in some ways, perpetuates the “pandemic of misinformation” that minimizes the need for masks and social distancing.

If schools are to re-open, it is imperative that children wear masks, are socially distanced, wash hands frequently, and are in classrooms with fewer students. There needs to be adequate funding and resources allocated to allow for these measures to take effect.

From a social, emotional, and developmental perspective, it is so important for children to have face-to-face and peer-to-peer interactions with other students and teachers. However, not at the expense of their health. While allowing for students to return back to school in the fall is ideal for so many reasons (learning, more balance in life, separation between home and school, parent burnout, etc.), it has to be done in a safe manner!

In areas like California currently, where there is a surge of cases of COVID-19, it makes me nervous to think about schools reopening. And as a parent, at this snapshot of time, I wouldn’t be comfortable sending my child to school, despite wishing that I could and understanding in what he is missing out.

In my opinion, schools should only reopen if all safety measures are in place and there is an effective system for early identification and intervention for students and teachers who may get sick as a result of the pandemic.


CYBERBULLYING IS ON THE RISE DURING THIS PANDEMIC! WHY?

According to L1ght, an organization that monitors online harassment and hate speech, there has been a 70% increase in cyberbullying in the past few months. 

Some of the reasons for this increase include: more time is spent online as much of learning/school is done virtually; more leisure time is spent online; boredom; an increase in stress; isolation; issues within friend groups (which may be harder to resolve when not physically seeing each other); a decrease in screen time supervision. 

The gravity of cyberbullying is no different than other types of bullying, as it can lead children to feel overwhelmed, powerless, humiliated, isolated, anxious, depressed and even worthless. Victims of cyberbullying may even retaliate, which only feeds a vicious bully-victim cycle. At its worst, cyberbullying can lead to “bullycide,” or death by suicide when bullying is the primary factor involved.

It is imperative that both parents and school administrators (when appropriate) are involved in managing cyberbullying situations. Parents, please:

Talk to your kids. 
Check in with them about how they are doing emotionally. 
Listen, just listen. 
Have screentime structure and guidelines. 
Adjust privacy settings as necessary. 
Urge your kids to connect socially, albeit remotely. 
Encourage your kids to be open. 

The most important thing in any cyberbullying situation is that a child feels safe, heard, validated, advocated for, and protected.

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