By Sonia Heidenreich, LCSW
School-Based Mental Health Therapist, Alameda SBS
As a school-based therapist, this week marks a milestone for me: it has been over one month since schools across the Bay Area shut their doors because of COVID-19. For all the parents across the Bay Area, congratulations on the 1 month anniversary of transforming your home into a one-stop shop for all of your children’s needs, including: schooling, nutrition, entertainment, physical activity, and mental health support! My proverbial hat is truly off to all the parents out there for managing such a herculean task.
For parents of children who have depression or anxiety, this time presents unique challenges. It might be especially hard for kids who are depressed or anxious to cope with having a disrupted routine, being stuck inside, feeling cut off from friends, and the uncertainty of the present. What follows is by no means an exhaustive list, but my hope is that this can provide helpful ideas of ways to support kids with mental health needs:
- First, take care of yourself: It is well-known that we can’t care for others unless we’re caring for ourselves first. This might mean reaching out for support from your partner, friends, therapist, online community, or somewhere else. It might mean taking 30 minutes out of your day to go for a walk, practice yoga, or sit quietly and drink a cup of tea. You are allowed to have your own feelings about what is going on in the world (how could you not?) and asking for and receiving support will help you to weather this uncertainty with patience, flexibility, and compassion.
- Validate your child’s feelings: So often, when someone comes to us and expresses sadness or worry, we just want to make them feel better. We do this because we are well-meaning, we care about this person, and it makes us sad to see them suffer. We sometimes do this by trying to change their thoughts (“It’s not that bad!”), urging them to take a different perspective (“Think about how much better you have it than X person!”), or jumping to point out moments that contradict whatever feeling it is they are expressing (“Remember how happy you were when you were playing your favorite game yesterday?”). However noble our intentions, the impact of our efforts is to invalidate the emotions of our loved one. Instead of trying to change how your child feels, communicate to her that her feeling is valid—that is, that her feeling makes sense to you. Try: “It’s okay to be sad,” or “Tell me about what part of this stinks the most for you right now,” or “It makes sense to me that you’re feeling worried right now, because this situation is really weird and sometimes scary.” Rather than denying your child’s inner experience, let him know that you understand him. How good does it feel when someone just “gets” how we’re feeling? We suddenly feel seen, heard, and less alone.
- Encourage the use of a schedule/routine: This is a pragmatic suggestion, but an important one. The structure of a school day provides routine and predictability, which can help kids with depression or anxiety cope because they know what to expect throughout the day. Obviously, this has all been turned upside down by our current circumstances, but helping kids establish a routine at home can go a long way towards helping them cope with anxiety and depression. Depending on the age of your child, you may need to take a more directive approach (try a visual schedule for elementary school aged kids) or give them more freedom to determine the course of their day (for adolescents, try having them choose a time to wake up, a lunchtime, a work time, and a time for leisure/social media). Ask them how their schedule felt at the end of the day: Did they like it? Did it make the day go by faster/slower? Is there anything they want to change about their schedule for tomorrow? Encouraging the use of schedule that can be altered depending on how useful it felt might decrease some of the resistance from kids who want to make their own decisions.
- Use behavioral activation: This is a therapeutic intervention is extremely effective at treating depression, and what it all boils down to is: Do stuff! When we feel depressed, we tend to lose motivation, want to be alone, and forget about doing things that used to bring us joy or made us feel fulfilled. Behavioral activation reminds us to do activities we enjoy (eg: drawing, exercise, playing games) even when our brain is telling us to stay in bed all day. Encourage your child to pick one thing to do—however small—and commit to doing it each day. Whether that means scheduling a video chat with a friend, practicing a new TikTok dance, walking around the neighborhood, or reading a book for 20 minutes—small, positive efforts result in accumulated positive experiences.
- Fight the negativity bias—Our brains are hard wired to pay more attention to negative thoughts and experiences than positive ones. In this time, it’s hard enough for adults not to become inundated with negative news and fear-based thoughts. Kids, particularly kids who are coping with depression and anxiety, are also experiencing this. We can counteract this bias by encouraging kids (and ourselves) to practice identifying one positive thing at the end of each day. Even on the worst days, there is almost always one tiny thing that went well (eg: finishing one piece of homework, the sun shining, or listening to a favorite song). Identifying one positive aspect helps to contradict all-or-nothing thinking (“Today was awful!”) that keeps kids feeling sad and stuck.
- Encourage the creation of a comfortable and healing environment— This may sound silly, but our space influences our mood, and this is part of why being stuck inside is so hard! Help your child to make their space feel good to them in simple ways: Open a window to get some fresh air, light a candle (with adult supervision if necessary), hang up art or inspiring words, or bring a plant or a flower inside to add a little bit of nature. If we’re going to be inside, we might as well encourage our kids to take ownership of their space in a positive way.
Of course, if your child is having an especially hard time, put them in touch with a trained professional. Crisis lines are available nationally and across Bay Area counties, and social service agencies have quickly pivoted to provide telehealth services. You can also reach out to your child’s school, which will likely be able refer you to the school-based mental health providers who are providing mental health services.
For more information on our work at Fred Finch Youth & Family Services, check out our website www.fredfinch.org