Kids (& Others) Coping with COVID-19 4/10/2020

Who in their right mind would have thought that an extra month off from school could ever be a burden?

But now, after nearly a month away from friends and classmates, and with a loss of routine and social interaction, many youth are totally done with being free from the rigors of school and being detached from their normal lives in normal times. While many teens already live significant parts of their lives in the virtual sphere – on their phones, chatting, texting and relating at a distance– the compulsory lack of social interaction, the constraints to normal physical activity, and the loss of actual physical contact with their peers is draining and demanding.

It is, of course, not just youth who are challenged, as most everyone faced with sheltering in place is at risk of feeling closed in. It is easy to feel burdened with empty and seemingly endless time. It is frustrating, especially in a time of community need, to be stuck with a constricted menu of purposeful activities. While time with family is precious, uninterrupted time with even the best of kin, can lead to increased conflict and frustration.

Though current conditions do not now encourage office visits with primary care providers for these sorts of challenges by either youth or their families (not to mention visits for even routine health difficulties that normally would be managed in face-to-face clinical contacts), this is a time when all care providers can reach out (albeit, virtually) to those in their practices to preventatively address the questions of “What do I do with myself in this difficult time? How do I keep my mood up, my worries under control, my motivation activated, and my energy flowing?”

These questions address typical challenges faced by all, but for youth with underlying difficulties in their self-management, mood regulation, sleep hygiene, self-esteem, and interpersonal relationships, it can be particularly important for healthcare providers to be able to offer concrete guidance that can help.

Now, if ever, is a time when we can provide guidance and prescribe sound recommendations to address these challenges, utilizing basic counseling tools to motivate healthy behaviors and attitudes.

Now is a time when we really should be ready to say to all of our patients:

“I’d like you to…”

– establish a schedule for the day and stick with it

– eat well and wisely

– exercise your body

– exercise your mind

– be intentional in your interactions with others

– be intentional with your self— don’t give in to frustration, boredom, or negative self-cognition

– respect the gravity of the moment, but keep up your faith and optimism about the future

We should also be prepared to recognize those of our patients who are already dealing with or are predisposed to anxiety and depression. For those already in treatment for these concerns it is important to support their engagement in treatment and continued compliance with previously prescribed medications. For those in significant distress, medication adjustments may be appropriate and for others for whom the new stressors of the day are trip-wire challenges, short-term medication interventions to help with sleep and mood may be worth considering, with appropriate consideration and caution.

The staff at the SmartCare program remain available for consultative support for providers (858 880-6405) and for patients and parents (848 956-5900).   Call or refer and we will be there to assist.



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