by: Children’s Health of Texas 

Many families are facing major changes in their day-to-day lives because of coronavirus disease (COVID-19). With all the unknowns that come with a new virus, it’s normal to feel anxious about the “what ifs” and the future. This stress does not just affect adults – children and teens are also at risk for anxiety, especially as their daily routines are affected.

“Children of any age can experience anxiety,” explains Roshini Kumar, LPC, clinical therapist at Children’s Health℠. “Right now, it’s difficult to anticipate the future, and kids have been pulled from their normal routines. Any time a child faces significant change, it can cause fear and anxiety.”

When anxiety is not managed, it can affect both the body and brain, and cause feelings of helplessness and sadness. However, there are ways parents can help children cope with stress and anxiety about COVID-19. Kumar shares eight tips to help.

How to help children with anxiety about COVID-19

1. Create a routine

One of the best ways to help children cope with change is to implement structure again. “Routines help us anticipate what’s coming and make us feel safe and secure,” says Kumar. “Structure and stability have been drastically affected for many families, so it’s important to establish a new normal for your child.”

Work with your child to create a new daily schedule. A healthy routine will encourage children to maintain a regular sleep schedule, healthy eating habits and daily physical activity (see ideas to stay active at home). Turn to trusted resources, such as your child’s school, for suggestions of daily work or activities. Make a goal chart or to-do list and display the chart in an easy-to-see place like the refrigerator. This will allow your child to track progress and be reminded of their hard work.

“Make an effort to acknowledge your child’s accomplishments right now,” encourages Kumar. “Tiny acknowledgements can make a big difference right now in helping your child’s mood.”While a schedule will help, Kumar says it’s also okay to acknowledge that the new normal is not normal. “Be understanding of the fact that it’s going to take time to adjust,” she says. “If the daily schedule doesn’t go as planned, that’s okay! Try again tomorrow.”

2. Check in frequently and listen

Check in with your child frequently about how they’re feeling and listen without interrupting. Hearing your child’s concerns, validating their feelings and keeping communication open is an important way to support them during this time. You can help your child manage feelings of anxiety by sharing ways you cope when you feel anxious. Let them know it’s normal to feel upset or anxious and that you are there to help. Ask your child how you can best encourage them when they don’t feel good.

“For example, you can ask ‘What are two of your best qualities I can remind you of when you’re feeling sad?’ or ‘What is a book we can read together when you’re feeling worried?'” suggests Kumar. “Often, your child might just want to hear that you’re there for them and you love them.” It’s also important to create healthy boundaries when it comes to media coverage surrounding COVID-19, relying only on trusted sources of information. See more tips for talking to your child about COVID-19.

3. Catch the signs of anxiety early

One of the most important tools in managing anxiety is to recognize and address early warning signs of anxiety. Kumar encourages families to think about anxiety on a scale from 1-10. Many times, anxiety will increase to a level 8 or 9 before we ever realize we were creeping up the scale.

Early signs of anxiety can look different for everybody. For some, it might be biting nails or being fidgety; for others, it can look like irritability. Become familiar with the warning signs your child displays, as well as signs that you yourself are feeling anxious. Typical symptoms of anxiety include excessive worry, restlessness, fatigue, difficulty concentrating and trouble sleeping.

Anxiety can also present differently depending on a child’s age. Young children do not have the words or ability to express how they’re feeling, so anxiety can show up in physical ways such as tantrums, meltdowns or aggression. Older children, including teenagers, tend to be more irritable or prone to isolation when they feel anxious. Talk to your children about recognizing these warning signs and give them ways to respond when signs appear.

4. Teach children coping skills for anxiety

The more anxious a child is, the more difficult it can be to use rational thinking to calm down. During these times, it’s important to use physical coping skills to decrease levels of anxiety.

Children can do things like taking deep breaths, counting backwards from 100 or going to a safe space in your home to relax. Work with your child to identify a place that makes them feel calm, like a bedroom or playroom. Set up the space so they have something tactile to touch or hold, such as a soft blanket, a favorite stuffed animal or a stress ball. Include activities to do in the space, whether reading, drawing a picture or watching a video. These physical actions can help reduce feelings of anxiety and allow you to talk more with your child about how they’re feeling as their anxiety goes down the scale.

5. Focus on what you can control

Instead of dwelling on issues that are out of our control, teach your child to focus on the things they can control. Focusing on controllable tasks can help children think more logically and rationally.

“A lot of anxiety is steeped in “what-if” thinking which focuses on the worst case scenario. This way of thinking can lead to fear and negativity,” explains Kumar. “If you can stop what-if thinking in its early stages, and instead focus on the things you can control, like what you can accomplish today or how you can stay safe, that will help remove those anxious thoughts.”

Things children can control include finishing their work or daily tasks, telling family you love them, or drawing a picture or writing a letter to a teacher or friend. Remind your child of the practical steps they are taking to stay safe as well, such as washing hands frequently and social distancing.

6. Encourage positive thinking

Reframing negative thoughts to be more positive is a common practice in cognitive behavioral therapy (CBT), one of the most evidence-based treatments for anxiety.

“You can’t tell a child to stop being anxious, but you can say, ‘Tell me what you’re thinking,'” says Kumar. “Then, you can help your child figure out if a thought is based in fact or based in what-if thinking. If it’s based in what-if thinking, work together to change it to reflect something positive.”

Take time to share what you are grateful for during this time or to share what you appreciate about your child. If you can focus on the positives and encourage positive conversation, moods will eventually change.

7. Stay connected with others

While social distancing is an important way to help prevent the spread of COVID-19, it can present unique challenges when managing anxiety. “We’re being told to isolate, which is actually a symptom of depression,” explains Kumar. “That’s why it’s important to actively and creatively find ways to foster human connection.”

Even while maintaining safe social distance, there are ways to connect with others. Video chat or call family and friends, draw pictures for classmates or write your teacher an email or letter. Decorate signs to put in your windows for neighbors to see when they walk by. Some families are even making approved handmade masks to donate to health care workers who are on the frontlines.

8. Seek professional help if needed

It’s very normal and understandable to experience anxiety during a time like this. However, if your child’s anxiety persists and starts to become debilitating, it may be helpful to consult a mental health professional. Signs your child may benefit from professional help include not being able to accomplish everyday tasks, not wanting to participate in activities they used to enjoy or not sleeping well which can affect their energy and appetite. It might be difficult to identify these signs during this time but continue to monitor your child and reach out for help if signs of anxiety continue.

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