Mental health of children: Not a teeny-weeny issue

Parental insecurity and anxiety, loss of financial stability, increasing domestic and family violence, and anger issues are all risk factors for depression and anxiety in children, writes Dr Aruna Muralidhar

The Covid-19 pandemic now seems just the tip of the iceberg. The larger and more complex issues are submerged under the surface. Although the pandemic has affected the mental health of all ages, the impact on children and teenagers seems to have immediate and long-term effects.

Adolescence (10-19 years of age) is characterised by a rollercoaster of physical, emotional, and psychological changes. They are apparently healthy individuals and yet emotionally vulnerable in this impressionable age. Normalcy and routine form an important base for them. Having a predictable structure helps them cope better. The interaction with peers, teachers, and mentors gives them a perspective of life that parents alone may not be able to provide. The school or college environment provides discipline, the ability to focus, drive, and compete. Extracurricular activities such as physical training, art etc., give them a well-rounded personality. The visual and other sensory cues and stimuli help them assimilate more information subconsciously. The necessary stress of an examination and the ability to plan for their future course are important milestones for the mid-and late-adolescents.

Changes during the pandemic

In March 2020, a stringent lockdown was imposed. Schools and colleges were closed. This rocked the boat for many adolescents who were suddenly asked to stay indoors. The initial exhilaration led to some important family bonding and refuelling of hobbies. When this extended well over an academic year and into the second year, the repercussions began to show in the form of prolonged use of the computer or mobile screen, unrestricted and unsupervised use of the internet, feeling lonely and demotivated, lack of peer interaction, and lack of disciplined enforcements of the school environment. Although, home confinement has improved family bonding and parental supervision and involvement; these are restricted to some families only.

A sedentary lifestyle has paved the way for serious health problems especially clinical obesity. Children are likely to binge eat when at home and with no calorie expenditure, it tends to accumulate as fat. Inadequate or suboptimal sleep may result from long hours of screen viewing and lack of exercise. This affects their concentration, focus, motivation and may also lead to hormonal imbalance. Lack of peer interaction and being bottled up may lead to a feeling of hopelessness, demotivation, and sadness. Online teaching may make subjects feel drab and boring. Boredom is a major fallout of the rigmarole of online schooling at home.

Excessive internet use has opened Pandora’s box. The unsupervised and frequent use of the internet is causing some major issues. Firstly, there is an addiction to video games, YouTube, etc., leading to a lack of focus and poor school grades. Parent-child conflict in this regard is also raising doubts about unhealthy family relationships. Unsupervised internet use is also associated with self-harm and suicidal behaviours in children with psychological risk factors. Secondly, online pornography viewing is on the rise leading to altered perceptions of sexuality and unhealthy sexual development. Thirdly, news on social, press, or online media with false information and reporting may aggravate anxiety and depression. Loss of family members due to Covid-19, unexpected medical bills, and lack of employment are also contributors to parental angst and an unstable family structure. Parents may not be able to provide emotional support to their children.

What can we do?

So, what is it that we, as a society can do to prevent, identify and manage this problem? Parents can allay anxiety by openly communicating with their adolescents providing the right information about the numbers treated and recovered. They can be vigilant about certain symptoms in their adolescents such as sleep disturbances, anger and irritability, and lack of focus and concentration. Other pointers are poor scores at school or college, sadness or hopelessness, tearfulness, social withdrawal from friends and family, loss of interest, changes in eating or sleeping patterns. If these symptoms last for more than two weeks, parents must seek professional help for their wards without delay. Depression and anxiety are serious and can be life-threatening.

Several protective factors can prevent and allay the symptoms. Having a predictable routine to include good habits for eating, learning, exercising, and sleeping helps. Acknowledging their anxieties, encouraging them to interact with peers online or by phone and encouraging them to express themselves, being honest and open without shielding them from information are all strategies that parents and teachers can use. Online access may be limited on mutually agreeable terms. The unregulated and inappropriate use of the internet may be curbed by parental controls. They must be encouraged to use healthy coping mechanisms like physical exercise, yoga, meditation, pursuing hobbies, and journaling. Regular physical activity of at least 60 mins of structured or unstructured exercise helps immensely in reducing obesity and improving mental health. Avoiding stocking up of junk foods and instead having plenty of fruits, dry fruits, and healthy snacks will avoid temptation and limit unhealthy choices.

At the school level, principals and teachers may be vigilant of the student’s performance and engagement in school work. Organising online sessions for adolescents and their parents would sensitise them and arm them with the necessary information to prevent and identify mental health problems early. Media, NGOs, and the Government must also be actively involved in spreading awareness and providing timely help to children and adolescents. Mentally healthy children and teenagers function better at home, school and society. They are
more likely to become resilient and productive and lead happy and successful lives.

(The author is a Bengaluru-based senior consultant obstetrician & gynaecologist.)