An Open Letter about Child & Adolescent Mental Health

Friends:

At the beginning of the Covid-19 pandemic, I predicted that America would become a traumatized nation. Why? Because you cannot strip away daily routines of life and expect people to respond to things in a normal way. Routines and rituals make us feel safe. Going to the grocery store, the pub, and sports practices or work, school, and socializing with friends are rituals that add structure to our lives. They are light-posts and boundaries which frame time. Losing predictability, certainty, and connection while injecting fear from an invisible virus would never evoke a neutral response. Adding unscrupulous social media platforms to exacerbate social, physical, and ideological insecurities plus an overly generous helping of polarized politics in communities torn apart by racial injustice, inequity, and disputes about vaccine science and it would equal a recipe for a second pandemic: mental health. I did not want to be correct, but insight into trauma is an occupational hazard for me as a therapist.

Pre-pandemic statistics of child and adolescent mental health according to the National Alliance for Mental Illness (NAMI) are that:

• 50% of lifetime cases of mental illness begin by age 14.

• 1 in 5 children ages 13-18 have or will have a serious mental illness

• Suicide is the 3rd leading cause of death in youth ages 10 -24

• 37% of students with a mental health condition age 14 and older drop out of school

In August 2021, the Journal of the America Medical Association/Pediatrics published an article: Global Prevalence of Depression and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-Analysis by Racine & McArthur et al., which stated, “pooled estimates obtained in the first year of Covid-19 pandemic suggest that 1-4 youth globally are experiencing clinically elevated depression symptoms, while 1 in 5 youth are experiencing clinically elevated anxiety symptoms. These pooled estimates, which increased over time, are DOUBLE of pre-pandemic estimates.”

I am a Licensed Clinical Social worker and therapist trained to treat trauma, anxiety, and depression, among other things. I work with children ages 8-18, adults, and families. In my practice with children and teens this school year, I have seen a 50% increase in obsessive-compulsive disorder diagnosis, a 50 % increase in social anxiety disorder diagnosis, and a 25% increase in major depressive disorder. The rate of school refusal and absenteeism that parents and schools report after a return to in-person learning has increased significantly this year. The academic loss continues to be evaluated. In July 2021, McKinsey and Co. research indicated “that the impact of the pandemic on K–12 student learning was significant, leaving students on average five months behind in mathematics and four months behind in reading by the end of the school year. “The research can be found here.

Here are some things to consider when thinking about how to help any person, regardless of age, improve their mental health:

Exercise, Nutrition, and Sleep are the pillars of health. We cannot expect to feel good if we are not actively practicing balance in these areas. Many people are unaware that 90% of serotonin, one of the happy chemicals in the brain, is created in the stomach or that while we are sleeping, plaque is removed from the brain and a process of myelination occurs, which helps improve thinking and efficacy. Certain foods and activities allow us to produce and release different chemicals in the brain. Consult with your physician to develop a plan if you are not eating well, moving enough, or your sleep is poor, too little, or excessive.

Track screen usage – Many phones provide the user with data about how much time they use their phone and or tablet and break it down by App. This data alone offers the opportunity to empower each of us to look at how we spend our time and what we do with it. We each get 168 hours a week. If you spend 75 looking at your screen, the awareness that 27 hours a week is spent on Cookie Run or Instagram may prompt one to make a different decision.

Scale Back Social Media Use - The research is pretty straightforward regarding the effects of social media on children and adolescents, especially adolescent girls. Frances Haugen, the Facebook whistleblower, testified before Congress about how Instagram drives teen girls toward eating disorders, body dysmorphia, and increased suicidal thoughts. According to the Atlantic article, “The Dangerous Experient on Teen Girls,” found here, “there is a preponderance of evidence that social media is causing real damage to adolescents.

Chew Gum, Sing, Hum, or Whistle – According to Polyvagal theory pioneered by Dr. Stephen Porges, Ph.D., doing these things activates the Vagus nerve, the longest nerve in the body, which helps to activate calming part of the nervous system. Doing so consistently helps to increase overall vagal tone strengthening our resiliency response to stress.

Breathe right – There are a million different diaphragmatic breathing exercises that can be found if you look on YouTube. Choosing to stop, think and slow and control one’s breathing activates the parasympathetic nervous system, which creates a sense of internal calm. It is the antidote to fight and flight response which is characteristic of trauma and anxiety

Recognize and respond to highly charged emotions effectively - When any person, young or old, is in a visibly angry, sad, or defensive posture, their brain is not in a position of readiness to listen, receive or act on new information, or say those that study the brain. In therapy, I talk with kids and adults about what happens when a person “flips their lid,” a term coined by Dr. Dan Siegel, a neurobiologist. When a person flips their lid, brain signals from the internal part of the brain (the limbic system) do not communicate with the exterior portions of the brain, the prefrontal cortex, where decisions get made based on logic. Science tells us that if you talk to someone upset, they make decisions and statements based on emotion, not intellect or reason. Watch a video here to learn more.

Practice Mindfulness & Gratitude– There are many ways to ensure that you are engaged in the present moment and not trapped in your head. Brushing your teeth with your non-dominant hand, using aromatherapy, and practicing grounding techniques help us be mindful and present-focused. Another tool is gratitude which helps to ensure that we are orienting our perspective to be strength-based.

Externalize your feelings – Talking to a friend or journaling provides both an outlet and a way to label your emotions and create space from the feeling itself by talking or writing about it.

© Alexandra Phillips-Burke November 2021