By Dr. Joseph Mechak and Dr. Lauren Zohler
This month’s blog is a re-post from August 2020 about mental health and the pandemic. We are posting it again because mental health remains a huge concern for our patients and it is a priority for pediatricians everywhere. We are over 2-years into the pandemic and many of our realities remain very different from the pre-COVID world. This weighs on all of us, but can be particularly difficult for teens and children. We have seen a dramatic increase in depression, anxiety, eating disorders, and other mental health issues in our patients. As such we have expanded our mental health services at Potomac Pediatrics to accommodate this ongoing and growing needs of our patients.
We have provided some information, below, on how to identify mental health issues and the first steps to take if you have concerns. As always, reach out to the office with questions, concerns, or to get started with the mental health program at Potomac Pediatrics.
Warning signs for anxiety/depression
- Expressing feelings of hopelessness, sadness, feeling depressed – Some kids may come right out and say it. In others, it may come up with some gentle probing. But, many children feel nervous, embarrassed, or uncomfortable talking about their mental health. It is important to have open and honest conversations about mental health and how the changes or stressors that have come from the pandemic are impacting them.
- Changes in behavior or mood – Many parents will say some of the first signs of depression or anxiety are changes in behavior. We often hear things like “they seem different” or “they are not themselves” or “they seem sad” or “they are crying more.” This parental intuition is often spot-on – so listen to it. Changes in attitude, moodiness, being more withdrawn are sometimes considered ‘normal teenage behavior’ but it could also be a sign of underlying mental health struggles.
- Loss of interest in hobbies/activities – In the medical world we call this anhedonia. This is one of the more specific and reliable signs of depression in children and teens. If your child stops participating in their favorite activity or seems to be just going through the motions these could be a big warning sign that something is wrong.
- Changes in relationships – Depression or anxiety can take a toll on your child relationships. They often take their feelings out on those closest to them. If your normally social child now prefers to stay in their room alone, or if your child is seeming to start fights with their best friends/siblings/girlfriend more than normal, or if your relationship with them seems to be different, consider their mental health.
- Frequent Physical complaints – Mental health problems will often present with physical symptoms, especially in younger children that may struggle to describe their feelings. Many children will complain of frequent belly pain, headaches, fatigue, or low energy as physical signs of underlying mental health concerns.
- Changes in eating habits – Eating more, eating less, weight loss and weight gain can all occur as physical expressions of anxiety or depression.
- Changes in sleeping habits – Sleeping more, insomnia, or drastic changes in sleep schedule can also be a sign of an underlying struggle.
- Increases in risky behaviors – Many with underlying mental health concerns will start engaging in high risk behaviors like drug, alcohol, nicotine use or risky sexual behaviors. These behaviors will only perpetuate the underlying mental health issue. If you suspect or have noticed any of these changes – seek help.
Recognition of a problem is the first step in getting help. If you are concerned your child is depressed or anxious or have noticed any of the signs above, seek help. Below are a few of the first steps in getting your child the help they need.
- Prevention – Open communication and a healthy, active lifestyle can help prevent mental health problems before they start. Take a look at the helpful AAP articles below with some tips to staying healthy and well during the COVID pandemic. It is important to say, however, that your family shouldn’t ‘go-it-alone,’ see the next steps below if your child or your family needs help.
- Make an appointment with your pediatrician – Your pediatrician at Potomac Pediatrics is your first stop for help. We are all well-versed in depression, anxiety, and other mental health disorders in children and teens. We can start and/or direct therapy based on your child’s situation.
- Counseling/therapy – Therapy is one of the most effective treatments for depression and anxiety in children. Therapy isn’t always what it looks like in the movies. Rather than psychoanalyze your child, the therapist/counselor will help them recognize and process their emotions and give them tools or strategies for when they are feeling down, worried, or frustrated. We have new and expanded counseling services at Potomac Pediatrics. Talk to your pediatrician or our mental health coordinator for more information or to make an appointment with one of our amazing therapists.
- Psychiatry services – We now have 2 excellent board certified Child and Adolescent Psychiatrist on staff at Potomac Pediatrics. Your pediatrician may choose to refer your child to see Dr. Zohler or Dr. Thomas for a number of reasons, including the possibility of starting antidepressants or anti-anxiety medications. They are an excellent resource for the doctors and patients, alike.
- Suicide hotline – Make sure you and your teen know the number to the National Suicide Hotline. Put this in their phones or post it somewhere in the home. If you can’t remember the number you can also call 9-1-1 to receive help.
- National Suicide Prevention Lifeline – 1-800-273-8255
- Mental Health Emergencies – If your child has ever made threats to hurt or kill themselves, this is an emergency. They should be seen in the Emergency Department right away.
There are a wealth of mental health resources out there. As with any advice, make sure you are getting your information from a reliable source. Below are a few articles from trusted organizations that may be helpful in identifying or navigating mental health concerns during the Coronavirus pandemic: