It has wreaked havoc on their lives. Closed schools. Interrupted access to free lunch and essential technology. Canceled activities. Forced an inability to hang out with friends.
In the United States’ desire to return to “normal” last year, we deprioritized young people. We floundered through decisions on closing schools and cobbled together plans for virtual learning. Though we have come to understand schools’ fundamental role in the lives of young people, some states reopened bars before ensuring the safety of classrooms. We still don’t aggressively fight for the welfare of teenagers.
As an adolescent medicine physician, I have seen the results close-up. Some of my patients fear coming into any health-care setting, especially if they have lost a family member. Others have gained or lost significant weight, in search of comfort or control. Some who had manageable levels of anxiety before the pandemic have worsening symptoms. Isolation precipitates depression or suicidal ideation. More than younger children, adolescents notice and are affected by their parents’ emotions, including financial pressure.
The teens of the pandemic are living through a significant and prolonged stress that most adults have never known. I do not know what it feels like to be an adolescent in this age, but I ask and listen. We all can.
I ask all my patients, regardless of the reason for their visit, how they are doing in general. I create space by asking their family to leave the room and reviewing doctor-patient confidentiality practices. “How’s school? How is your family? Your friends?” I sympathize with the struggles of remote education and acknowledge that, even with the most advanced technology, connecting with friends is just not the same as seeing them. “How is your mood? Are you experiencing any anxiety?” Some tell me they’re managing: They have picked up home-based hobbies or found ways to continue old amusements virtually. They try online workout videos or learn to bake.
Others, asked about their emotions, burst into tears. The pressure to hold it all together seems to release in that instant. The stress is hard to manage and even harder to talk about. I pull in parents and social workers to support them, and consider options for therapy or, if indicated, medication.
Our nationwide New Year’s resolution should be going all in to fight the coronavirus, prioritizing the comprehensive health of everyone, including adolescents. We should all get the vaccine series as soon as it is offered, while wearing our masks, social distancing and avoiding nonessential travel until recommendations change. Adolescents have been forced to give up a crucial part of their youth to help fight the spread of coronavirus. We owe it to them to see this crisis through.
Until that happens, parents and anyone who works with teenagers have a critical role. Asking kids how they are doing and creating the space for them to speak openly is the most important thing you can do for them. Listen and let them know there is no right way to act or feel right now. Anxious, sad, overwhelmed, scared and even okay are all valid ways to feel. Give young people grace to get through these challenging circumstances without having to keep up their previous level of performance. Resist the “fix it” urge that tries to make everything better by dismissing, minimizing or replacing feelings. Help them break up the monotony with activities or make safe connections with friends to bring them joy. Show them they are not alone by sharing some of your worries and how you manage. Normalize that sometimes we need outside help, and be prepared to seek help from a health-care provider and/or therapist.
While teenagers are young enough to only rarely experience physical consequences of covid-19, they are old enough to experience the pandemic’s emotional challenges. It is essential that we see the struggles they are facing and work collectively to mitigate them.