What’s normal, and what’s anxiety/depression?
Q&A with Dr. Claudia Ma
This pandemic seems to have triggered some anxiety / depression in my child (and me too!). How much is expected because of the pandemic or lack of interaction with friends, and when should we get professional help?
This is the most common question I’ve been asked lately, and it’s an incredibly important one! I think it is great that parents are paying more attention to mental health during this really trying time. Humans are made to be adaptive and resilient. But what we’ve been experiencing these past several months is not normal – this unprecedented stressor is creating too much stress to our autonomic nervous system, and it’s taking a toll on us all. Even mental health pros are looking for guidance on what to say and how to help. Additionally, this pandemic exposes our limitations and can further exacerbate what we have already been struggling with.
As the parent, I would ask yourself this question: did my child have signs and symptoms of mental health concerns prior to the pandemic? Did he/she have difficulties with anxiety, depression, ADHD, or other childhood mental health concerns prior to the pandemic? If the child is presenting with these signs and symptoms AFTER the pandemic, then we know more that these mental health concerns are due to an exposure to an identifiable stressor (e.g., pandemic). In this case, we are looking at the child possibly meeting the criteria for an adjustment disorder (with mixed anxiety and depressed mood). This child’s responses must be occurring within 3 months of the onset of the identifiable stressor. Adjustment disorders could be acute or chronic, but the root cause is identifiable, the duration is usually not that long, and once the identifiable stressor is removed, the child has an easier time bouncing back. In the case where the child was experiencing noticeable mood and behavior concerns prior to the pandemic, and significant changes have been noted during the pandemic, then the parents should bring the child to get formally evaluated by a psychologist or qualifying mental health professionals.
One thing to note- an individual can fully meet criteria for Major Depressive Disorder or General Anxiety Disorder without needing to meet criteria for Adjustment DO first. Parents, continue to pay attention to your child! Watch out for significant changes in these areas: sleep quality, interactions/interest with friends, appetite, concentration, irritability, motivation, somatic complaints, thoughts of self-harm, complaints of depressed mood, preoccupation in worries, development of phobias and extreme fears. Are things getting better or worse? Is your child feeling “stuck” and can’t pull out of a behavior or mood? It’s helpful to understand the big picture of whether things are improving, staying the same, or getting worse. If your child is struggling, working with a psychologist or therapist can certainly help.
In my practice, I see a wide range of parents. Sometimes they themselves are feeling panicked or guilty, or even projecting their own anxiety on their child, even though the child’s behavior is well within the normal range. Other times I see a child whose parents have been in denial about clinical symptoms for longer than is healthy. The key is to realize that (A) it’s very normal for kids to be struggling right now, but (B) there is no harm in chatting with a professional if you want to clarify the extent of your child’s struggle or simply have some “tools” as a parent to help them cope. Just remember — this is new territory, and I have no doubt that by even thinking about these questions, you are on the right track as a parent!