9 tips for helping young people deal with COVID-19 anxiety

Dr. Roselyn Wilson, a psychiatrist at St. Joseph's Healthcare Hamilton's Youth Wellness Centre, offers some tips to help young people cope with the stress and anxiety they face while on lockdown under COVID-19.

She spoke with the CBC's Conrad Collaco during a Facebook Live interview on Thursday May 6, 2020. Watch the video above for the full interview or read the text below for an edited and abridged transcript of some of her answers to many questions about how to deal with the stress young people are facing while on quarantine.

Dr. Roselyn Wilson — St. Joseph's Healthcare Hamilton's Youth Wellness Centre

How would you describe the unique challenges young people face today with the quarantine?

I'm seeing a lot of young people are struggling with the same thing that all of us are struggling with. When will this end? What's going on? How do we adjust? There is a subset of kids that are really struggling with anxiety and worry. Am I going to get the virus? Are my mom or dad going to get the virus? What's going to happen in general with society?

Economic work is certainly on some kid's minds. A lot of other young people that I work with are more struggling with boredom, disappointment, even annoyance or anger, frustration, loneliness — they are not as worried about the virus per se but they're worried about coping with all the changes that come with the virus. Losing important milestones, not being able to spend time with friends and adjusting to being at home with parents — spending a lot more time with family members than they used to.

For young people that are in really stressful family situations or not in safe housing situations this has been especially tough for them.

I do think it's really important to remember that, as wild as these times are, this is not the first time that humanity has been through global pandemics. It is not the first time that we have been through massive challenges together.

1. Don't panic

It's pretty tempting to panic. For those of us that watch the news pretty carefully or that make news, it can be really easy to get into spirals of "oh my gosh this is a terrible thing that is going to have a mental health consequences for generations." That's actually not true. Based on what we know — in terms of like global challenges like this we actually have evolved as a species to cope with really tough things. So, I'm actually quite hopeful that some potential strength and resilience could come out of this. The majority of people that have really traumatic things happen to them don't go on to serious mental health concerns. I think that's important to remember. Some people do and we certainly need to be watching for that, to be looking out for each other and checking in with each other and making sure that people are OK.

2. Build structure

What advice do you have for parents and young people as they take whatever steps they can to cope with this quarantine? 

The number one thing that I'm encouraging people to do right now is have some kind of structure to your life. We are all struggling more to keep to regular rhythms of life because our normal routine school work is just totally out the window. And that makes it all the more important to be really intentional about having a regular rhythm of life. So, have regular wake up times and bedtimes. That may need some extra enforcement because there isn't a natural routine.

This is probably not going to be the most academically productive time in your life. That's OK. But we can be easy on ourselves. I've been recommending that people do something every day that makes you feel productive. It could be schoolwork. It could be a chore or it could be playing a musical instrument. Every day do one thing that's physically active or do something outside. Do one thing that on purpose connects you to other people. Maybe you FaceTime with a friend every night or maybe you call a grandparent. Maybe you have a family meal.

Also, have a distinction between weeks and weekends. Do fun stuff on weekends. Be a little bit easier on yourself. It helps us to not feel like every day is grey and the same.

3. Avoid too much screen time

Avoid lots and lots of screen time. The young people that I'm worried about right now with Covid-19 are the same young people I was most worried about before COVID-19, the ones that are mostly staying at home on their phones or laptops, staying in bed all day. Not really keeping regular hours. Not having a lot of face to face interaction with people. It's really easy to get into right now. I think people of all ages are tempted to fall into that pattern right now and we know it's bad for us. It leads to depression. 

4. Create meaning, practice gratitude

It's also really important to, on purpose, create meaning for ourselves, especially for folks that are off work. They're not doing the roles that normally give them a sense that their work and their life is meaningful. Gratitude practice. Making sure to take time every day to say what you're grateful for. Take time to reflect on what you're looking forward to doing when some of the restrictions are lifted and maybe one thing that you want to be different about your life before and after the pandemic.

We know that young people are some of the safest people in society with respect to their risk of getting really seriously ill with the infection. They are at risk of spreading it to other people which is why social distancing or physical distancing is so important. They already are doing a lot of important frontline work. I've seen young people buying groceries, helping seniors with purchases. I know that there's a great group of volunteers in Hamilton "sharemongering" — sort of a grassroots organization mostly of young people that are doing helpful things for neighbours that are socially isolated.

5. Keep time with the sun

A lot of young people don't have to be up as early as they would during school. They're able to go to bed a lot later. How should parents and young people manage bedtime?

I think that it's reasonable to relax expectations a little bit. It's good to kind of keep with the sun. So, if you can be awake mostly when the sun is up and asleep mostly at night we know biologically that's better for most of us.

I'd say being in bed by midnight or even a little bit earlier and then waking up at the same time-ish every day and actually getting out of bed at 8 or 9 or 10. It really depends on the kid. If you're staying up all night and sleeping until 3:00 p.m., maybe tomorrow you get up at 1:00 p.m. and that's a huge accomplishment for you and now you have your afternoon free. It's more about being regular and keeping to, more or less, biological rhythms — rather than saying everybody needs to get up at 9 AM.

Avoid screens at night. That is general public health advice that I give for all of us. Don't be in bed looking at your phone until all hours. Have a separation between the rest of the day and nighttime.

6. Acknowledge difficult emotions

What do you suggest for parents of young people who don't feel comfortable talking about their anxiety?

I'm really glad you mentioned that because I think one of the key things we can do to help ourselves and young people at this time is to acknowledge difficult emotions. If we're are asking young people to do that, model that by doing it yourself. People have told me that their kids found it really meaningful when they shared their own struggle as parents saying 'I'm struggling to both go to work working from home and figure out how to help you with school or I'm noticing I'm really having a lot of worry about what will happen to our family.'

It's really meaningful. It creates emotional connection when we're real with our emotions and that includes negative emotions like anxiety, fear, sadness, boredom and loneliness.

7. Beware of substance use

Substance use is definitely something to keep an eye on for people of all ages right now. It can be tempting when we're having more negative emotions to just try not to feel those emotions. One way we do that is by using cannabis or alcohol or any things that can kind of get us out of our emotions. Try not to use every day. Try to limit our use and not to use substances to cope with emotions is really important.

Also, I don't think we need to assume that every young person is anxious about coronavirus. So, if your young person says 'I'm not that anxious, layoff.' That's OK.

Heather Jones, a nurse, writes that her eldest son is really struggling with concerns about the virus infecting her and the family. She wants to support him knowing there are no guarantees but doesn't want to get him panicked. What advice would you have for Heather?

Great question. Young people whose parents are healthcare workers, there are a lot of them that are having their worries. Acknowledge emotions as a way to open up the conversation. You can say 'I'm also feeling anxious' and you can validate that it makes sense to have extra worries right now. We tend to better if we feel like our emotions are seen by the people that care about us. So, even though it might be tempting as a parent to say 'everything's fine, there's nothing to worry about,' that tends to make us not feel heard and shut down when we get that response.

I would suggest that it makes sense that your son's having these worries. Sometimes our worries aren't actually lined up with fact. So, I hope that your employer is taking precautions to help keep you safe from getting sick. There are ways that you're actively trying to keep yourself safe. I think, probably, your son's overestimating his risk of having the virus which is totally understandable given some of the stuff that's around in the media. It's really important to remember that many, many people that get this virus will have a really mild case. It can be helpful to think even in the worst case scenario if mom or dad get sick at work and then accidentally infect a young person, you'll probably be OK.

8. Focus on the positive

What advice, to ensure good mental health among students, do you have for educators and for teachers as governments consider reopening schools?

I have really come to appreciate face to face contact with people. In schools I imagine they will be having fewer students per classroom. They'll be minimizing contact at recess and things like that. Those things will be different and feel weird but oh my gosh we get to see our friends face to face! We get to hear our teachers give us lessons. A lot of young people I've talked to are saying all these things that I dreaded like my first period algebra class, now I would die to go.

Focus on the positive aspects of coming back together and not letting the excessive worries like 'oh my gosh I'm back in school and I'm gonna get COVID' or this could get bad again. There's going to be a lot of anxiety in the days ahead. There's no way to avoid that but appreciating what we have in the moment will give us some kind of protection against that. 

I'm really heartened by the way that politicians are listening to scientists and medical people and there's a lot of concern for the data out from public health.

9. Help is available

Sophia Divita wrote to us. She is a Grade 12 student at Notre Dame High School. She says she and other student leaders from across Canada are throwing a virtual prom to raise money for Kids Help Phone. It will take place May 22. There will be a DJ. It's called #Promison2020. What do you think about that idea?

That is awesome. I love that example, Sophia, as something positive you're doing right now and contributing to your city, to your province, to your world. That is a good reminder that things like Kids Help Phone, COAST, Youth Wellness Centre — these services are actually still open. If people are experiencing overwhelming stress, they're in crisis — we're still in business doing things by video or phone but we're still doing what we do every day.