CHKD Blog

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Helping Children with Anxiety During a Pandemic

Author: Children's Specialty Group, Dr. James Paulson, PhD
Published Date: Friday, June 05, 2020

By: Dr. James Paulson, PhD, licensed clinical psychologist at CHKD

There’s a lot for parents and children to worry about in this time of changing routines, schedules, and demands.

For many, stress extends beyond adapting our lives to take measures to stay healthy and productive while slowing the spread of COVID-19. Uncertainty about the future, concerns about health, and difficulty establishing a sense of calm and comfort can be particularly hard for children who have been diagnosed with anxiety disorders and those who are prone to anxiety.

Children with anxiety tend to be more tuned into cues that may signal negative outcomes, such as being hurt, embarrassed, or getting sick. They experience these signs of trouble with greater intensity than less anxious children and are more likely to expect bad outcomes, even when those outcomes are unlikely to occur.

Because anxiety affects children and adolescents of all ages and tends to be based around personal experiences, the expression of anxiety can look very different from one child to the next. For most children with anxiety, there is a strong motivation to avoid anxious situations.

In younger children, this might appear as obvious fear and worry, but it can also look like self-isolation, hiding, or even defiance and being oppositional. The drive to avoid anxious situations is also typical in older children and adolescents, although it’s often expressed differently. In teenagers, anxiety is almost as likely to look like sullenness or an expressed desire to avoid certain activities, as it is to appear as obvious fear and worry.

Children with anxiety need support from their caregivers, particularly during times of increased fear and uncertainty. It’s important for parents to show openness to talking with their children about anxiety, making room for conversation about fears and worries without shame or judgment. This sort of communication between parents and children can set the stage for teaming up to manage anxiety and can keep anxiety from being overly disruptive.

Children with anxiety and their parents may find some of the following strategies useful as they work together to navigate these waters:

Develop a routine and follow it flexibly.

Having a reasonably structured routine and day-to-day expectations can help increase feelings of security and comfort, which makes it harder for anxiety to grow. Make an effort to create a daily schedule and support your child in understanding and following it. Daily routines are different for each family but are best kept flexible so that they can be adapted to your family’s changing needs.

Check in and listen.

Some children feel a sense of embarrassment about anxiety, which can make them feel more isolated, and more anxious, because it is difficult to talk about. Check in with your child from time to time and listen to their thoughts, worries, and hopes for the future. Doing so in a way that is open and nonjudgmental can help to reduce embarrassment and will make it easier for you to team up with your child to work together to manage anxiety.

Use active coping skills.

There are dozens of active coping skills that children can learn in order to reduce anxiety in the moment. Taking slow, deep breaths, tensing and relaxing muscles, imagining a place where they feel safe and relaxed, or going to a comfortable “chill out” space at home to unwind are some of the more popular varieties of these strategies. The good news with most of these active coping strategies is that if one isn’t the right fit, there are many more options to try. The better news is that the more a child practices active coping, the better it tends to work.

Try distraction.

Sometimes the best choice for managing anxiety is finding an activity that can take your child’s mind off of a source of worry. While some distractions, like various forms of screen time, should be used sparingly, there are many options. Consider going for a walk, having a conversation about something your child is interested in, playing a game, or trying some other interactive activity.

Focus on what is important and controllable.

In talking with children about anxiety, it is often helpful to focus on what they can do in their current circumstances. Talk with your child about what is important for them to do right now, and in the near future. Focusing on what is possible and important in the present moment can be a powerful antidote to anxiety.

Avoid fueling anxious routines.

While it is beneficial to have a daily routine so that your child knows what to expect, some children are prone to developing anxious routines. For caregivers and parents, this can be a challenge, as it is important to listen to children and try to respond to their needs. For children who ask repeatedly about sources of anxiety or insist on certain repetitive routines, it may be best for parents to answer or indulge a routine once, explaining that it’s not likely to help for them to continue to respond. In cases where this behavior is persistent or becomes more disruptive, contacting a mental health professional may be in order.

Stay active and connected.

In these times of greater social distance, it’s easier for children to feel more isolated from their peers, teachers, and other important parts of their social network. Finding ways to stay connected to these social circles, or reconnecting, is likely to help. In addition to talking on the phone and using platforms like FaceTime and Skype, smartphones and other devices offer many options for working toward greater connection to others.

Seek support from a mental health professional.

Anxiety can be complicated and difficult for children and caregivers to manage. While these strategies may be helpful, if your child’s anxiety seems to worsen, or if it becomes overwhelming, unsafe, or debilitating, it is a good idea to seek help from a mental health professional. This may be done directly or with a referral from your child’s pediatrician. There are many good evidence-based treatments for child and adolescent anxiety and with this sort of help, most children see significant improvement. 

Dr. James Paulson, PhD, is a licensed clinical psychologist at CHKD, an associate professor of pediatrics at Eastern Virginia Medical School, and an associate professor of psychology at Old Dominion University. He has been a practicing psychologist, working with children, adolescents, and their families, since 1998.



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About Children's Specialty Group

Children's Specialty Group is the only pediatric multi-specialty practice serving southeastern Virginia and northeastern North Carolina. The physicians of Children's Specialty Group base their practices at Children's Hospital of The King's Daughters and serve as faculty in the Department of Pediatrics at Eastern Virginia Medical School. Learn more about our specialists here.