thetruthfultherapist

HOW THE COVID RESPONSE HAS IMPACTED YOUTH AND WHAT PARENTS CAN DO

by Pamela Garfield-Jaeger, LCSW February 2022

 

It's undeniable that we have all been impacted by the COVID-19 pandemic. In this essay, I would like
to distinguish between the impact of COVID itself and the response to COVID in order to help us
recognize the ways we have control and choices despite the fact many things that make us feel
powerless. The more empowered we feel as adults and parents, the better our children's mental health
can be.
First, I will cover many elements of the COVID response that have impacted both adults and children
and then discuss ways we can respond to reduce the fear, anxiety and other detrimental responses.

Emotional response
COVID-19 had a huge impact on everyone. Adults and parents exhibited a wide range of responses to
the pandemic including fear and uncertainty. Children, however, not only had their own personal
responses to the pandemic, but necessarily reacted to the way their parents have handled the situation.
Thus, children have multiple stressors to work through.
The most common emotional response experienced by adults and children has been anxiety. There
was fear of the virus itself, fear of the unknown, fear for the safety of our vulnerable loved ones, fear of
losing household income, fear of government control, and many more. Compounding all of these fears
is the confusing and contradicting messaging from experts and authority, which bring about more fear
from the public.
Another emotion has been anger. We were angry when important life events were canceled. We were
angry when we were told that life would get back to normal if we complied with the rules and that
didn't happen. We were angry with friends and neighbors who believed in different policies and were
then pitted against each other. Long school shutdowns, social isolation, loss of work left many of those
impacted very angry.

Anger and anxiety lead directly to feelings of grief, hopelessness and despair. Many adults and
children suffered tremendous loss. Loss of work, loss of relationships and loss of important life events
all compounded. When someone feels powerless and voiceless, they can feel despair. It is difficult for
children to feel hope for their future when they are not able to participate in regular childhood
activities.
The emotions adults feel have a direct impact on how children feel. Children are most impacted
by feelings of those around them.

Masks
Masks have been a controversial topic. There have been conflicting studies on their effectiveness of
preventing the spread of COVID. Per Atlantic Magazine article titled “The CDC's Flawed Case for
Wearing Masks in School” by David Zweig, dated December 21, 2021: “The agency's [CDC] director
has said, repeatedly that schools without mask mandates have triple the risk of COVID outbreaks. That
claim is based on very shaky science.”
Regardless of your belief in how effective masks are to protect people from COVID-19, the harms of
masks, especially to children are rarely discussed. Outlined below are several of the many negative
repercussions of masking. Many of these statements have been backed by research. There are
conflicting articles and opinions about this if you search the subject. However, if you read news using
critical thinking, you can see that the articles that proclaim that masks do not pose any issue on social
and emotional development do not cite research or data.
-Masks reinforce fear and isolation. Seeing the masks is a visual reminder of the pandemic. When
people are wearing masks, they are less social and become more isolated. No one can deny the
unsettled feeling we all had when we first seeing crowds of people in masks. Many have gotten used to
this “new normal”, but it is always a visual reminder that there is a pandemic and to be vigilant.

-Masks take away individualism. When faces and expressions are less recognized, their individualism
is taken away. Children struggle to recognize others and are less recognized by their teachers and peers
as their faces are covered.
-Masks hinder social and emotional development in children. Dr. Sean Paul, a child psychiatrist
stated, “Infants who are just learning to read facial expressions and verbal cues may have a difficult
time receiving that input clearly when people have their noses and mouths covered.” There is much
data to show that when a person smiles, it produces a powerful chemical reaction in the brain that can
make you feel happier. Even a forced smile can have this impact. We all know smiles are contagious so
what happens when we see less smiles? We smile less. According to an article by Very Well Mind, a
2010 study found that people who smile more actually live longer. It's been researched that facial
expressions in general are contagious because people learn to mirror emotions. Without seeing smiles
and other facial expressions, there is a serious loss to people of all ages.
In addition, smiles and faces are important to the intellectual development of children, especially
babies. According to Erin Vollmer of Therapy Works, interviewed by Kars4Kids blog entry entitled,
“What happens When Babies Can't See Faces?' “Babies learn through watching and modeling. They
copy what the adults around them do. When they can't see our faces, it's hard for babies to learn.” She
further states, “Focusing on facial expressions and facial movement is highly important when
developing mirror neurons and ultimately speech and language skills. That's why it's important that an
infant see the face of their communicative partner when developing early speech sounds.”
-Masks make it more difficult to communicate verbally and non-verbally. It's difficult to hear
people through their masks, it’s hard to read lips, it’s hard to read the tone and expressions of what
people are saying. Taking away the view of people's mouths, the vessel they use most to communicate
creates serious communication barriers. Yale university researcher David Lewkowicz sites his research
in babies and studied how they pay most attention to eyes at four months of age and then their attention
shifts to the mouth around eight months of age. He concluded that lipreading the mouth and lower face
is crucial to speech and language development. Jaclyn Theek, clinic director of The Speech and
Learning Institute in North Palm Beach, Florida reports a 364% increase in patients who were babies
and toddlers amidst the pandemic. Pre-pandemic, only 5% were babies and toddlers, and as of January
2022, it stands at 20%.
-Masks hinder oxygen intake which effects physical health, mood and ability to focus. Many
people suffer headaches, dizziness, short of breath and other physical symptoms as a result of not
getting enough oxygen.
In 2014 University of Utah professor of psychiatry, Perry Renshaw did research to show that Utah had
the highest rates of suicide and depression because of high altitudes. He states “I think if you look at
the maps they would show these very funny phenomenon of people both largely feeling good but also
feeling bad. It really is the mountain areas that are implicated. And, as you can imagine, across the inter
mountain west, there are states with quite different regional variations and cultures. So just looking at
oxygen in the air seemed like one simple way to begin to try to understand what might be happening.”
“Because I had this fixation on altitude, we got on the internet and looked up the altitude of states and
sort of plotted things out. There was this amazingly strong correlation between altitude and rates of
suicide”. He found there were some specific reasons for this connected to neurotransmitters in the
brain and how they are impacted by low oxygen levels. For more information on this topic, look at the
article on Utah Public Radio (UPR), dated December 12, 2014.
-Masks breed bacteria. In June of 2021, A group of parents in Gainesville, FL submitted six face
masks that were worn for 5 to 8 hours by children aged 6-11. to a lab for analysis. A t-shirt was tested
for control. Per the press release: “The resulting report found that five masks were contaminated with
bacteria, parasites, and fungi, including three with dangerous pathogenic and pneumonia-causing
bacteria....no pathogens were found on the controls.”
-Masks make it especially difficult for the hearing impaired to communicate. This is obvious since
lip reading is so important for hearing impaired individuals and voices are muffled under masks.
Communication has been hindered for all people, but those with hearing impairments have been
impacted even more.
-Masks have become a way to divide and pit people against each other, and this is happening at all
age levels. Mask rules are inconsistent and confusing, creating more conflict over them. Now (early
2022) there is new CDC guidance stating that cloth masks are ineffective and an N95 is needed for
protection. However, the data on this is conflicting. There are many videos on the internet of people
yelling and even assaulting each other over wearing masks, what message does that send to the
children? Countless parents tell the story that parents prevent their child from playing with other
children depending on their mask status. Children are growing up in a world where people are divided
and angry over this issue.
-Masks are difficult for people with social anxiety. According to David A Moscovitch, a professor of
psychology at the University of Waterloo and Sidney A Saint, an undergraduate psychology student,
“Research has shown that social anxiety is driven by the desire to behave in ways that conform to
perceived social norms in order to avoid negative evaluation from others. When it comes to mask
wearing, social norms around how we are expected to behave have begun to shift and are often unclear
and uncertain.” “We found that this struggle may be amplified for people with higher social anxiety
because shifting norms heighten the fear of making a mistake and being judged negatively by others.”
“Our review also suggested that people who struggle with social anxiety may feel reluctant to take their
masks off even if it's crystal clear in certain contexts that masks are unnecessary, because masks may
have made them feel safe during the pandemic, not only as a way to prevent contagion but as a way of
concealing their visible signs of anxiety or perceived flaws in physical appearance.” In addition, the
authors went on to explain how people with social anxiety tend to interpret ambiguous cues as negative
which brings on more anxiety when in a setting with others wearing masks and they can see fewer
facial expressions.
-Masks have been found to be especially harmful to people with trauma and mental illness. One
of the most common emotional regulation skills is using deep breaths to slow down the heart rate to
calm down the parasympathetic nervous symptom. This technique isn't easy to do in a mask. In the
book “The Body Keeps Score: Brain, Mind and Body in the Healing of Trauma by Bessel Van der
Kolk, she talks about how trauma is stored in the body and not just in the mind. She states, “Trauma by
nature drives us to the edge of comprehension, cutting us off from language based on common
experience or an imaginable past.” Covering our noses and mouths have a deep implication to many
people with trauma.
-Mask wearing and the norms have created or exacerbated eating disorders in some people. If it
is only acceptable to have your mask off when eating and drinking, this can create an unhealthy
relationship with food. Children are getting the message that it’s OK to have their mask off when
eating. This may cause them to want to eat when they aren't hungry and associate eating with freedom
from the mask.

 

Lockdowns/cancellations
Loss/isolation
No group paid a bigger price during the lockdowns than children. They were home from school, forced
inside, forced to be on screens, isolated from friends, family and important activities. Children missed
important events like proms, graduations, athletic events, plays and other things that cannot be
replaced. They missed opportunities that will be forever unknown. In addition, if the adults were forced
to stay home from their jobs and loose income, this has tremendous impact on the children they provide
for. The insurmountable stress job loss or even the threat of job loss has created on families no doubt
will have long lasting impact on children.
Lack of structure
Children need structure even more than adults and lockdowns created a tremendous disruption to that
needed structure. School and activity routine is so important for children. During the lockdowns, most
people lived with a sense of uneasiness and uncertainty while losing the very structure they were
accustomed to, impacting children to a greater degree. Children need to feel a hope for the future and
if important events are being canceled, this can lead to feelings of hopelessness. This is especially true
for teens trying to take SAT exams, go to college and think about their decisions for the future. Working
towards these life goals are hard enough in regular times. In addition, children are growing up in an
environment where adults fight over how to follow lockdown rules and children are left feeling
powerless. When children feel no agency over their lives, this no doubt can impact emotional and
behavioral development.
Physical consequences
There are many physical consequences that are difficult to measure and will have long-term impacts.
Children are reported to have more eye issues from being on screens for too long and not getting the
proper glasses. Most children got less sunlight, fresh air and exercise. Many children missed important
medical visits such as dental appointments and check-ups. Children with medical issues did not receive
the same quality care they would have with no lockdowns due to limited appointments. In addition to
appointments being limited, people were simply afraid to go to in person appointments and did not get
needed screenings and treatments for other medical issues.
Combined with income losses and schools, churches and charitable organizations closing, many
families and children didn't get food such as free lunches and necessities they would have access to.
Per an article on Reuters dated 12/14/2021, “During the first two weeks of October, 19.8 million
American households reported being food insecure-defines as 'sometimes or often' not having enough
to eat, according to the most recent US Census Bureau's Pulse Survey. The survey shows 8% of US
households faces hunger pre-pandemic, a figure that peaked at 14% last December and was still
elevated at 9% in October 2021.
Child abuse
The rise in Child abuse in 2020 is a concern. Since child abuse is most often detected in schools,
incidents of child abuse were likely underreported during the shutdowns. Per a research study in a US
News and World Report dated October 8, 2021, the number of child abuse victims aged 5 and older
tripled during the time period of March-September 2020. The child abuse increased for school aged
children who were stuck at home, but not for younger children. Dr. Andrea Asnes, leader of the AAP
council on Child Abuse and Neglect and director of Yale Programs for safety Advocacy and Healing in
New Haven, Connecticut stated, “Daycare centers for little kids were considered essential and
remained open, which allowed some families to function, but older kids were stuck at home.”
Domestic Violence
In addition, with families more isolated, there have been more reports of domestic violence and spousal
abuse. There were many studies that reported an increase in domestic violence calls during the
lockdown months. In July of 2020, the National Bureau of Economic Research released a paper about
DV incidents in India and the areas with strictest lockdowns “red zone districts” saw a 13 % increase in
domestic violence complaints relative to the districts that had less strict measures “green zone
districts”. A study by the NCCCJ in March 2021 found that there was an 8.1% increase in domestic
violence incidents in the US after the stay-at-home orders. They attributed this to the lockdowns and
economic stress. Obviously, children in families with domestic violence are directly impacted. They
experience trauma and are at higher risk of repeating the violence once they become adults.
Substance Abuse
In an article dated March 1, 2021, in the American Psychological Association “According to the CDC,
as of June 2020, 13% of Americans reported starting or increasing substance use as a way of coping
with stress or emotions related to COVID-19. Overdoses have also spiked since the onset of the
pandemic. A reporting system called ODMAP shows that the early months of the pandemic brought an
18% increase nationwide in overdoses compared with those same months in 2019. The trend continued
throughout 2020. Many of these statistics are also difficult to measure because these incidents go
unreported. With the added stress of the pandemic, lockdowns, isolation, fear of the virus, both adults
and children are using drugs and alcohol more. Also, with people not having access to support and
treatment including 12-step programs, there have been higher incidences of substance abuse and even
overdose. In San Francisco, in 2019 there were 441 deaths from overdose. In 2020, there were 711. In
2021, 650 died of overdose. For reference, in 2021, 430 were reported to die of COVID-19. (This
number may be less as the CDC stated there is a discrepancy between people who died of and with
COVID-19)
Youth Suicide
According to an article by NBC news in June of 2021, the CDC reported that there was a 22.3 % spike
in ER trips for potential suicides by children aged 12-17 in the summer of 2020 compared to 2019. The
article continued to say “The data was particularly alarming among girls aged 12-17. Between February
21st and March 20th this year [2021], emergency department visits for potential suicide attempts were
up 50.6% compared to the same period in 2019, data showed.” This is a massive problem, especially
since these lockdown measures are meant to protect our children, yet we know COVID poses little
threat to children.
Divorce
In 2020, there was an uptick in break-ups and divorce. The children of these couples will undoubtedly
be impacted. A BBC article written in December of 2020 states, “In the US, a major legal contract-
creation site recently announced a 34% rise in sales of its basic divorce agreement.” There was a
similar pattern in China, Sweden and Britain.
Cognitive decline in children
Children's cognitive functioning has also been impacted by the lockdowns. According to a study at
Brown University in August of 2021, IQ scores of children born in the pandemic went from an average
of 100 down to 78. The study hypothesized this decline in IQ was due to several factors including
workplace and, school closures which created added stress on parents. According to lead study author
Sean Deoni, associate professor of pediatrics research at Brown University, this drop in IQ scores is
“not subtle at all, and mostly due to “lack of stimulation and interaction at home”. “Parents are stressed
and frazzled...that interaction the child would normally get has decreased substantially.” He also talked
about how the damages will increase as restrictions and stressors related to the pandemic continue.
“The ability to course correct becomes smaller, the older that child gets. Sir Terence Stephenson, a
Nuffield professor of child health at University College stated “Perhaps not surprising that children
from lower socioeconomic families have been most affected as this resonates with many of the other
financial. Employment and health impacts of the pandemic”
The unintended consequences of these lockdowns are so vast and long-term, they are difficult to
measure, and we will see them for years to come, especially in this young generation.

Vaccine mandates
As certain cities and companies enforce vaccine mandates, and many parents and children choose not
to get the vaccine, activities and events become restricted causing further isolation and segregating our
society. These innocent children miss out on fun and important events due to their and their family's
personal choice. In the state of California, children ages 5 and up are being mandated to get the
COVID vaccine to attend school. After enduring the lockdowns, this presents new dilemmas for
children and families who wish to attend their school and choose not to get the vaccine. For many
children, fighting for their medical freedom will become an important fight in their lives. In addition to
the loss of employment and ability to participate in activities, perhaps the worst consequence of these
mandates is the conflict and division they created.

So much change
There are all these consequences, and many will lead to significant change that are hugely disruptive in
children's lives. Families are moving, children are changing schools and beginning to home-school,
leaving important extra-curricular activities, and more.

WHAT CAN YOU AS A PARENT DO?

Create structure and routine as much as possible.
Try to maintain as many pre COVID activities and routines as possible. Some examples are:  go to
church, make a schedule, keep bedtimes reasonable. Make sure meals happen in reasonably structured
way. Plan outings and activities your family always did before.
Be present
There have been so many stressors on parents and families since the pandemic started and sadly many
children are paying the price. Despite all the stress, do your best to make time to be present with your
children. Put your phones and devices away. Make time together away from everyday stressors. Plan
family time together.
Find activities away from screens
Make sure everyone gets outside and gets exercise.
Plan family activities that you can do no matter what restrictions there are such as art projects or
baking. Have activities available they can do one their own such as interactive games, art supplies,
sports equipment, etc. Put limits on devices. Find ways to do schoolwork off screen when possible.
Take care of yourself and your emotional state
Find a therapist for yourself if you need one. Take time for yourself to re-charge. Make sure you
connect with other adults. Notice when fear or anxiety overwhelm you and use your own coping skills
to manage your feelings. Don't be afraid to ask for help if you need it. Make sure you get adult time.
Find other adults that you can talk to and be yourself with and have fun with.
Keep masks off as much as possible
Make sure your child sees faces, both faces of familiar people and strangers. Keep your mask off
whenever possible. Seek out places where your child can see faces and smiles even with strangers.
Answer questions and communicate about family changes as much as you can age-appropriately.
Often the unknown brings up the most anxiety. Try to communicate what you can about family plans
and transitions. Involve your children in big decisions such as moving or changing schools. This can
just mean sharing why you are making these major life-changing decisions. Give them a chance to
express their feelings about big life changes. You may not have all the answers, but if they feel included
in what is happening and why, it helps control imagination and keeps free floating anxiety from setting
in.
When seeking a therapist: Find a therapist for your child that does not play into the fear
narrative. A therapist's role is to help a person manage fears and anxieties, not add to them. There are
many reasons to be scared every day that aren't even related to COVID. Any reasonable therapist would
not be talking about those things with their clients and adding to their worries. A therapist needs to be
able to manage their own fears, and not project them onto a client.
When looking for a therapist, be mindful that virtual therapy or therapy in a mask is less
beneficial, especially for children.
Find school and extra-curricular activities with policies that match your values.

This can be a challenge but take the time to find places that do. Find chat groups and support groups that may have
good suggestions. If you can't find a chat group, start one! Many families are making sacrifice to
ensure that their child can be in an emotionally healthy environment. Moving or changing schools are
not decisions to be made lightly, but something to consider based on your child’s response and your
family circumstances.
Consider moving, changing schools or homeschooling (if not already)
Many families are making huge sacrifices to ensure that their child can be in an emotionally healthy
environment. Moving or changing schools are not decisions to be made lightly, but something to
consider based on your family circumstances.
Be honest, but age appropriate with your children
It's OK to be honest with your children about your feelings, the struggles you and your family may be
facing due to all the challenges placed on you during this COVID response. You want to model being
real and those feelings are OK. But remember when you are sharing that you are doing it for them and
not for yourself. You should support you children, not use them to support you. Try and find adult
support when you need someone to talk to. If you have certain fears, you can share them, but balance
that with ways you are being strong and brave in difficult times. Use this challenge to model how you
and your family will persevere during adversity. Think about the life lessons your child might learn
from your struggles and perseverance. They are learning from your actions. Also remember that they
are relying on you for their livelihood, and they need to feel taken care of no matter what.
Focus on the positive and practice gratitude
Gratitude is very important. No matter what the circumstances, there is always something to be
grateful for. If you have a home, food and family, these are things in life to appreciate. This is a great
habit to get into. Of course, this can't be done on days of real crisis, but in most days when there is no
crisis, gratitude is important for adults and children to practice.
Try to connect with other families that share your values.
If you and your children have lost relationships during the last two years, find online groups and
connect with more like-minded families. There are many families looking for new connections. Set up
play dates.
If a child points out the simple inconsistencies of rules, be honest with them.

“I know this rule doesn't make sense, but we need to follow the rule to finish our shopping.” If you don't agree with the
rules, talk to your child about ways that you will be fighting against it and possibly involve them.
Validate their feelings of frustration about how unfair it is and talk about appropriate ways to speak up
and fight back against unfair rules.
Normalize getting a mild cold or sniffle
Getting sick is a part of life. It is not healthy to worry about germs 24 hours a day. It isn’t heathy for
them to view themselves and others as germ vectors. Let them know that it’s OK to get sick
occasionally and their bodies are made to fend off germs. Allow them to get dirty and play normally
with other children. This is part of childhood and is essential.
Empower yourself. Get involved.
Speak at board meetings, go to rallies, join or lead groups that are fighting policies that are negatively
impacting your family.
Model for your children that you fight for what you believe.

You are not voiceless, and neither are they.
This may possibly be the biggest lesson you are teaching your children.
Remember that you are your children’s biggest advocate
If you are seeing some concerns I listed above in your child, such as speech issues, learning difficulties,
emotional problems, or physical symptoms, work collaboratively with professionals. Be sure doctors
are evaluating your child as a whole person, explore answers before dismissing your concerns and they
rule out mask wearing as a possible reason for symptoms. Most importantly, they should work with you
and your values. Don't be shy to question them and continue to pursue answers. It will take effort but
continue to seek providers who meet these qualifications.

 

Pamela received her Master's in Social Work in 1999 at New York University. She has been licensed in California since 2005. Pamela has experience working in schools in New York City, San Francisco and in Silicon Valley California. She has been a clinical supervisor for over ten years overseeing therapists working in school-based programs and in mental health settings. She has worked in residential and outpatient programs for adults and teens who are severely mentally ill. After losing her job at Sutter Health in 2021 due to Vaccine mandates, Pamela has been building a curriculum to guide parents through the mental health system. Her goal is to provide parents with the information and language so they can be the best advocates for their child's mental health. Pamela's mission is to educate parents on how to avoid therapists who lack skill or try to indoctrinate their children.