Speaker Series: Child Anxiety in a Covid World
November 2020

Dr Roby Marcou, Developmental & Behavioral Pediatrician, shared her extensive knowledge and experience in dealing with child and adolescent stress and anxiety.

The new world in which we find ourselves has challenged the resilience of many and thrown up some unique challenges for those experiencing stress or anxiety. All ages experience stress and an ability to deal with stress is, in fact, hard wired into our make-up (think fight or flight) but, when stress overwhelms, it can have negative health implications.

Predictable, moderate and controlled stress leads to resilience. Children don’t learn resilience from being protected from stress, rather from exposure to small doses of stress and being taught ways to cope with stress. However, unpredictable, severe and prolonged stress can lead to vulnerability.

A global pandemic is a very different stress trigger. The outcomes are unknown and uncertain. There is no timeline to work with and there is no end in sight. We are all ‘learning on the job’ and, significantly, the natural instinct to reach out for help is restricted by the need to isolate.

For the most part, our basic physiological and safety needs, as per Maslow’s hierarchy of needs, are being met but our psychological needs for love and belonging are being challenged by a call for isolation. This makes it harder to reach out for help and to receive help. For adolescents this is exacerbated because, whilst they can go to school, they lack the usual opportunities to be themselves, to express themselves and to work through who they are at a time when their brains are learning to regulate emotions and mood and their response to stress.  

Strategies to help children suffering with stress or anxiety:
  1. Recognition of Control – work out with your child what they can and cannot control. Then help them to focus on what can be controlled and to let go of what cannot be controlled.
  2. Growth Mindset – cultivate a flexible attitude: acknowledge loss, have realistic expectations and focus on priorities.
  3. Resilience – bouncing back and adapting:
    • Teach gratitude and incorporate a ritual of giving thanks.
    • Practice delayed gratification.
    • Encourage the use of affirmation phrases: ‘I can’ ‘I will’ ‘I am’
    • Replace ‘shoulds’ with ‘coulds’
    • Fake it till you make it!
  4. Emotional vocabulary – now is the time to expand it.
    • ‘Annoyed’ is a secondary emotion – something else makes you annoyed.
    • Give names to a broad spectrum of emotions to empower your child to express themselves.
    • Make time to talk about feelings and show empathy for the very real emotions that you child shares.
  5. Mindfulness – teach the capacity to experience the here and now and to let go of the ‘what ifs’: stop, breathe and be still.
  6. Screen time – quality screen time shared with an adult is preferable, agree house rules around screens and ensure 2 hours screen free time before bed.
  7. Exercise – encourage daily fresh air and exercise.
  8. Sleep – ensure an appropriate amount of sleep for the age of the child and encourage healthy bedtime routines.