“In my 23 years of experience, I’ve never seen higher levels of depression, anxiety, and self-harm among children and teens,” says Madhurani Khare, MD, Medical Director of Child and Adolescent Psychiatry at Penn Medicine Princeton House Behavioral Health. “They’ve been isolated from so many experiential aspects of life that are integral to growth for this age group, resulting in a great deal of hopelessness.”
Despite the need for social connections and academic structure, the return to school in person this fall will come with its own challenges. And Dr. Khare notes that while stress and anxiety usually subside in the summer, it’s not the case this year.
“The thought of going back to a fully in-person school schedule is very distressing for many young people, particularly those with social anxiety,” she says. “It means having to wake up early, face societal pressures, and handle a more rigorous academic schedule on the heels of a year where they may have fallen behind.”
Dr. Khare offers this advice for behavioral health providers working with young patients who are experiencing distress about the new school year:
Normalize anxiety. Remind children and teens that they are not alone in experiencing anxiety. Every student will likely have a greater adjustment period this fall.
Connect with helpers early. Many schools made mental health a priority during the pandemic. Help patients connect with these resources early or set up weekly guidance counselor appointments to create a safe space at school.
Review the toolkit. Help patients recognize the cues of an anxiety attack and have a plan for coping—whether it’s deep breathing, a stress ball, or a trip to the nurse’s office or restroom to decompress.
Tackle issues as they come up. Cope-ahead strategies are essential, but providers should also anticipate a greater need to tackle the unexpected. Examine triggers as they come up.
Recommend a consistent sleep schedule. Sleep cycle disruptions during the pandemic and the summer can make depression and anxiety worse. Ideally, young people should have at least 8 to 9 hours of sleep to go through all stages of the sleep cycle so that the body can naturally release melatonin. Consistent bedtimes and wake times are important.
Promote self-care. Showering and dressing for the day can help young people feel better overall, and building good exercise and eating habits can reduce the risk for depression.
“If you’re seeing self-harming behaviors or a decrease in functioning, a higher level of care may be needed,” adds Dr. Khare. “The criteria haven’t changed, but the number of young people meeting those criteria certainly has.”
Article as seen in the Fall 2021 issue of Princeton House Behavioral Health Today.
