School's out and social distancing - Reducing mental health burdens during coronavirus isolation
All over the country right now, schools are out, some indefinitely. My own daughter will be home at least the next 4 weeks, and, as a healthcare professional, I fully expect this absence to be extended through perhaps the rest of the school year. On top of being out of school, we are all being asked to follow "social distancing," the term used by public health officials to encourage behaviors designed to reduce the spread of infectious disease (we'll see below that I prefer a different term, "compassionate spacing," which I'll define later). Between being out of school and exercising social distancing, our kids are at increased risk of loneliness and boredom, which, in certain individuals, over time, can also translate to clinical depression. So, in this blog, I explore some ways to help reduce the likelihood of these symptoms in our kids (and in ourselves) as we all transition to a new norm of extended stays at home.
A change in terminology - not "social distancing" but "compassionate spacing"
A fellow psychologist (unfortunately, I don't know who) suggested this change in terminology, and it stuck with me. "Social distancing" has so many negative connotations. The term suggests, "You're sick! I'm staying away from you." Humans don't (normally) distance ourselves from things we enjoy or things that are good for us. We distance ourselves from "bad" things, as a way to keep ourselves safe. Sure, that's the whole point of social distancing, but wouldn't it be better if we used a term that instead communicated, "I'm giving you space because I care about you, and care about the world as a whole. I'm doing my part to help stop this pandemic nightmare"? That's why I prefer "compassionate spacing." It has completely different connotations. Compassion, in fact, is one of the "eight pillars of joy" core as described in the book, The Book of Joy, by His Holiness the Dalai Lama and Archbishop Desmond Tutu (with Douglas Abrams). Compassion is considered to be a core feature of true, lasting positive emotion, and some say (the Dalai Lama and the Archbishop included) that compassion is 1 of the 2 most important pillars of joy (generosity is the other). So, I encourage parents to use this change in terminology with our kids. Social distancing communicates fear and loneliness. Compassionate spacing implies love and a fellow belonging.
Keep some structure
Kids in school are used to structure and predictability. They have roughly the same schedule everyday, and this helps reduce anxiety about what to expect across time. Thus, I highly encourage parents to print out a schedule for homeschool which their kids can see and understand. This schedule does not have to be terribly detailed for everyone. My daughter is 9, and her schedule is broken down by activity (school for 90 minutes, creative time for 60 minutes, lunch time for 60 minutes, more school for 90 minutes, play time for 60 minutes, and so on). But we did this because we know it works for our daughter. She's good at focusing, enjoys schoolwork, and self-manages well. Your child may be different (and there's nothing wrong with that). If your child has ADHD or other problems with sustained attention, you may consider a more detailed schedule, perhaps broken down into manageable 30-minute segments, with more frequent breaks. The point is to keep as much structure as you can and to outline that structure for your child to follow. This takes some burden off you too, to allow you to do your own work from home while your child completes their schoolwork.
Allow your child to maintain some contacts with some friends
Fortunately, we live in a world with great technology that allows us to practice compassionate spacing but still talk to our friends. As much as you can, let your kids talk to their friends using this technology, perhaps daily. Be cautious, though, of social media. For some guidelines on social media, check out the Fall 2019 CAPTVRE Imagination Newsletter, found here.
If you arrange play dates, limit those playdates to a consistent, few kids, and don't intermingle. In other words, choose a few kids who will play together and have your child play with only those kids, at least for now. Try to arrange these in a controlled, outdoor setting (like your backyard). This will protect children from having to "reject" any other children who may come along and want to play. We don't want to give our kids the responsibility of having to say, "Sorry, I can't play with you." That's too much of a burden for most kids. Instead, arrange play dates yourself and supervise. Before the play, remind your kids about good public health habits, like compassionate spacing, refraining from touching the face, and frequent handwashing/sanitizing. After play, have kids wash their face also with soap. Also, as noted above, make sure the play is kept outdoors, where droplets containing the coronavirus are less likely to settle on surfaces a child may touch.
Take time to play with your kids yourself
I know as well as anyone this is easier said then done. If I were the one working from home (my wife is taking that on right now), it would be difficult for me to pause my own work to play at my child's will. A lot of us are busy professionals who still need to fulfill important work duties from home, and its easy for us to allow work stress to make us forget that our kids may speak a different love language than us. So, in your kid's daily schedule (and in your own), work in some time for parent-child interaction, where you just do something fun together. It will be a welcome respite for both of you (or all of you, if you have multiple kids). The novel coronavirus may be causing a lot of bad around the world, but if nothing else we are at least being given an opportunity to be together with our families, something I know most of us parents always want more of.
Ensure some sort of daily physical activity
Physical inactivity is one of the best, most robust predictors of negative emotions, including depression and anxiety. Activity, on the other hand, releases endorphins and other "feel good" hormones that trick the brain into happiness. Increasing physical activity is a core aspect of treatments I regularly do for kids with psychiatric symptoms. It works reliably. It's not just good for the brain though. It's good for overall health as well. So, plan some physical activity time in your child's daily schedule. Be creative with this activity. If you've got a BeachBody On-Demand subscription (or something similar), let your child do one of those workouts. Have a dance party. Do a pushup contest. Complete an obstacle course. A person is more likely to engage in physical activity if they either have a partner or have an immediate objective as part of the exercise. Whatever you choose, keep in mind your child's physical fitness. A fit child will tolerate more exercise than one who hasn't run in 3 years. So maybe don't force the latter child to do 45 burpees and 100 situps. Keep it manageable, but try to give your kids about 30-minutes of physical activity per day.
And while you're at it, don't be afraid to join in the activity yourself. =)
Limit screen time
Except for school-related activities, follow the same screen-time rules you follow when your child is attending school normally. This means no TV or videogames during school hours. Of course, there can be exceptions to this. Your child may take a virtual museum tour, for example, or may watch educational TV or play educational games during the school day. Just keep an eye on the clock, if they do a lot of screen time for school activities, reduce after-school screen time accordingly. I suggest an overall limit of 4 hours screen time per day, including school and after-school, with no more than 2 of those hours being completed during after-school hours.
Screen time limits are important because we know that excessive screen time agitates a lot of children. It also creates dependence. Screens are extremely engaging for our brains, and we can become dependent on them similar to how we can become dependent on drugs. A full review of screen dependence is beyond the scope of this blog, as there's a lot I could say about that. For now, let it suffice to say that, as in everything in life, balance is key. Screens are not inherently bad and shouldn't necessarily be fully eliminated from our lives. But, its important we monitor our screen use and respond accordingly if usage gets too high.
Respond to coronavirus fears with facts
Most kids are fully aware of the current coronavirus panic, and there is no sense in keeping the truth from them. Your child may have some anxiety specifically about the virus or about the "fallout" related to the virus. If nothing else, they may just be empathically picking up on everyone else's anxiety, making them anxious without really knowing why. The best thing you can do for your child's anxiety is to first modulate your own. Stay calm and confident and tell your child that although the novel coronavirus sounds pretty scary, most people won't get it, and of those that do, most, especially kids, don't even get very sick. If your child is a worrier, they may need extra reassurance and more opportunity to work through anxieties. There are many good books for helping kids with worry. I like "What to Do When You Worry Too Much" by Dawn Huebner, Ph.D. You can also help them draw pictures of the virus and then destroy the virus (tear it up, throw it in a fire, rub alcohol/disinfecting wipes all over it). They can also use play to fight the virus. Act out a scene with dolls where one character is sick and help your child play through supporting the character and helping them get better. Be alert that in play, your child may do funny things like killing the infected character and then bringing them back to life (or just killing them altogether). Don't get worried if that happens. It's a normal way for kids to work through anxiety in play. If killing the characters seems to be the only way they respond, you can suggest alternatives, "You know, I don't think killing is the only way to stay safe. Maybe we can help give medicine instead? or let them take a vacation? or maybe we can call a superhero to save them?" The beauty of play is that the solution doesn't have to be realistic to work, in most kids.
If your child has pre-existing anxiety or OCD, they may need some extra professional help in managing symptoms. Therapists are still available during the current pandemic to help, and most can even provide telehealth services, meeting with you and/or your child over secure video-conferencing. If your child is having excessive coronavirus anxiety, don't hesitate to reach out to a professional for some more expert tips on how to manage it.