The kids are not alright: These doctors share what to watch for as children navigate the pandemic

When Dr. Aruna Dhara's kids began telling her that they were struggling to make friends, she knew that what they were experiencing was a symptom of the pandemic — one she's heard from patients as a family doctor and from other concerned parents. 

There's a spectrum of mental health, and while a diagnosis of depression or social anxiety lies at one end, it doesn't have to be that extreme for a child not to be coping, said Dhara, a Nova Scotia family doctor and mother of three. 

"I certainly have seen my kids kind of look like they're OK, they're kind of functioning and then every once in a while, something will come out," she told CBC Radio's Information Morning. "And more recently, it's come out maybe a little bit more. My kids will say something to me like, 'I'm invisible and nobody knows who I am,' or, you know, 'I don't have any friends,' or there's been a conversation about 'Am I going to die of coronavirus?'

"I think that probably lots of us are having our kids ask these really uncomfortable questions and … say these things to us that are really heartbreaking." 

Interruptions to school

Health experts from across Canada have repeatedly raised concerns about children's well-being in interviews with CBC News since the pandemic began here in March 2020. In Toronto, the Hospital for Sick Children saw a 35 per cent annual increase in admissions to its eating disorder program, while its in-patient psychiatry and adolescent medicine unit has been consistently at or over capacity. 

Listen to Dr. Aruna Dhara's full interview with CBC's Information Morning here: 

And in Nova Scotia, a CBC News investigation found the number of people seeking help due to a mental health crisis rose by 30 per cent since the beginning of the pandemic.

While those figures include adults as well as children, both Dhara and Dr. Jackie Kinley, a Halifax psychiatrist and clinical professor at Dalhousie University, say the province will need to provide ongoing support in pediatric mental health as it navigates its way out of the pandemic. 

One of the biggest hurdles for families has been the interruptions to in-school learning since March 2020 as restrictions have closed schools for weeks and months at a time and moved to online learning. 

While there are concerns around how that affects a child's academic performance, the larger issue for most is the impact it's had on social development, Kinley said.

"This is the time kids learn through interacting," she said. "They learn how to manage emotions, how to get along with people, and when they don't have those opportunities, they don't develop those skills. And that's when we start to see the behavioural problems and some of the emotional problems." 

Children in different age groups signal they're struggling in different ways. Very young children haven't developed the ability to talk about their feelings, Kinley said, so anxiety often manifests in physical symptoms like fatigue, headaches and stomach trouble.

Outdoor play and video calls

"And then as they get a little bit older and they sort of start to think more clearly for themselves, when they're anxious, what happens is it actually interferes with their thinking," Kinley said. "So there can be more attentional problems, behavioural problems."

Both doctors suggest speaking honestly with children about their feelings and about what's happening in the world, in a way that's appropriate for their age. 

And trying to find opportunities for kids to safely interact, whether it's outside or on a video call, is equally important. 

Finally, it's important for parents to also find time to care for themselves, Dhara said. 

"We as adults have to have a language to talk about it, to talk about the fact that this has been a really hard two years — and it's been hard for families and for adults, too."  

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