COVID-Related Anxiety in Children and Adolescents: How Parents Can Help

The COVID-19 pandemic disrupted nearly every aspect of childhood and adolescence—from school routines and social connections to family dynamics and future certainties. While many children have shown remarkable resilience, others have struggled with heightened anxiety, stress, and other mental health challenges that continue even as society moves forward.

As parents, teachers, and caregivers, understanding how the pandemic affects young people's mental health is crucial for providing appropriate support. This comprehensive guide explores pandemic-related anxiety in children and adolescents, recognizes warning signs, and offers practical strategies to help your child or teen navigate these challenging times.

Understanding Stress and Anxiety in Children and Adolescents

While the pandemic affected everyone, children and teenagers may have experienced its impacts more acutely due to their developmental stage and limited coping resources. The constant uncertainty, dramatic routine changes, and social isolation occurred during critical periods of emotional, cognitive, and social development.

Why Children Are Particularly Vulnerable

Several factors make young people especially susceptible to pandemic-related anxiety:

• Developing coping skills: Children and teens are still learning how to manage stress and regulate emotions
• Need for routine: Young people thrive on predictability and structure, both severely disrupted by the pandemic
• Social development: Critical social learning and connection happen during childhood and adolescence
• Limited control: Children had little agency over pandemic-related changes affecting their lives
• Absorbing adult stress: Young people pick up on parental anxiety and worry, even when parents try to hide it
• Developmental brain changes: Adolescent brains are particularly sensitive to stress during this formative period

The Range of Resilience

It's important to recognize that children respond differently to stress. Some prove remarkably resilient, adapting to changes with relative ease and even developing new strengths. Others struggle significantly with anxiety, depression, or behavioral changes. Neither response is wrong—they simply reflect individual differences in temperament, previous experiences, support systems, and other factors.

As one child psychiatrist notes, "After any disaster or traumatic experience, while the wish and hope is for a rapid return to 'normal,' the psychological and emotional aftermath greatly exceeds the more defined boundaries of the trauma itself. Children's reactions may appear immediately or may not appear for days, weeks, even years."

Common Causes of Pandemic-Related Anxiety in Youth

Understanding what specifically triggers anxiety helps parents address root causes rather than just symptoms. The pandemic introduced numerous stressors that continue affecting children's mental health.

Disrupted Routines and Loss of Normalcy

Children thrive on predictable routines that provide a sense of safety and control. The pandemic shattered these routines repeatedly:

• School closures and shifts between remote, hybrid, and in-person learning
• Canceled activities, sports, performances, and social events
• Disrupted holiday traditions and family gatherings
• Changes in parents' work situations affecting family dynamics
• Uncertainty about what would happen next, making it impossible to plan ahead

Even as restrictions ease, the unpredictability itself becomes a source of anxiety. Children may wonder: "Will school close again? Will plans get canceled? Can I count on anything?"

Separation Anxiety and Reemergence Challenges

Extended time at home created both closeness and dependence on family. As normal activities resume, many children experience "reemergence anxiety"—difficulty readjusting to separation from parents and family routines.

Reemergence anxiety can manifest as:

• Reluctance or refusal to return to school
• Increased clinginess or fear when separated from parents
• Physical complaints (stomachaches, headaches) before school or activities
• Sleep difficulties when sleeping away from home is required
• Regression to behaviors from younger ages (baby talk, needing security objects)

One expert explains: "Children thrive with consistency, and consistency has gone out of the window over the past few years." This inconsistency makes reentry particularly challenging.

Fear of Illness and Death

The pandemic forced children to confront mortality and vulnerability in ways most hadn't before:

• Fear of catching COVID-19 themselves
• Worry about loved ones, especially grandparents or vulnerable family members, getting sick
• Witnessing or experiencing serious illness or death of family members, friends, or community members
• Constant messaging about danger, illness, and death in media and adult conversations

For young children especially, understanding that bad things can happen to people they love is developmentally overwhelming and can trigger persistent anxiety.

Grief and Loss

Many children and teens experienced loss during the pandemic—both direct losses (death of loved ones) and ambiguous losses (missed experiences, canceled milestones, lost friendships).

Types of loss affecting young people include:

• Death of family members, often without normal grieving rituals like funerals
• Missed milestones: graduations, proms, first days of school, sports championships
• Lost learning and educational opportunities
• Weakened or lost friendships due to extended separation
• Loss of childhood or adolescent experiences that can't be reclaimed

As one expert notes, "For the thousands who lost parents, grandparents, and other loved ones, the loss is immeasurable, and grief and bereavement can take many forms." The absence of traditional grieving processes may complicate children's ability to process these losses, potentially affecting mental health long-term.

Social Isolation and Peer Separation

Peer relationships are crucial for child and adolescent development. Extended periods of social distancing disrupted normal social learning:

• Missing opportunities to develop social skills through in-person interaction
• Difficulty maintaining friendships without regular contact
• Increased reliance on digital communication, which doesn't fully replace in-person connection
• Social anxiety when returning to group settings after extended isolation
• Feeling behind peers socially or developmentally

Academic Stress and Learning Disruptions

Educational disruptions created both immediate and ongoing challenges:

• Difficulty with remote learning for students who need structure or hands-on instruction
• Learning gaps from inconsistent instruction
• Stress about falling behind academically
• Challenges adjusting to different learning formats repeatedly
• Increased academic pressure as schools attempt to "catch up"

Family Stress and Economic Concerns

Children absorb stress from their environment, particularly family stress:

• Parents' job loss or financial strain affecting household stability
• Increased family conflict due to stress and close quarters
• Parents' mental health struggles affecting their ability to provide support
• Changes in living situations (moving, multigenerational living arrangements)

Recognizing Anxiety Symptoms in Children and Adolescents

Anxiety manifests differently depending on a child's age, personality, and circumstances. Parents should watch for changes in behavior, mood, or functioning that persist over time.

Symptoms of Anxiety in Young Children (Ages 5-10)

Younger children often can't verbalize their anxiety, so it emerges through behavior:

• Regressive behaviors: Returning to behaviors from younger ages like thumbsucking, bedwetting, or using "baby talk"
• Clinginess: Difficulty separating from parents, following them around the house, panic when parent is out of sight
• Sleep problems: Difficulty falling asleep, nightmares, fear of sleeping alone, wanting to sleep in parents' bed
• Physical complaints: Frequent stomachaches, headaches, or other complaints without medical cause
• Emotional outbursts: More frequent or intense tantrums, meltdowns over small issues
• Withdrawal: Becoming quiet, withdrawn, or less engaged in play
• Fearfulness: New or intensified fears (dark, monsters, being alone, loud noises)
• Sensitivity to adult reactions: Hypervigilance about parents' moods and reactions

Symptoms of Anxiety in Adolescents (Ages 11-18)

Teenagers may be better able to identify anxiety but might hide it or express it differently:

• Changes in eating or sleeping: Insomnia, sleeping too much, loss of appetite, or eating significantly more
• Concentration difficulties: Trouble focusing on schoolwork, reading, or activities they previously enjoyed
• Social withdrawal: Pulling away from friends and family, spending excessive time alone
• Avoidance behaviors: Refusing to attend school or activities, avoiding new or challenging situations
• Dropped grades: Academic decline due to difficulty concentrating or lack of motivation
• Physical complaints: Headaches, stomachaches, muscle tension, fatigue
• Irritability and mood changes: Increased irritability, anger, or emotional volatility
• Reassurance-seeking: Constantly asking if things are okay or safe
• Substance use: Some teens turn to alcohol or drugs to cope with anxiety
• Self-harm or suicidal thoughts: In severe cases, anxiety may lead to self-destructive behaviors

When Anxiety Becomes a Disorder

Some anxiety in response to the pandemic is normal and expected. However, anxiety becomes problematic when it:

• Persists for weeks or months without improvement
• Significantly interferes with daily functioning (school, relationships, activities)
• Causes significant distress to the child or teen
• Gets worse over time rather than better
• Includes physical symptoms that are disabling
• Leads to avoidance of normal activities

If your child shows several of these symptoms consistently, professional evaluation and treatment may be necessary.

Potential Long-Term Effects of Pandemic Trauma

While we don't yet fully understand the long-term impacts of the pandemic on children's mental health, research on childhood trauma provides important insights about potential lasting effects.

Factors Affecting Long-Term Impact

Several variables influence whether a child develops lasting problems:

• Age during the pandemic: Children under 8 are particularly vulnerable to lasting effects of trauma
• Duration and severity: Extended exposure to stress and more severe experiences (like losing a parent) create greater risk
• Prior trauma history: Children with previous traumatic experiences may be more vulnerable
• Support systems: Strong family support and access to mental health care provide protection
• Individual resilience factors: Some children are naturally more resilient due to temperament and coping skills

Possible Long-Term Mental Health Effects

Research on childhood trauma suggests potential lasting impacts may include:

• Increased risk of anxiety disorders, including generalized anxiety, social anxiety, and panic disorder
• Higher rates of depression and mood disorders
• Development of post-traumatic stress disorder (PTSD) or adjustment disorders
• Attachment difficulties and relationship challenges
• Increased risk of substance use disorders in adolescence or adulthood
• Sleep disorders and insomnia

Possible Physical Health Effects

Childhood stress and trauma can also affect physical health:

• Higher rates of chronic pain conditions
• Increased risk of cardiovascular problems later in life
• Greater susceptibility to obesity and metabolic disorders
• Weakened immune system functioning

Focusing on Resilience

Despite these concerning possibilities, it's essential to focus on children's remarkable capacity for resilience. As one expert notes: "It is most helpful to focus on the resilience of children and to give them many opportunities to return to play and the work of being children."

Many children will emerge from the pandemic with new strengths, including:

• Greater adaptability and flexibility
• Enhanced problem-solving skills
• Deeper appreciation for relationships and experiences
• Increased empathy and awareness of others' struggles
• Confidence in their ability to handle challenges

With appropriate support, most children can process their pandemic experiences and move forward with healthy development.

How Parents Can Help: Practical Strategies

Parents play a crucial role in helping children process pandemic-related anxiety and develop healthy coping skills. These evidence-based strategies can make a significant difference in your child's mental health.

1. Talk Openly with Your Child

Regular, open conversations help children process their feelings and experiences:

Create a safe space for conversation: Set aside regular time to talk without distractions. For some children, conversations flow more easily during activities like walking, crafts, or playing games rather than sitting face-to-face.

Ask open-ended questions: Instead of "Are you worried about school?" try "How are you feeling about school starting?" or "What's on your mind lately?" This invites fuller expression.

Listen more than you talk: Allow your child to fully express themselves before offering solutions or commentary. Sometimes they just need to be heard, not fixed.

Validate their feelings: Acknowledge emotions without judgment: "It makes sense that you feel anxious about that" or "Those feelings are real and okay." Never tell a child how they "should" feel.

Age-appropriate honesty: Answer questions truthfully but appropriately for your child's age and maturity. Avoid overwhelming them with adult-level concerns.

Help them problem-solve: Rather than immediately offering solutions, ask: "What do you think might help?" or "What could we try?" This builds their confidence and coping skills.

Normalize their experience: Let them know many children feel this way and that difficult feelings eventually pass with time and support.

2. Maintain Consistent Routines

Predictable routines provide security and reduce anxiety:

• Establish regular sleep and wake times, even on weekends
• Create consistent meal times and family dinner rituals
• Set up predictable after-school routines
• Maintain bedtime rituals that promote relaxation
• Schedule regular family time and activities
• Provide advance notice before changes to routine when possible

3. Teach and Practice Stress-Reduction Techniques

Give your child concrete tools for managing anxiety:

Deep breathing exercises: Teach simple techniques like belly breathing, box breathing (inhale 4, hold 4, exhale 4, hold 4), or blowing bubbles for young children.

Progressive muscle relaxation: Guide your child through tensing and relaxing different muscle groups, starting with toes and moving upward.

Mindfulness activities: Try age-appropriate mindfulness exercises like focusing on five senses, guided imagery, or mindfulness apps designed for children.

Physical activity: Regular exercise is one of the most effective anxiety reducers. Encourage daily active play, sports, dancing, or family walks.

Creative expression: Art, music, writing, or dramatic play help children process emotions that they can't verbalize.

4. Be a Calming, Reassuring Presence

Your demeanor significantly influences your child's emotional state:

• Offer extra physical affection—hugs, cuddles, or just sitting close
• Speak in a calm, measured tone even when you feel stressed
• Provide frequent verbal reassurance: "We're safe," "I'm here with you," "We'll figure this out together"
• Be patient with regressive behaviors or increased neediness
• Express unconditional love regularly
• Model healthy emotional expression and coping

5. Manage Your Own Stress

Children are incredibly perceptive about parental anxiety. As one expert emphasizes: "It is critical for parents to manage their own distress and worries, as it directly impacts their children's well-being."

• Seek support for your own mental health needs
• Practice stress management techniques yourself
• Limit exposure to news and social media that increases your anxiety
• Have adult conversations about stressful topics away from children
• Make time for self-care, even in small ways
• Ask for help from friends, family, or professionals when needed

6. Gradually Reintroduce Normal Activities

Help children rebuild confidence through gradual exposure:

• Start with lower-anxiety situations and gradually progress
• Break big challenges into smaller, manageable steps
• Celebrate small victories and efforts, not just outcomes
• Go at your child's pace rather than pushing too hard too fast
• Provide extra support during transitions or new situations
• Be patient—reentry takes time and may involve setbacks

7. Limit Media Exposure

Constant news consumption increases anxiety in adults and children:

• Turn off background news when children are present
• Monitor and limit your child's news and social media consumption
• Watch news together occasionally to answer questions and provide context
• Discuss what they've heard to correct misconceptions
• Focus on positive or solution-oriented news when possible

8. Foster Social Connection

Help rebuild peer relationships and social confidence:

• Arrange playdates or hangouts with friends
• Support participation in activities and clubs they enjoy
• Encourage video calls with distant friends or family
• Volunteer as a family to build community connection
• Be patient with social anxiety—skills may be rusty

9. Focus on Things You Can Control

Help children identify what they can control versus what they can't:

• Teach problem-solving for controllable situations
• Practice acceptance of uncontrollable circumstances
• Focus on present moment rather than anxious "what-ifs"
• Make plans together for things to look forward to
• Empower children with age-appropriate choices and responsibilities

10. Maintain Perspective and Hope

Help children see beyond current difficulties:

• Remind them that difficult feelings are temporary
• Point out their strengths and growth through challenges
• Share examples of times they've overcome difficulties before
• Express confidence in their resilience and ability to cope
• Talk about positive aspects of life and things to look forward to
• Focus on growth rather than just getting back to "normal"

When to Seek Professional Help

Sometimes parental support isn't enough, and professional intervention becomes necessary. Recognizing when your child needs additional help is crucial.

Signs Your Child Needs Professional Support

Consider consulting a mental health professional if your child shows:

• Persistent symptoms: Anxiety, depression, or behavioral changes lasting more than a few weeks without improvement
• Severe symptoms: Extreme distress, panic attacks, or debilitating anxiety that prevents normal functioning
• School refusal: Consistent resistance to attending school or inability to stay in school due to anxiety
• Social withdrawal: Complete avoidance of friends, activities, and social situations
• Academic decline: Significant drop in grades or inability to complete schoolwork
• Physical symptoms: Frequent headaches, stomachaches, or other complaints that interfere with daily life
• Sleep problems: Persistent insomnia, nightmares, or excessive sleeping
• Eating changes: Significant changes in appetite or weight
• Self-harm: Any cutting, burning, hitting, or other self-injurious behaviors
• Suicidal thoughts: Any mention of wanting to die, not existing, or ending their life
• Substance use: Using alcohol or drugs to cope with emotions
• Regression: Significant loss of previously mastered skills or extreme regressive behaviors

Types of Professional Help Available

Therapy: Child therapists use age-appropriate techniques like play therapy, cognitive-behavioral therapy (CBT), or family therapy to help children process experiences and develop coping skills.

Psychiatry: Child and adolescent psychiatrists can diagnose mental health conditions and prescribe medication when appropriate. They provide comprehensive psychiatric care including evaluation and ongoing management.

School counselors: School-based mental health professionals can provide support and connect families with additional resources.

Group therapy or support groups: Connecting with peers facing similar challenges can reduce isolation and provide valuable coping strategies.

Benefits of Early Intervention

Seeking help early offers significant advantages:

• Prevents symptoms from worsening or becoming chronic
• Teaches healthy coping skills early in development
• Reduces interference with social, academic, and emotional development
• Helps the whole family develop supportive strategies
• Normalizes mental health care and reduces stigma
• Provides professional guidance for parents navigating challenges

Overcoming Barriers to Seeking Help

Many parents hesitate to seek professional help due to:

• Stigma: Remember that seeking help is a sign of strength, not weakness
• Hoping it will pass: While some anxiety is temporary, persistent symptoms warrant evaluation
• Cost concerns: Many insurance plans cover mental health services; community mental health centers offer sliding-scale fees
• Not knowing where to start: Your pediatrician can provide referrals, or contact your insurance for provider lists
• Worry about judgment: Mental health professionals understand that seeking help demonstrates care for your child

How Next Step Psychiatry Can Help

At Next Step Psychiatry in Lilburn, Georgia, we understand the unique mental health challenges children and adolescents face following the pandemic. Our compassionate team specializes in helping young people navigate anxiety, depression, trauma, and other mental health concerns.

Comprehensive Services for Children and Adolescents

• Thorough psychiatric evaluation to understand your child's specific needs
• Evidence-based treatment for anxiety disorders, depression, ADHD, and other conditions
• Medication management when appropriate, with careful monitoring
• Family support and education to help parents understand and support their child
• Collaboration with schools and other providers for comprehensive care
• Both in-person and telehealth options for flexibility and convenience
• Acceptance of most major insurance plans

We believe in treating the whole child within the context of their family and environment. Our goal is not just symptom reduction but helping your child thrive and develop the resilience and skills they need for a healthy future.

If your child or teen is struggling with anxiety, depression, or other mental health concerns related to the pandemic or any other cause, we're here to help. Contact Next Step Psychiatry at 678-437-1659 to schedule a consultation and take the next step toward supporting your child's mental health and wellbeing.

Building Resilience for the Future

While the COVID-19 pandemic presented unprecedented challenges for children and families, it also created opportunities for growth, learning, and increased resilience. As we move forward, focusing on children's remarkable capacity to adapt and thrive becomes essential.

The strategies outlined in this guide—open communication, consistent routines, stress management skills, and professional support when needed—provide a foundation for helping your child not just recover from pandemic-related anxiety but develop lifelong emotional health and coping skills.

Remember that healing isn't linear. There will be good days and difficult days. Progress may be gradual. Be patient with your child and with yourself. The support, understanding, and love you provide make an immense difference in your child's mental health journey.

As one expert wisely notes: "It is most helpful to focus on the resilience of children and to give them many opportunities to return to play and the work of being children." Despite the challenges, most children will emerge from this experience with new strengths, deeper connections, and confidence in their ability to handle life's difficulties.

Key Takeaways for Parents

• The pandemic affected children's mental health in various ways; responses range from resilience to significant anxiety
• Common anxiety triggers include disrupted routines, separation anxiety, fear of illness, grief, and social isolation
• Recognize age-specific anxiety symptoms and when they indicate need for professional help
• Open communication, consistent routines, and stress management skills are essential supports
• Managing your own stress directly impacts your child's wellbeing
• Seek professional help when symptoms persist, worsen, or significantly impact functioning
• Focus on building resilience and providing opportunities for normal childhood experiences
• With appropriate support, most children will process their pandemic experiences and thrive