General

We are becoming more familiar with the effects that stress has on our everyday lives. As adults, the pressures we feel at work or home affect our ability to live well. In many instances, we experience stress related to finances, our health, family members, and finding enough time in the day to get everything accomplished. Sometimes it can be debilitating and completely overwhelming, and we need to enlist support from professionals for the benefit of our mental health.

It’s important to remember, that although children and youth today face similar experiences of growing up that most adults can relate to, there is an entire slate of new pressures unique to their generation. There’s a tendency for adults to think that “kids these days” have it easy compared to their own experiences as children. However, researchers have discovered that “our assessments of young people are almost certainly marred by faulty assessments of our own past character and abilities.”(1) Taking time to appreciate the realities that today’s children and youth face without this kind of harmful and subjective bias, may help us better understand the unique complexities that children face daily and may contribute to a mix of mental health crises that cannot be overlooked or taken lightly.

In this article, we explore a wide range of contributing factors that parents and caregivers should be aware of, possible reasons as to why children and youth are having difficulty coping with life stressors. We also look at the effects that the COVID-19 pandemic is having. We’ll share some suggestions on how you can contribute to building their confidence and resilience and establish boundaries that can reduce stress and promote positive mental, emotional and physical health and wellness practices.

The kids are alright, aren’t they?

Each generation grows up with distinct events that mark their childhood, and remarkably, regardless of the decade, the catalysts that cause children to worry all tend to collect under the same umbrella: learning how to find their way while growing up in a destabilized world. Suppose you look at the additional influences that personal computing, technology and the Internet have had recently. In that case, it becomes clear that both the volume and categories of information that children and youth have been exposed to in recent decades cannot be directly compared to the experience of children growing up in the 60s, 70s, and 80s. While it’s wonderful to have such transparency and connectivity, research is revealing that there are repercussions.

Today, children and youth are experiencing unique and serious mental health challenges that should not be overlooked, diminished or rationalized as a regular part of growing up. Regardless of what is believed to be causing the problems, statistics show children, youth, and young adults’ mental health concerns need careful and immediate attention by parents and other adults.

• In January 2020, a Youth Mental Wellness survey across Canada of 400 youth between the ages of 10 and 20 revealed that 32% of respondents contemplated or attempted suicide.(2) Canada has the third-highest youth suicide rate in the industrialized world. Approximately 446 youth aged 10-24 die this way each year. Males (of all ages) account for 75% of suicides. Further, 59% of the respondents did not know where they could get help managing their mental health.(3)
• 80% of children and youth with a diagnosable anxiety disorder and 60% with diagnosable depression do not get treatment. Untreated child anxiety leads to psychiatric disorders.(4)

What types of mental health challenges are most common?

While there are many different facets to consider regarding children’s behaviour and mental health, it’s important to differentiate between common occurrences and those that may cause more significant concern and intervention. Anxiety, mood disorders and depression tend to be most prevalent in children, youth and young adults.

Anxiety

Anxiety is a normal part of childhood and is usually temporary and harmless, but for some children, their responses to situations become prolonged, chronic, and intensified.(5) As part of a developmental phase, for example, a child might play with an imaginary friend, worry about monsters in the closet at bedtime, or want to eat foods of a particular colour. In youth and young adults, anxiety may appear in strained relationships with peers and family, avoidance and withdrawal from anxiety inducing situations that make them feel nervous or shy. It can also manifest as extreme fatigue, insomnia, and trouble focusing and concentrating on tasks and activities, leading to irritability and frustration.

When these types of behaviours don’t diminish over time, it may indicate the presence of an anxiety disorder. Not being able to move forward with the usual supports such as reassurance and encouragement can cause distress for everyone involved. It’s worthwhile seeking professional help. Anxiety disorders in untreated children can result in psychological and physical problems that continue through youth and into adulthood.

Working with qualified medical professionals can help determine if a behaviour observed in a child is cause for concern. While it’s true that stressful situations such as strained relationships with family and friends, losing someone close, moving, natural disasters, and educational demands can all contribute to anxiety, it’s important to note that stress alone is not a cause. A behaviour that has increased in both duration and intensity may indicate that the developmental differences noticed indicate a shift towards an anxiety disorder. It’s important to understand that when a child or youth has an anxiety disorder, it is “not a sign of weakness or poor parenting.”(6)

Untreated anxiety disorders can affect academic performance and social experiences. Youth and young adults may also be more susceptible to substance abuse. However, there are treatments available to help, such as Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention Therapy (ERP), Acceptance and Commitment Therapy (ACT), Dialectical Behaviour Therapy (DBT), as well as carefully prescribed antidepressant and anti-anxiety medications.

Depression

It’s not unusual for children, youth and young adults to experience sadness as a normal reaction to difficult situations. What can be worrisome is when the sadness or similar feelings last longer than two weeks, and daily activities are affected. If there is a family history of depression, children and youth could be at increased risk

of developing the condition. Sometimes anxiety disorders and depression occur together.

We have included a list of symptoms that may be indicative of depression. Some parents may feel that many items within this list are prevalent and common when living with teens. Keep in mind that may be part of the problem.

The symptoms may not be viewed with an eye towards mental health struggles, so they are often ignored. Studies show that only 1/3 of children and youth have received help from a mental health care professional, and the overwhelming majority don’t know where to get help.(7)

• Appearing depressed and reclusive, frequent sadness or crying
• Withdrawing from friends and activities
• Being irritable and experiencing frequent mood swings
• Having difficulty sleeping – with both going to sleep and staying asleep
• Exhibiting changes in eating habits – no appetite, over-eating, or reluctance to eat with other people which may lead to or be indicative of an eating disorder
• Having low energy, low self-esteem and low self-worth
• Experiencing thoughts of death or suicide, including making a plan

When someone experiences depression at an early age, they are at significant risk of developing other major psychiatric disorders as an adult. Helping to obtain treatment when these events happen is critical to establishing acceptable treatment practices and a model of commitment to communication, discussion while removing bias and normalizing life-long mental health hygiene.

The brain is a wondrous thing

We know that a lot is going in the minds of children and youth today. For a long time, it was thought that brains were fully developed by the time we were about nine years old. However, research emerged in the 1990s illustrating that our brains continue to grow and develop, not stopping until approximately age 25. Between 10 and 25, our brains are busy with a complicated rewiring of our synapses that reinforce the structure and help create brain communication efficiencies that are unique and distinct from adults. We see this in MRIs (Magnetic resonance imaging) that show teenagers using “different regions of the brain to accomplish tasks when compared against adults or children.”(8) This rewiring order contributes to the irrational thinking, unpredictable behaviour, risk-taking, and feelings of invincibility that we associate with growing up. It also means that activities we expect children and youth to excel in because they have achieved a chronological age, may be very difficult for them to complete because a part of their brain hasn’t fully developed yet. Having an awareness of brain development and being willing to compromise on expectations while providing instruction where gaps occur can help us to better understand one another.

We can also empathize with many of the unique high-school and post-secondary stresses associated with so much time focussed on choosing a career path. Perhaps, some of the challenges often seen regarding the completion of high volumes of post-secondary course work and some of the mental health struggle students often experience when living away from home for the first time make sense.

The scourge of screens

For elementary school aged children, high school youth and even post-secondary youth or young adults, the pervasiveness of technology and “screen-time” affects not just physical health but also mental and emotional wellness. Studies have shown that screen-based activities can generally lead to “consistent patterns around multiple different concerning outcomes, such as depression, anxiety, problems completing tasks and increased arguing” (Primack, 2018, as cited in Heid, 2018).(9)

While it may be easy to blame technology and the Internet for everything that’s going wrong in our children and youth’s minds, we need to pause and reflect on the reality of how different the world is today from when we were their age. Today’s children and youth have grown up with touch-screens and access to information through the web. Movies and TV viewing doesn’t necessarily happen on television. Getting a mobile/smart phone is now associated with coming of age and serves as a modern rite of passage. Essentially, a world of convenience and distraction are at their fingertips.

While Bill Gates recommends waiting until age (14), many children and youth receive their first smartphone at ten years old.10 Within another two years, half of them will have access to their first social media accounts on platforms like Instagram, SnapChat and TikTok. Adding boundaries and limiting screen time is a must because of its addictive nature. Children and youth are currently spending about 5 hours or more a day on screens, which doesn’t include time for online learning.(11) Parents must also be willing to have regular open discussions about appropriate usage and safety.

• Cyberbullying is rampant and can be challenging to navigate alone. Many tragic stories of devastating harassment and bullying have led to children and youth suicides because they feel there are no alternatives.
• Influencer culture has cultivated unrealistic expectationsin the minds of many children and youth as they aspire to become a “YouTuber” and find instant fame and wealth.
• “Reality” based content is not realistic. It often exposes children and youth to highly sexualized content, diet culture and body shaming, which can have detrimental effects on self-image that are still developing.

The Internet and particularly social media offer an attractive collective space for children and youth to participate, share concerns, and learn more about current issues like the environment, personal safety from abusive situations, politics, racism, and sexual identity. Connectivity is not just a way to obtain additional information; it’s also used to build friendships, express positions on causes and develop an awareness of current events.

It’s also a space where LGBTQ2+ youth can come out publicly and indicate their beliefs. While there is a mixed response and some face criticisms and disturbing comments on social posts, this space can provide a safe forum where like minds can connect. It’s something to think about as we’re reminded that the suicide risk is 14 times higher for children and youth who identify as LGBTQ2+.(12)

How has COVID-19 added an extra layer of complexity?

Over a year into the pandemic, children and youth’s lives have been transformed in ways that we never thought possible. All of the worry and stress around social distancing, masking and hand-washing may be diminishing because it’s become part of a new routine. Still, other aspects have created psychological and emotional scars.

Living with a stay-at-home order has meant that routines and social interactions have mainly been thrown out the window as parents try to cope and comply with frequent changes to procedures. School attendance may be “on” for children and high schoolers unless there is a lockdown or public health order not to attend. Setting up remote learning at home has been particularly challenging in some cases. It’s unfamiliar, and many people in the same household may be competing for the same resources to complete their learning. Even though post-secondary studies have been almost exclusively online, similar challenges exist. In every case, and despite the best efforts put forth by educators, students of all ages are experiencing online learning fatigue.

There is also a tremendous sense of loss. Children and youth have missed being able to hang out and socialize with friends. Older youth and young adults may have experienced job losses or conversely moved into roles as frontline workers, assuming some measure of risk working in public capacities and being exposed to COVID-19 infection. There are still questions about missed events such as prom, graduation, and convocation ceremonies that seem likely not ever to occur for those who experienced the grinding halt early on.

Some may be living in dangerous home situations where they cannot escape abusers or experience poor nutrition due to food insecurity. Still, others may have had to take on responsibilities beyond their years to care for sick family members.

One of the best things to do when COVID-19 adds additional stress is to implement more structure into daily activities and establish stronger routines as needed. Setting aside time for socializing through physically distanced walks outside with friends can help address the lack of in-person interactions. It also promotes exercise, which itself is a helpful treatment for symptoms of depression.

Where can you look for help and support?

Recognizing early signs of mental health struggles in children and youth is an essential first step. Remember

that these can be both emotional and physical, but it’s

the prolonged presence and intensity that should trigger involvement from a doctor or mental health care professional.

Here are a few commons signs that may warrant further discussion:

• Withdrawal and difficulty relating to family and friends
• Difficulties in school (inability to focus, concentrate, or plan, maintain work volumes, low grades, problems with punctuality and performance)
• Excessive fatigue or not being able to sleep
• Lack of interest in eating, personal care and hygiene
• Complaints of stomach-aches, headaches or other physical discomforts

To help, parents can create a sense of security by having age-appropriate, honest and open discussions that either you initiate or your child or your youth begins. Offer reassurance and show respect by listening to understand. For example, if a conversation leans towards current events, first get a sense of their views and what they know. Don’t over-explain. Fill in the blanks as needed. Seek their opinion and critical thinking and try not to overshadow what they share with your own beliefs. Parents can also recommend positive and highly credible online resources such as Kid’s Help Phone, YMHC (Youth Mental health Canada). Children and youth can have discussions with anonymity and leverage online mental health supports.

Here are some other ideas for being supportive:

• Model healthy unconditional expressions of love and ensure that boundaries for behaviour expectations and household contributions have been established and are met to build discipline, life skills and confidence, with an eye toward eventual independence.
• Ensure healthy nutrition and regular eating habits with food that supports brain and body development. Avoid body shaming. Appreciate sensitivities to changes happening as they grow and develop.
• Discuss optimal sleep habits and the need to disconnect. Consider a requirement to leave devices outside of bedrooms and sleeping areas. You may also be able to place connectivity restrictions on WIFI for certain times of the day or even specific devices.
• Model regular physical activity and encourage play and participation.
• Seek professional help when you notice behaviour changes or shifts. Don’t shy away from arranging counselling and therapy. Maintain involvement but be respectful of older youth’s need for privacy.
• Think of their brain neuroplasticity. Use emotional intelligence to avoid conflict. Recognize when you need to de-escalate a situation and give them at least 20 minutes to reset and stress hormones to dissipate.

Above all, approach relationships with an open mind and seek information so that you are better informed. Let your child or youth guide discussion or explain things. Ask questions. You don’t need and won’t have all of the answers, and that’s okay.

References:

1. Stillman, J. (2019, October 25). A New Study Reveals the Surprising Reason Why Every Generation Complains About ‘Kids These Days’. Inc. https://www.inc.com/jessica-stillman/a-new-study-reveals-surprising-reason-why-every-generation-complains-about-kids-these-days.html
2. Youth Mental Health Canada, YMCH. (2020, January 10) Survey Shows Alarming Number of Young People Have Considered Suicide. https://ymhc.ngo/blog/2020/01/survey-shows-alarming-number-of-young-people-have-considered-suicide/
3. Youth Mental Health Canada, YMHC. (n.d.).Youth Mental Health Reality section https://edu.ymhc.ngo
4. Child Mind Institute, Inc.(2015). Children’s Mental Health Report. Who doesn’t get treatment? [Section] (p.8). Early anxiety leads to later psychiatric disorder [section] (p.9) Child Mind Institute. https://childmind.org/downloads/2015%20Childrens%20Mental%20Health%20Report.pdf
5. Anxiety Disorders Association of America, ADAA. (n.d). Anxiety Disorders in Children. ADAA. https://adaa.org/sites/default/files/Anxiety%20Disorders%20in%20Children.pdf
6. Ibid.
7. Hamilton Health Sciences. (2019, April 17). Hamilton researchers find one in five children have a mental health disorder. Hamilton Health Sciences. https://www.hamiltonhealthsciences.ca/share/ontario-child-health-study/
8. CBC Radio. (2020, January 31). Inside the teenage brain: How science is helping us understand adolescents. Canadian Broadcasting Corporation. https://www.cbc.ca/radio/ideas/inside-the-teenage-brain-how-science-is-helping-us-understand-adolescents-1.5443307
9. Heid, M. (2018, October 29). There’s Worrying New Research About Kids’ Screen Time and Their Mental Health. Time. https://time.com/5437607/smartphones-teens-mental-health/
10. Curtin, M. (2017, May 10). Bill Gates Says This Is the ‘Safest’ Age to Give a Child a Smartphone. Inc.com https://www.inc.com/melanie-curtin/bill-gates-says-this-is-the-safest-age-to-give-a-child-a-smartphone.html
11. Pappas, S. (2020, April 1). What do we really know about kids and screens? Growing up digital [Section]. American Psychological Association. Vol.51,
    No. 3.
    https://www.apa.org/monitor/2020/04/cover-kids-screens
12. Canadian Mental Health Association (CMHA) (n.d.). Lesbian, Gay, Bisexual, Trans & Queer identified People and Mental Health. CMHA. https://ontario.cmha.ca/documents/lesbian-gay-bisexual-trans-queer-identified-people-and-mental-health/

For some people, it’s very easy to get caught up in the responsibility of taking care of others. We’re taught to be kind and considerate and help people in need of care. We’re rewarded for our efforts with endorphins and experience emotions that make us feel good about helping others. So, why is it so difficult to focus on personal wellness and to dedicate the same investment in time, energy and care for ourselves? We often worry about appearing selfish and tend to give more credence to negative or judgmental thoughts. We also don’t recognize that being caught up in a cycle of continually giving ourselves to others can become toxic.

In this article, we’re sharing information about how important and necessary it is to focus on yourself and what you can do to achieve better overall wellness.

What is wellness?

Wellness is a term that we hear mentioned often, both in and outside of our workplaces. While it holds a different meaning for different people, it’s important to determine what it means for you to “be well” and to recognize when you’re taking action and making choices that affect your well-being. Some people aspire to achieve a sort of wellness nirvana, which isn’t everyone’s cup of tea, and it may not be realistic or authentic. At its most basic, feeling well means that you are generally healthy physically, mentally and emotionally. Perhaps a more well-rounded definition includes the notion that wellness is more than just a

state of being. The pursuit of wellness has an aspect of self-direction: you need to have the motivation to pursue goals and to make improvements that can enhance your life. So, to view wellness as perpetual happiness may not be the most realistic approach. Wellness has many different dimensions. Sometimes, we can experience poor wellness when different stressors make our lives feel less balanced. At other times, our awareness and motivation to be well introduces many positive changes in our lives and helps us to develop and grow as individuals. Recognizing that many factors can influence how we measure our wellness is important, because it will fluctuate significantly throughout our lives, depending on the reality of our circumstances and situations.

Are you motivated?

Abraham Maslow created a theory that helped explain how we develop motivation, growth, and progress to fulfilling our needs as individuals. His Hierarchy of Needs shared that people are motivated first to satisfy lower level basic needs moving to progressively more complex needs. That motivation increases as each level of need is met. ¹

A complete picture of someone’s wellness, should consider how well those basic and progressive needs are being satisfied. If someone is experiencing financial or food insecurity, they may not feel safe or secure in their job. They may not have somewhere to live, hence their motivation will focus on fixing these elements. Only after they are feeling satisfied will they feel motivated to focus on psychological needs like developing friendships, finding loving relationships and increasing self-esteem.

At the top of Maslow’s Hierarchy are activities that help people achieve their full potential and self-fulfillment. Being aware of what to focus on and the idea of what wellness means to you comes into play. Focusing on yourself means that you recognize the importance of self-care and self-kindness and give attention to self-esteem and self-worth. In short, you’ve been able to view these as essential elements of your identity. Honest self-assessment and self-perception are required, as is the ability to acknowledge personal growth. It’s something that many people struggle with and it can lead to them feeling both unfulfilled and incomplete.

Stress. Understanding the impact.

Suppose you’re struggling because your needs have not been met. In this scenario you are more likely to develop mental health challenges such as anxiety and depression and physical diseases such as obesity and heart disease that can affect your overall wellness. The common catalyst that runs like an undercurrent through these struggles is stress. Stress is a powerful influence that can dredge up memories of traumatic events that occurred decades earlier and affect someone’s ability to focus on improving their wellness. These individuals may only focus on those earlier events and have difficulty processing and/or managing any additional environmental stressors.

Pandemic life has illuminated the need to focus on improving wellness

If you asked most people how well they feel in the midst of the COVID-19 pandemic, they would likely express

their vulnerability and fatigue. Public Health protocols surrounding social distancing, isolation/quarantine requirements, the demands of working from home while simultaneously helping school-age children with online learning or managing the daily challenges of caring for younger children are all having detrimental effects on people’s mental, physical and emotional health.

People are experiencing insomnia and disinterest in tasks that require physical effort. There’s been increases in obsessive-compulsive behaviours, social anxiety, and germaphobia relating to cleanliness protocols. Some people have also experienced significant losses, be it of the lives of family and friends who have succumbed to COVID-19,or their own health if they happen to be dealing with longer-term effects of COVID-19 on their lungs and heart, for example.

Right now, researchers and psychologists are quite concerned about the long-term effects that stress has been having on people as we continue to live in the uncertainty of the COVID-19 pandemic. They’re apprehensive because of the duration and scale of all aspects of life that have been affected. Many people who have experienced job loss have had difficulty maintaining adequate food supply and/or maintaining housing or related costs. They have yet to see reliable recovery and are dealing with high rates of adverse mental health due to chronic stress.

Joshua C Morganstein, Assistant Director of the Centre for Study of Traumatic Stress, points to catastrophic events worldwide — everything from the Chernobyl nuclear accident, the SARS pandemic in 2003 to Hurricane Katrina in New Orleans in 2005. He cautions that the “adverse mental health effects of disasters impact more people and last much longer than the health effects.”
² Morganstein recognizes how detrimental stress is and how deeply it can affect people and consequently, society. He advocates that we need to begin to view stress “like a toxin, such as lead or radon” and appreciate how exposure to stress will affect people longer-term.³

However, for a subset of people, pandemic life has been “remarkably positive.” ⁴ For some people who experienced high levels of stress in the pre-pandemic world, the restrictions have reduced their anxiety, eliminated panic attacks, and they have enjoyed a greater sense of freedom and safety. In these instances, they’ve achieved better work-life balance and accomplished tasks they may have previously avoided, such as decluttering and have even started hobbies.

Getting back on track to creating wellness by looking holistically at mental, emotional and physical health

It’s not enough to focus on just the physical or mental aspects of feeling well. It also makes sense to focus on emotional health to build “skills and resources to manage the ups and downs of day-to-day life” and “foster resilience, self-awareness and overall contentment.” ⁵ While it makes sense that all aspects should be of equal importance because of the interconnectivity between them, there is still an obvious bias towards physical health that needs to change. Until that happens, underreporting of mental health because of fear, stigma, and misunderstanding will make it challenging to find a better balance and to recognize the relationship to physical conditions such as diabetes and heart disease.

• Mental health disorders account for 15% of the world’s diseases.⁶
• Depression is most common; 300 million people live with this debilating condition.⁷
• The World Health Organization has projected that depression will be the leading cause of disease in the world by the end of this decade.⁸

What can I do to improve my wellness?

One of the best ways to start is to reflect upon where you are within your life’s mental, physical, and social aspects. Think about any concerns you have or behaviours you want to address to support better wellness.

From a mental health standpoint:

Focus on the present and practice relaxation and stress reduction through mindfulness and meditation.

Maintain relationships with friends and family by exploring new ways to connect and come together while apart. You may be able to participate or host watch parties to view different television programs or movies, attend virtual events such as paint nights or cooking classes, and even explore collaborative online gaming. It’s important to revive the social aspects of life by talking and listening. Remember to reach out to people who you haven’t heard from in a while as they may be facing challenges of their own.

Explore services and supports offered through programs such as Wellness Together Canada.

From a physical health standpoint:

Keep up with simple exercise such as walking and housework, or explore online classes, like yoga, that are low impact and don’t require equipment.

Maintain good sleep hygiene and sleep routines. Plan on getting eight hours on a regular sleep schedule and where possible, plan for naps as well.

Ensure that your nutrition is optimized to provide the nourishment, vitamins and minerals that your body needs. Food sources are generally preferred over supplements but consult your health care providers about their recommendations for common deficiencies.

From a social standpoint:

Keep connected to your health care providers who can offer input and advice.

Don’t feel that you need validation from friends or family. It’s for you. What you can focus on is setting healthy boundaries with them that support your wellness needs.

Above all, recognize the need to be kind to yourself. Taking action is the first step to shifting into regular behaviours that will help you optimize your wellness.

References:

1. McLeod, Saul. (December 29, 2020). Maslow’s Hierarchy of Needs. Simple Psychology. Retrieved January 5, 2021 from https://www.simplypsychology.org/maslow.html

2. Savage, Maddy. (October 28, 2020). Coronavirus: The possible long-term mental health impacts. BBC Worklife Unknown Questions, COVID-19. Retrieved on January 5, 2021 from https://www.bbc.com/worklife/article/20201021-coronavirus-the-possible-long-term-mental-health-impacts

3. Ibid.

4. Ibid.

5. Lamothe, Cindy. (June 14, 2019). Reviewed by Timothy J. Legg, Ph.D., CRNP. How to build good emotional health. Healthline. Retrieved on January 5, 2021 from https://www.healthline.com/health/emotional-health.

6. Galea, Sandro, M.D. (March 25, 2019). Mental health should matter as much as physical health. Psychology Today. Retrieved on January 5, 2021 from https://www.psychologytoday.com/ca/blog/talking-about-health/201903/mental-health-should-matter-much-physical-health

7. Ibid.

8. Ibid.