Helping our kids with quarantine-induced social anxiety

Has it happened yet? Have you watched a sitcom and felt uncomfortability arise as you watched the characters walk into coffee shops without masks?

As we lean into 2021, so many of us are hopeful that our social climate will return to normal. Yet, as we anticipate our old, familiar, comforting ways of life, many of us are experiencing a new, unusual sense of anxiety we have not experienced before: social anxiety.

Perhaps, if you reach far enough, you can find the morsel of memory from middle school. The anxiety that riddled your very bones as you walked between towering lockers and 8th graders, wondering what thoughts were racing through other students’ heads about you (little did you know, their minds were full of the very same thoughts and fears.) And now, as you begin to revisit that time, I want you to consider all of the middle schoolers who are bracing themselves to re-enter “normal” life. While momlife and dadlife are hard, I assure you that hard is unmatched compared to the person who entered the Covid19 pandemic as a 5th grader and is leaving as a 6th grader. Or truly any grade between 5-12th.

Consider all of the moral, cognitive and social development that occurs between the ages of 10 and 18. This population has had to tackle incredibly challenging and monumental milestones through unprecedented times. So if you’re pubescent kiddo is acting like a butthead, pause and empathize. Know that the primary influencers of milestones during this season include their neighborhood, school, and peers. Most of which have been unavailable to them in the traditional sense.

Ten to twelve year olds are grappling with what Erik Erickson described as “industry vs. inferiority.” Essentially, these youth are asking the question, “How can I be competent enough to survive and thrive?” … consider how answering that question has been impacted by the crises of 2020. Individuals who have not successfully been able to answer this question, could struggle with low self esteem and a sense of inferiority. These feelings can result in social anxiety.

Thirteen to eighteen year olds are grappling with a stage called, “identity vs. role confusion.” During this time an individual is asking, “how can I survive in the adult world?” They are searching for a sense of self, and this often presents as exploration of their personal belief systems, values and convictions. Failure to feel unique and integrated can result in lack of fidelity, confusion and a low self esteem. This, too, can result in a myriad of mental health disruptions, including social anxiety.

So, how can we boost our kids’ self esteem and help them brave the big, open, Covid-free world?

Be patient. Do not scold anxiety. Do not force a child to be social against his or her will. In fact, forcing your youth to engage socially will ultimately undermine their need to feel competent and confident. Instead, you can coach them on bravery, teach skills for managing anxiety, and offer rewards for when they choose to make small, brave choices. The key is reward even the smallest social risks taken, they call this the “stepladder” approach, and it’s a gentle approach to exposure therapy. Again, force nothing. Encourage, instead.
Normalize. Talk about times when you have experienced social anxiety. Allow your child to see that you still make brave choices in an effort to make friends. Celebrate moments when you are brave and when you have been brave in the past in front of your kiddo.
Teach Relaxation Skills. Teach your child deep belly breathing. You can do this by having the individual place one hand on their belly and breathing in for 3 seconds, allowing his or her belly to rise (not the chest), and then breathing out for 4 seconds. For children, I encourage them to pretend to sniff a warm cookie, filling their belly with air, and then blow the hot cookie to cool it off. If they do this 3 times then you can reward them with an actual cookie and make this a game. It is important to model this behavior. Other relaxation skills you can find on youtube include guided imagery, and comforting sensory experiences the child can take into social situations (calming smells, a soft necklace or sweater, etc.). The app Stop. Breathe. Think! Has a childrens’ app that can help teach these skills.
Teach Cognitive Skills Teach your child thought-awareness. Have them down the thoughts that go through their mind when they are entering a social situation. Gently invite him or her to come up with 3 possible outcomes for each risk taken, and/or 3 possible thoughts other kids might be having about him or her.
Come alongside the youth as he or she claims his or her own top values and guiding belief systems. What does he/she want to be known for? What resources do they need to explore their questions related to values, belief systems, and passions? Encourage who they are and show interest in what interests them! Do not allow differences to threaten your sense of parenthood or self. Honor your youth’s process.

My loved one has PPD, how can I help?

Please engage this list noting that everyone’s experience is unique. What is helpful for some, may not be helpful to others. And what is helpful one day, may not be considered helpful the next day. The foundation of becoming a helpful support person is made first by acknowledging that you cannot fix this problem. Your loved one is suffering from an illness that is deeply emotional and biologically driven. You must acknowledge that this condition is not his or her fault, it is not your fault, it is simply the reality of your loved one’s situation. The key is to listen and observe with a thoughtful and patient posture, understanding that the victim may not be able to communicate his or her exact needs during this fragile time.

1. Listen

Listen to him or her cry in despair and hopelessness. Do not interject with platitudes, alternative ways of thinking or even Scripture. Simply listen and witness the hardship. Feel sorry for him/her. Though this may feel like a helpless method of support, it’s actually one of the greatest blessings to those struggling with PPD. The truth is, unless you’ve been there, you will not understand. It’s often better to simply listen and allow space for catharsis.

2. Sympathize

A strong support person is one who can stand in the gap of a loved one’s hopelessness and simply feel bad for him or her without trying to fix things. It’s okay to simply sit as a love one cries and say, “this is just so unfair and sad. I’m so sorry you are going through this,” without providing tangible solutions. Often times, those words of sympathy are more powerful and healing than changing diapers, doing laundry, or bringing a meal.

Do not compare your personal history to his or her current situation! That is not always helpful. The loved one who is suffering needs to feel the hardship of their unique situation without feeling compared to your past adversity. Do not rely on pleasantries such as “this too shall pass” – “it gets better” – “the days are long but the years are short” – “your baby is healthy, and that’s what matters,” etc. Not only are these phrases impersonal, they are honestly not helpful and can produce more shame and guilt than hope and healing.

3. Connect with Therapist

While you can provide a special space for listening and sympathy, a therapist can provide professional intervention that will help your loved one find their voice and strength in the midst of PPD. If you call PSI at 1-800-944-4773 and leave a message indicating your need for a list of therapists in your area, you will receive a call back from a person who can help connect you to therapists. While I would love the opportunity to work with your loved one, I understand I am not a good fit for all consumers and would be happy to assist in connecting individuals with the right provider if they are willing to get help.

4. Permission

Your loved one needs to know there is permission to feel and think the unexpected. Those suffering with perinatal mood disorders are often plagued with guilt and shame for the hidden thoughts and feelings that lurk within. Provide a safe space for him or her to admit the unthinkable to you without feeling judged or shame. Let them know it’s okay to feel like hurting their baby sometimes and that it’s okay to admit that they hate their role as parent in that exact moment. Let them feel what they feel and say what they think, even if it’s dark and scary.

If he or she admits to thoughts or actions of self harm or harming the baby, be sure to connect them to a professional that very moment, or drive them to the local emergency room to discuss their situation with a professional. Remind him or her that these thoughts and feelings are not coming from within, but are being caused by an illness and bio-chemical imbalance.

5. Presence

Simply being physically present with your loved one during this time is powerful.

Often times the one who is suffering just needs a witness to his or her hardship without having to narrate every thought and feeling. Offer a quick text to your loved one during the day: “I’m at Chic-fil-a with the kids, what can I bring you?” – “I’m running by Starbucks, what do you want?” – “I’m just hanging out today and thought I’d swing by we can watch TV in silence or just chat” – “I’m taking the kids to a park, want to walk with us?” –Randomly drop off a little note with flowers, or a chocolate bar…it’s the little things that remind him or her that you are there as a witness to their hardship, and a friend regardless of their appearance or attitude.

6. Patience

There will be moments that you want to clap your hands and yell, “snap out of it!” But you must remind yourself, this is not your loved one’s fault. This is not coming from a self-destructive disposition, spiritual weakness, or simply sleep deprivation. This is an illness. Just like you wouldn’t ask a friend with diabetes to “snap out of it,” you cannot ask a friend suffering from PPD to “snap out of it.”

Healing and recovery is a process that will involve layers of intervention and time. Let your friend or family member know that it’s okay to take 10 steps forward and 7 steps backwards. Let your loved one know that you are not leaving him or her, and that it is normal for healing to take weeks, months or even years.

Take care of yourself as a support person! If you need to see a therapist, do so (preferably someone educated in perinatal mental health). You will only be a strong support person if you are able to care for yourself and create a separate space to vent your frustrations and feelings regarding the situation.

7. Consistency

The individual suffering with a perinatal mood disorder will usually not want company. They will not want to leave their house. They will not want other people to come to their home.

One of the best ways you might show up for a loved one during this time is to have a “standing appointment” each week during which you do a mutual check-in and time of encouragement. Ask each other hard questions about life, relationships, and spirituality. Be vulnerable with one another. Sometimes when the one suffering is put in a position to not feel like the only broken one, the only patient, or the only weak one, he or she may feel not as alone. Like a fellow human in need of community and grace. It is sometimes helpful for the one suffering to also feel as though there is space to speak into someone else’s world and to feel permission to be broken at the same time.

8. Help

Not everyone may be quick to admit that physical help around the house is necessary to make it through PPD. The laundry, dishes, walk the dog, cook a meal, sweep the floors kind of help. I think what becomes most difficult to a person suffering with a perinatal mood disorder is finding the energy to come up with specific ways to help.

It may actually be more helpful for you to show up and simply say, “I’m going to go fold some laundry.” Or to let them know, “I’d like to come Wednesday at 10AM to empty your dishwasher and take your trash out. I can also walk the dog if that’d be helpful. Let me know if there’s anything else I can do, if you’d rather me not do one of those things, or if a different day or time would be better…” Just be awkwardly forward. It’s honestly most helpful and loving, even if it feels pushy.

Let the loved one know he or she can stay asleep while you’re there and that they can just leave a key under the doormat. Remember research shows sleep can be the most effective intervention for PPD.

9. Prayer

Prayer can move mountains, break bonds, heal the sick, raise the dead, restore hope and life…prayer is the tool God gives us for partnering with Him in change. Pray for your loved one! Just as God will heal someone suffering from cancer, or the flu, He can and will heal your loved one from PPD! Pray that He would turn this season to good, as only He can!

It doesn’t have to be anything formal or fancy. Just place your hand on his or her shoulder and say something like “Please make this better for my friend, Lord.” before you leave their house.

10. Encourage

Let your loved one know what they are doing well, and let them know often. “I’ve never met someone as persevering as you! It’s amazing you’re living through this difficulty with such beauty.” Or, “I’m so impressed by your ability to know what you need and admit it to others. I want to be more like you in that way.” Or, “you are just so strong! Watching you mom/dad through this illness with such tenderness toward your baby is challenging and inspiring!” Or, simply, “How in the world did you manage to shower today? Way to go!! You’re awesome!”

It’s these little words of encouragement that can breathe a little bit of hope and strength into your loved one’s heart, even if he or she doesn’t acknowledge it in the moment.

10 Dont’s – 10 of the more damaging things you can say or do:

Don’t deny or belittle the diagnosis
Don’t discourage medication or therapy
Don’t blame the individual
Don’t blame sleep deprivation
Don’t criticize his or her actions during this fragile time
Don’t abandon him or her
Don’t compare your personal history to his or her current situation
Don’t ignore the signs of PPD
Don’t ignore comments alluding to self-harm or self-hate
Don’t avoid direct questions

Facts about PMADs...

Every year, more than 400,000 infants are born to mothers who are depressed, which makes perinatal depression the most under diagnosed obstetric complication in America.

At least 1 in 7 women suffer from postpartum depression or anxiety.

Postpartum depression is considered the number one complication of childbirth.

Suicide accounts for up to 20% of postpartum deaths and is the second leading cause of mortality in postpartum women.

In Colorado, self-harm is the #1 cause of death in new mothers.

Suicide is the second leading cause of death among postpartum women.

Not all women with PPD are suicidal, but many do suffer from thoughts of harming themselves or their babies.

Women who are most likely to successfully commit suicide are those who are high achieving and successful individuals and typically have a strong “helping,” personality.

Approximately 6% of women experience prenatal anxiety disorder.

10% of postpartum women experience postpartum anxiety disorder.

Perinatal women are 1.5 to 2 times more likely than the general population to experience Postpartum OCD (P-OCD).

3-5% of new mamas and some new fathers will experience some symptoms of P-OCD, though they may not officially qualify for a full diagnosis.

70% of women previously diagnosed with OCD experience a recurrence of symptoms during pregnancy.

Approximately 9% of postpartum women have postpartum PTSD.

This can be caused by a number of traumas including, prolapsed cord, unplanned c-section, use of vacuum extractor or forceps during delivery, baby going to NICU, baby having health issues or extremely difficult temperament, feeling powerless during the delivery, women who have experienced former sexual trauma, women who experienced severe physical complications related to childbirth or pregnancy.

Postpartum psychosis is an extremely rare and dangerous mental illness that occurs in 1-2 in 1,000 postpartum women.

This illness is what most of the general public think of when referring to perinatal mental illness due to media coverage of those who have suffered this particular disease. Postpartum psychosis is a medical emergency. People experiencing symptoms of postpartum psychosis should immediately go to the closest hospital.

If you are having thoughts of harming yourself or your baby, go to your nearest Emergency Room immediately.

Suicide hotline: 1-800-273-8255.

You can also contact someone for a live online chat at this Suicide Prevention Live Chat link

Text this Crisis Text Line (Text HOME to 741741)

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