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Anxiety in Young People during COVID-19

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Understanding and Supporting Anxiety in Young People during COVID-19

Dr. Denise O’Dwyer, Chartered Psychologist, National Learning Network, Rehab Group

Recent weeks have seen us becoming unsteadily accustomed to a new way of life. Vocabulary such as quarantine, self isolation , social and physical distancing, respiratory etiquette and hand hygiene have become our new norm - their respective practice, our daily routine. For the most part, we have been remarkably compliant in adhering to all that’s been asked of us, trusting that we are being lead in the best possible way by the Government and Health Authorities. But it hasn’t been easy, and it has shaken us up in more ways than one.

Fear, lack of control, and uncertainty are the surest ways to provoke anxiety and stress in even the strongest, most resilient individuals. Throw an unpredictable global pandemic into the mix, and anxiety gathers momentum in all kinds of crippling, catastrophic directions. In adults, anxiety presents variably as restlessness, anger, irritability, hostility, difficulty concentrating, thought disturbance, inability to relax, under/over eating, substance misuse, fatigue, sleep disturbance, withdrawal. At its peak intensity, we stop being able to think and function effectively in our daily lives.

National Learning Network (NLN), Rehab Group, is the largest private provider of personalised education, training and employment services in Ireland for people with additional support needs. It provides a range of flexible training courses for those who have experienced a setback due to an accident, injury, illness, mental health issue, or disability. In line with Government and HSE guidelines, NLN closed its doors on March 12th, and whilst students continue to be supported by staff electronically from their homes, there is a palpable sense of worry and anxiety from many parents, families, carers and students alike.

The Government’s recently imposed further restrictions on movement, have heightened concerns regarding the effects of the COVID-19 pandemic, not just physically, but psychologically and emotionally. Of particular concern, are those with pre-existing anxiety and mental health disorders; those who have difficulty with self regulation, and those who are unable to effectively communicate their fear, anxiety and frustration due to language and communication difficulties. With this newly restricted, less colourful landscape, how can we best support positive behaviour and good mental health hygiene in our young people who’s worlds have so suddenly and dramatically contracted?

The intended language of “make it stop” is spoken through a host of physical, psychological, and emotional expressions. Visible, high impact behaviours such as meltdowns, angry outbursts or tearful episodes often gain our attention, but with anxiety we must be equally mindful of the quiet, more subtle internalisation of anxiety. This frequently manifests as self harm, skin pricking, eating disorders or self injurious behaviour. Other subtle signs may include unexplained and repeated tummy aches, temperatures, vomiting, headaches, disturbed sleep or withdrawal. For those on the autistic spectrum, blank or neutral facial expressions may be an indication of fear and anxiety, as well as the more challenging, overt behaviours.

If we view all behaviour with curiosity, seeing it as a form of communication, as opposed to a deliberate attempt at being defiant or oppositional, it will help us to better understand and relate to people in a more positive, constructive way. Now more then ever, within the confines of our quarantined environments, we need to cut people a little slack, and understand that each person is doing the best they can, and will have a different way of responding to their newly confined living spaces. Some will adapt with ease, while others will respond with heightened sensitivity, fear and anxiety.

Most, if not all anxiety stems from a feeling of not being safe. Given the uncertainty and unpredictability of the current climate, coupled with an inability for some, to express their feelings, the onus is on us to learn to read the body language and subtle signs of anxiety or distress in our loved ones. This may be an additional inconvenience to our already growing list of things to do in our busy, quarantined environments of home schooling, maintaining households, managing workloads, and keeping our own worries and concerns under control. However, it’s a vital one. Avoid becoming so busy or getting so caught up with completing lesson plans, schedules and agendas, that you lose sight of what is most important. There is nothing easy about this time for any of us, but we each have to play our part in working together consciously, with empathy and compassion.

Toward this end, the following may offer some practical suggestions to assist during this crisis period:

-          Self Care: We cannot pour from a glass that is half full, so it is imperative that we manage our own mental health and wellbeing. Activities such as mindfulness, exercise, healthy diet, online connection with friends and family, spiritual practice, exposure to nature (where possible), prayer, meditation, painting, drawing, playing/listening to music, maintaining a gratitude journal. These are just some of the ways we can support and maintain our positive mental health and wellbeing.

-          Daily Schedules: Setting up visual schedules helps to minimise anxiety by offering a sense of predictability, consistency and routine. These will enable self regulation, as well as helping to support co-regulation in individuals where this is required. Schedules activate ownership and responsibility around daily activities, tasks and chores.

-          Ask for help: Asking for help and assistance from teachers, instructors and other professionals who usually work with your loved ones, will facilitate enhanced teaching, learning communication and further emotional support methods.

-          Online Resources : In the case of young children, free online supports, e.g. Audible, RTE School Online, The Body Coach, enable self directed, independent learning and exercise for children, which may be invaluable in freeing up your time to complete work and other tasks.

-          Time Specific Support: Suggest a worry diary where a child can independently (verbally or pictorially) capture any anxieties or concerns that may arise for them throughout the day. Offer your support at a consistent time each day to work through and alleviate any worries captured, whether real or hypothetical.

-          Compassion and Empathy: Maintain an attitude of nonjudgment and compassion toward yourself and others. Do what you can each day and recognise that we are each trying to navigate a global emergency, so try to maintain perspective and not judge yourself or others too harshly.

-          Harmony and Humour: Avoid conflict, seek to understand, look for holistic solutions and encourage an atmosphere of positivity, enthusiasm, fun, and joy. Nothing arrests the anxiety of being in quarantine as swiftly as harmony and good humour!