Mental Health: How to Help Kids in a Pandemic

Dr. Pam Davis again joins Dan and Rachael to continue their conversation about how to help kids in this year of pandemic and the many other global and social events our kids are exposed to. This week, she talks about how we can differentiate between normal mental health struggles in children, when we may need to seek help, and how to tell the difference. Listen and learn what steps you can take to engage children’s mental health and be reminded that this is not a normal time—we need an abundance of kindness both towards ourselves and those around us as we navigate this challenging season.

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Episode Transcript

Rachael: Well we’re back today here with Dan, and also Dr. Pam Davis and we’re going to pick up our conversation talking about how to help our kids and our teenagers cultivate resilience and also just how to have more awareness and more help and more ways to be in relationship in this season of a global pandemic that is still ongoing and in the midst of all the other, I would say social frameworks that have been exposed that they’re exposed to. And so in our last conversation, we were talking about ways to be engaging our kids and our grandkids and our nieces and our nephews and our god kids and our step kids and all the different ways we’re involved in kids’ lives. But, how we can be engaging with them at this time and the things I took away was just this sense of how to help them cultivate resilience. How to use play as a way to engage in a part of that cultivating resilience. And also just acknowledging that this is not a normal time and our tendency, especially as parents, to just kind of try to do things as normal, just being hyper-focused on school work and maybe putting undue pressure on kids. And I think, Pam, you said, maybe it’s time to stop working so hard on school and actually work on mental health. And so as we come into this conversation today, we want to talk a little bit more about how we differentiate between kind of normal struggles with mental health, that in many ways we’re all having right now, being in a really unprecedented time that’s required more resilience from many of us than we knew we had. And when kids are struggling with mental health in a way that you actually need to seek help outside of your home outside of your family and how to differentiate between the two and what are some of the steps you could take? Because anxiety and depression looks really different in kids and how it manifests and teenagers, and so I want to hear more. I want to hear more from you both, Dan and Pam, around: What sort of framework we should be having as we’re engaging with our kids and our teenagers at this time, especially as we’re trying to work on mental health?

Pam: Well, let me start by first of all saying, you know, as I think about the category of what is normal, one thing I learned back in my days being a missionary in Thailand is that normal is over, like there is no normal. And I think it’s an important way to structure this conversation that when we begin to talk about normal, it is so idiosyncratic. It is so, it has so much to do with the person of the child and the individual and their family that it’s really hard to say what’s normal. But I think beyond that, the question of when do we seek help outside the family is a really good one. And it’s one that what we’re seeing, first of all, is that those of us who work with children, teenagers and families are busier than ever in counseling and our schedules are six weeks waiting list is very common for many of us who are working in this realm. But some of the things I think that are typical during this time is we should expect more acting out behaviors. We should expect more anger and defiance. We should expect it to be harder for our kids to focus. We should expect less concentration. We should expect more physical complaints, you know, I have a headache. My stomach hurts. I’m bored is often a very key statement that kids make when what they’re really saying is I need connection. I’m bored means I need connection. And so, you know, I think again, and we’re going to go back again to this category of ways of connecting with our kids.

Dan: Well, in that process of learning how to kid speak, it feels like so often, the adults that I have been engaging, and my work so far has been more dealing with parents than dealing with children. But as heightened levels of trauma are permeating everyone’s lives, there is often this insistence that you do better than what you are capable of doing, and resilience often gets poorly defined as: buck up, keep going, do what needs to be done. And I just want to come back to the core messages that I’m sure there are people struggling with what you’ve said Pam. And that is: stop putting so much emphasis on performance and getting work done in school when the process of literally creating more time to play, for many adults, it’s the same issue. I don’t have the bandwidth to do much other than order you, tell you what to do, to remind you of what’s ahead and what’s responsible, and to actually take play time would open the door for me as an adult to actually have to engage my own mental health or my own sense of incapacity. So, you know, as we come into this conversation, I just want to remind our listeners so much of what we’re saying with regard to children we’re also underscoring needs to be addressed for you, grandparent, for you parent, in your own life, do you have space to play? And are you under so much pressure that indirectly you are creating a massive total mood of despair and exhaustion? And again there’s no way for us to escape it. But how do we engage it both verbally, but also physically in a way that gives us some level of ground to be able to do what you’re inviting us to do? Pam?

P: Sure. And I think that there are a lot of parents that are right in that category. Either they don’t have the space to play or they don’t have the time. Or maybe their kids are home alone doing school and they’re out at work. You know, they’re not working from home, and I think that for those parents, my suggestion would be it’s even more important, actually, and it doesn’t have to be difficult. One of my messages here is this can be really simple. What I would say is even saying, what new ritual are we going to create during the time of this pandemic because we don’t have our old rituals, So maybe we don’t go to soccer anymore every week, but instead we’re going to bake once a week. It can be really simple. The idea of creating a new ritual is where I would go with that.

D: Yeah, and to further it then into that category of the parent who’s saying my child is so anxious. My child is so depressed. So when mental health issues seem to rise above the normal level of just we’re not all, we’re all not doing that well, how do we help those parents differentiate? Not doing well to really not doing well.

P: Yeah, here’s what I would say, you know, and actually, these principles are very similar to what I recommend to pastors of when do I know this counseling is beyond me and I have to refer. I think some of these principles are the same. One is that any time that there is a risk of harm, self harm or suicide, I think that’s a clear indicator. When you find that your child is either saying or writing down, which happens more often with kids, that they don’t want to live anymore, that they want to hurt themselves. When you find notes that your child has left or when they scream out, I hate myself! Those are really strong indicators that it’s time to get help. If your teenager is cutting or burning themselves or engaging in self harm behaviors that also, I think, is a time to seek help. Another time to seek help is when you, as a parent, feel like you’re at your wit’s end. Because again, parents provide so much of the stability and safety for their children, that if you as a parent aren’t able to do that, it’s likely time to reach out for help for your child. I think that that’s a really important component to pull in here: Remember what we say on the airline. First, put on your own oxygen mask before you put on the oxygen mask of the person next to you in a crisis. Well, it’s true. And it’s the same, even in this pandemic. And so when you as a parent get this feeling of, I can’t do this anymore. This child, I don’t know what to do. I’ve tried everything and nothing’s working, I would say, then seek out a counselor.

D: And when you see or hear statements of, I don’t want to live, or what’s the point in living? These are tough, tough issues to invite people to engage. And we’re not doing an entire talk on dealing with the issue of suicide, but at least to underscore Pam, where do parents fail most dramatically and what’s most important at that initial engagement?

P: Yeah, well, I think that I’m not sure I can say where they fail most dramatically, but I will highlight a couple of things that I think parents perhaps sometimes can misinterpret. One is to think that they’re just exaggerating or they’re just being dramatic, you know that they don’t really mean it is one way. Another way is to go the other way and to say, what’s wrong with you? I don’t know why you’re saying this. You have a great life. You should be thankful for the life that you have instead of looking at this. And I think either of those categories sends a message to a child that what you feel and your experience isn’t important. And it’s really important instead to engage that in some way, like when I hear you talk about wanting to hurt yourself, what it tells me is that this is really hard for you. When I hear you talking about how much you hate yourself, what it tells me is that you are at your wit’s end and engaging on this other level.

D: So as simple as it may sound, it’s not simple in the moment because, you know, a parent will feel panic, a parent will feel overwhelmed. And that’s where, I mean, the two words I was going to use that I’ve engaged over the last six months with folks is dismissiveness. Kind of, ah, you know, she or he is exaggerating. Or criticism, like, what’s wrong with you? And those to me would be like, those are the most significant ways to fail your child. Or at least in another context, to panic. You know, well, we’ve got to get you to the emergency room right now. Where you know you’re going off one of two extremes. Dismissiveness, criticism, or overreacting. But the way you put words, you’re inviting the parent or grandparent to begin to move towards the heart of that child. And in that movement, rather than dismissing it, criticizing or overwhelmed response, you’re inviting the child to begin to put words. And I think, with regard to suicide, we often have this wretched notion that if we hear something of despair, that by asking directly: are you thinking of harming yourself? Would be viewed as giving them an idea that they wouldn’t have and, as a result, putting the idea in their heads. Whereas most people, particularly adolescents, have made some statement, some kind of gesture to indicate that there is a warning that we’re asking you to take considerably. And I’m afraid that a lot of parents would back away, fearing that if they spoke, that it might put the idea into the mind of that child.

P: And I would say from my perspective that if we have a child or an adolescent, teenager who is thinking about hurting themselves, thinking about taking their life, thinking about suicide, one of the best things we can do is open up that conversation. Where I would say it a little differently than you Dan is: I don’t know—sometimes kids can’t put words to it. And now our teenagers can. Our teenagers can put words, our 12-year-olds and up 13, 14, but eight-year-olds, nine-year-olds. I don’t think they’re going to put words to that.

D: No, they can’t.

P: Right. And so recognizing again, though, that they will play about it. You know, they might bury all their little figurines in the sand and say, you know, so I think we have to look for it in different ways with our children, but yes, to allow that to occur and then to get help when we need it.

D: And where and how would you begin to invite parents in this excessively difficult season? With what you said with regard to your own practice, I know regarding almost every therapist I know I get countless emails every week asking for a referral. And it has been agonizing of this season to say: I can give you the names of two or three people I trust deeply, and I know they’re waiting list is long. So when we invite parents to hear you’ve got, you know, you’ve got some significant things to address, you may need outside help in this day where a lot of really good people are already overwhelmingly booked. What’s to be said?

P: Mm, prayer. [laughs] The reality of the situation is that, yes, there’s a lot of people that are all experiencing heavy schedules, and then it can create this sense of hopelessness, right? Or this sense of grief, which I think hopelessness and grief are tied together here. But I think that it is in those areas of hopelessness and grief that we can also invite hope, right? Like those two, those concepts go together. And I also want to say this. I don’t know if all professionals have a waiting list. I think that as the world is opening back up, people are seeing, you know, mental health professionals, many of us have been vaccinated. People are seeing more people in person. And I do think that we are opening up more appointments. So I would encourage that. I would also encourage you to, as the world opens back up, to start into these small group functions again too for your children as those become available to you.

D: Well, one acquaintance asked for help, and I said, look, I don’t know your area. I’ve got one or two people that are within a few hours, but what would it be like for you to begin to canvas the people you have contact within your own geography to find, you know, a good therapist for your children or for you and it was interesting. The pushback that I heard was: I just don’t want anybody to think my children are not doing well. And again, we’re right back to: kids are the siren. Who’s really in the back of that particular vehicle? Sometimes it’s the parents’ shame. Sometimes it’s the refusal to actually say: I’m going to canvas my community to find somebody who really is available and can be of help. But that may take, again, an energy and a time, but also an acknowledgment that there are things that need to be addressed. I mean, there’s so many factors of trauma related to our own shame that keeps us often from being able to do the work that we want to do. Rachael, any direction that you want to take?

R: I’m mostly just sitting with these realities, and I just feel in some ways, my own sense of I think the scarcity of this season has just been so extreme. And so, you know, I’m just thinking. They’re also hotlines and places that you can call if you find yourself desperate and you just know you need help in a moment that you don’t quite know how to navigate and you’re not at a place where you can, you know, get referrals or you feel like you don’t have that kind of time. And so I think I would be curious. What are some of the resources for parents who find, you know: because I also feel like kids and teenagers, sometimes again, because anxiety and depression looks really different and they’re not often as verbal about it or they don’t always have the same kind of litmus test to really be able to go: Oh, what am I feeling? Yeah, like what happens for the parents who are aware that kids are struggling and have been paying attention. But then all of a sudden there’s kind of a really rapid increase in distress, and you feel in yourself like: I want to get my kids help and I’ll do anything I can! But you maybe have never been in this situation before and so you don’t quite know where to turn. How do you know when you have some time to try to find a therapist and get to help? And how do you know when it’s okay to just reach out to more emergency type opportunities? I’m getting this question a lot from parents: How do I know when I should be really worried?

P: Sure. Well, I think that as far as reaching out to emergency services or dialing 911, any time that you feel like your child’s life is in danger, your child runs away and you can’t find them, any of these extreme situations I think it’s absolutely important that you do call emergency services. When can you call and canvas and find a therapist is when you’re feeling like your own resources are limited. You’ve tried everything you know to do. I need to reach out and try something new. That’s when I think you can look for a mental health professional in your area. I would say this too: start with the network that you have. Maybe you know a therapist, maybe you have friends. Maybe you have a pastor that you could start with and say, who do you know that sees children and families? That’s a great way to begin.

D: Well, it opens up again this larger issue of we know that there is something of the light at the end of the tunnel. Kids are going back to school in some areas. Somewhere between 30 to 40 million have been vaccinated. You know, as we look to spring, summer, and perhaps to the fall, Pam, before we end, I just want you to think out loud with us about: Trauma often shows itself like soft tissue injury after an accident. It shows itself sometimes weeks and months later, and that reality of not using the term PTSD, but post traumatic stress, there will be some residual effects for everyone. But what do you think will be some of the residual effects for our children once something of normalcy, whatever that means, becomes a little bit more part of our lives?

P: Yeah, it’s a good question, because absolutely I do think there will be residual effects on our children. One is, you know, the impact of doing all of this online schooling and online connecting. I think that we’re going to have to rethink what we mean by screen time. You know? Like, the CDC has put out these guidelines of what’s appropriate screen time. Like that has just been blown out of the water.

D: [laughs] For everyone!

P: Yes. So I think that what I mean by that for our children is there’s going to be a resistance and push back. How come? Now you’re saying I can only have 90 minutes of screen time a day when before I had seven or eight hours. I also think for some children we are going to see and I’m starting to see this already, I’m on the East Coast, and several of the states here have opened up. Mask mandates have fallen away in some states here. What I would say to that is: I’m already seeing the parents who are saying, my kids don’t want to go back to school. There’s all this anxiety of, no, please just let me continue to do virtual school. When actually, that’s not really what’s going to be best in the long run, Dan, I think that answers your question of what is some of the residual impact of this. And I think we will see residual anxiety for sure. I think we will see residual PTSD. And I do think children absolutely have PTSD in things like lack of focus and avoidance. Those are going to be two of the categories for us to look for.

D: Yeah, And as we as a whole nation begin to metabolize the residual effects, I think it’s just so important to go: You, as a parent have to lead rather than again going, we’re at the end of the tunnel. There’s the light. We’re done. Yes, there will be some effects, but it’s the integrity of a parent to deal with their own life first that opens the possibility for some of those realities then to be addressed. You set the mood, you set the tone and the sense of what is going to be named. I mean, even with my nine-year-old granddaughter, we’ve been talking about the reality of the brain and just talking in broad terms. You have two brains. You have a left hemisphere, right hemisphere and something called the Corpus Colosseum between that holds them. And let’s just talk about what happens when you go through stress and trauma and heartache. And again, you know, I’m not taking her into the limbic system or the executive functioning left frontal lobe quite yet, but we’re not too far from being able to go, we’ve got to give maps something of a clarity as to what to expect, so that there is not utter surprise that these residual effects are actually going to show themselves.

P: Yeah. And I think what you’re saying there is that it’s so important, which is that parents and caregivers are the safe place for their children, or they should be. And I recognize that there are many children, many of us perhaps grew up in places where our parents and caregivers weren’t the safe space. But let’s you know, say, for now, people listening to this podcast, you can be that safe place for your child or your grandchild for the children that you’re caring for, and that then requires you to hold that space. You know, maybe that means limiting exposure to media and the news for those kids. Just stay off it. Kids pick up way more than we think they do. They listen to what you’re saying on the phone when you’re talking to someone else.

D: [laughs] Oh, yes!

P: So, really important for us as we are helping our kids deal with the residual effects of this that we also pay attention to what we’re allowing them to see and hear.

D: Yeah, well, as we open the door to this deeply precious and important topic, I feel like we will be knocking on your door, Pam, to, in many ways provide sort of stepping stones from where we are right now to what needs to be addressed. And so a whole conversation on how parents can participate in play. I just want to say I think that’s one of the most important things we’ve talked about over these last two times is: We need to participate in play not just as a diversion, but actually as a context for disclosure. For a way of gaining access to our children’s hearts to know what’s there, what they’re feeling. And if we can begin to engage that without dismissiveness or on the other hand, without executing a kind of criticism for not doing all the work that they need to be doing, we’re developing the soil that we can begin to plant very new crops for what will be needed to feed our children and ourselves for the days ahead. So again, Thank you, Pam. Thank you for joining us, and we’ll look forward to more. Rachael, any thoughts before we end?

R: Yeah, I think what I’m feeling for myself and I want to just extend to the parents out there, or primary care providers who have heard things that you’re actually realizing some ways maybe you failed or, you know, you thought you were doing something well, and now you’re realizing there’s kind of a shift you can make. I think I just want to speak mercy to those places and just remind you that feeling more heavy burdens is not our hope. And that’s not our heart and our posture, and it won’t actually be helpful, and we didn’t get to talk about this as much. But just something I always try to remember and we know is true is that repair is also one of the most powerful things in building resilience, in our bodies, in our brains, in new neural pathways that help us to flourish as human beings. I think I would just say if you’re feeling a sense of like: Oh, I’ve wanted to be helpful and now I’m getting some ideas on ways I can be more helpful! I think there’s that freedom to start again. And it’s important that you would not let any sense of accusation or condemnation kind of heap heavy burdens, but that you would feel invitation and hopefully kind of some imagination and creativity of ways you can move closer to your kids, your teenagers, to each other and to yourself in this season. And I don’t know, that just felt– there was literally nothing I feel like we were saying, I was just hearing even in myself, like man, this is a hard season and we get to start again and again and again, so that would just be my two cents here at the end.

P: Thank you for saying that it’s so important and I think that’s so well said.

D: There’s no area where, as a parent, I feel more sense of grief and accusation. So that is a gift for us to be able to say it is the kindness of God that leads to repentance. And may your own kindness in the midst of the inevitable failures of the season be also what you most deeply offer your children and grandchildren.