COVID-19 has wreaked havoc on the lives of children and adolescents.

Female adolescents trump male adolescents in severity of anxiety and depressive symptoms. Studies also demonstrated that anxiety levels among children were significantly lower than anxiety levels among adolescents. It is still too early to know the precise effects of the pandemic on children and adolescents, and there is widespread concern that there may be long term effects for this group. Variables such as female gender, the presence of chronic physical conditions, and older adolescent age are all factors associated with worse COVID mental issue outcomes.

Furthermore, research notes that what is known as lifestyle transformations — which includes isolation, quarantine, the threat of being infected, physical distancing and school closures — are associated with anxiety and depression among adolescents and children. A recent research article notes that “the psychological distress of fear, helplessness, worry, anxiety-related insomnia, isolation, boredom and sadness was more common in the quarantine group.” This indicates that it is traumatic for children and families to participate in the containment and disease-control measures induced by the pandemic. Significantly, a study found that PTSD occurred in as many as 30% of children who had been separated and quarantined in comparison to the non-quarantined groups. PTSD can be associated with poor sleep, hyper vigilance in the environment, an exaggerated startle response and the intrusive memories and experiences of the traumatic event.

In a 2021 article by Meherali, et al., it is noted that “school routines are essential coping mechanisms for young people with mental health issues. During school closures, children lose an anchor in life, and their symptoms can return. For children and adolescents with mental health issues, school closures mean a lack of access to the resources that they usually have through schools.”

The impact of COVID-19 on the mental health of children and adolescents is of great concern. Anxiety, depression, disturbances in sleep and appetite, as well as impairment in social interactions, are the most common presentations.

It has been indicated that compared to adults, this pandemic may continue to have increased long term adverse consequences on childrens’ and adolescents’ mental health. As the pandemic continues, it is important to monitor the impact on childrens’ and adolescents’ mental health status and learn how to help them to improve their mental health outcomes in the time of the current or future pandemics.

The pandemic has dramatically increased the need for mental health professionals. Although all demographics have been impacted by COVID-19, younger children and adolescents have been specifically affected. School serves as a gateway for children who require psychological interventions, such as in school therapy and autism support. The need for social distancing and the transition from in-person to virtual schooling, has had a deleterious influence on children. In fact, it has been demonstrated that knowledge and education about the pandemic can serve to minimize its effects on children and adolescents. This supports the role of evidence-based educational interventions, such as videos and comic books, that can mitigate the severe impact of COVID-19 on emotional health and resilience.

Children and adolescents certainly can become depressed and anxious as a result of the unpredictable impact of the virus on school attendance and interaction with classmates. However, the fear and worry about parents and other family members can be a trigger for additional mental health issues.

Although youth has often been cited to explain resilience, this coping mechanism doesn’t seem to be as potent with the pandemic as with other stressors. Furthermore, there are both microeconomic and macroeconomic forces that differentially influence the mental health diatheses that are part of the coronavirus pandemic. Micro-stressors such as missing classmates and being deprived of structured physical exercises are potentially additive with macro sources. The latter can include the financial burdens related to a global recession and the financial struggles of families during this time. These worries among parents can be highly distressing to children and adolescents.

In addition, children and adolescents have still developing brains, and this might contribute to their increased susceptibility to mental health stressors.

A May 2022 review article in Child and Adolescent Mental Health notes that, compared to pre-pandemic levels, mental health issues such as anxiety and depression have increased with the pandemic. This was noted to occur “with high levels of fear and concern regarding the impact of COVID-19 on their lives.”

“Never since the Second World War,” according to a 2022 article by Buchanan, et al., in the International Journal of Primary, Elementary and Early Years Education, “has the UK experienced such a major disruption to the nation’s home, work, and educational life, as that which has been caused by the COVID-19 pandemic. One ramification is that the mental health of many people, including children, has been severely affected adversely by the pandemic, as the National Health Service (NHS 2020) reported that there was a rise from one in nine young people and children reporting mental health problems in 2017 to one in six in 2020.”

The article also notes the importance of school in providing meaning to school aged children. Existential issues, such as having a sense of purpose, declined for this young demographic during the pandemic.

The lack of meaning during the pandemic stems from the decrease and loss of the structured activities of the curriculum, and the loneliness and boredom that accompanies this loss, and that negatively impacts the personal meaning that might otherwise develop during an in person educational program. This, however, was not universal — those students who performed academically less well, and who were lower attaining in this cohort, may experience symptoms such as embarrassment and rejection compared to their higher attaining classmates, and who might have experienced psychological relief from being exonerated from attending. This perspective was not consistent between studies, and more research is needed to better understand the role of existential issues triggering significant negative emotions among school-aged children and adolescents.

A 2021 report by Ford, et al., at the University of Cambridge, notes that “the mental health of the UK’s children and young people was deteriorating before the pandemic, while health, educational, and social outcomes for children with mental health conditions are worse than for previous cohorts. Between 2004 and 2017 anxiety, depression and self-harm increased, particularly among teenage girls.”

Despite this, it is likely that the pandemic created an outsized stimulus in inciting significant mental health pathology beyond that of the trajectory that already was established before the pandemic.

Another research report from the same year notes that “adolescents, young children, LGBTQ youth, and children of color may be particularly vulnerable to negative mental health consequences of the pandemic. During the pandemic, more than 25% of high school students reported worsened emotional and cognitive health; and more than 20% of parents with children ages 5-12 reported their children experienced worsened mental or emotional health. A survey of LGBTQ youth found that many LGBTQ adolescent respondents (ages 13-17) reported symptoms of anxiety (73%) and depression (67%) and serious thoughts of suicide (48%) during the pandemic. Although data is limited on children of color, research suggests that even before the pandemic they had higher rates of mental illness, but were less likely to access care.”

The pandemic has dramatically interfered with social events such as weddings and large group celebrations, impacted work and school, significantly decreased interpersonal activities and communications, and will likely have long term effects on the majority of people who survive.

It is crucial, as indicated by the research, to pay close attention to the children and adolescents in our families, and to provide ongoing emotional support to mitigate the pandemic’s impact in producing negative outcomes.