Build structure and physical activity into every day.
Routines are important right now, because they help kids feel settled, cared for and in control. “The thing that’s so upsetting about Covid is the uncertainty,” Dr. Koplewicz said, so it can help to weave certainty and predictability into your kids’ lives and give them concrete things to look forward to. Maybe every Thursday becomes movie night, and every Saturday you go on a family hike. Dr. Koplewicz suggested making sure that weekends still feel different from weekdays, too, so that they continue to be something everyone can happily anticipate.
But while maintaining structure is important, experts also recommended easing up on kids during this difficult time, too. “It’s probably a good time to relax some of the rules that you can relax without causing damage,” said Dr. Neal D. Ryan, M.D., a child and adolescent psychiatrist at the University of Pittsburgh. Maybe ease up on screen time rules a bit (or, uh, a lot), or let kids have dessert with lunch sometimes. The idea is to sprinkle some comforting or joyful moments into each week to keep spirits up. Mindfulness meditation is another thing to consider, Dr. Koplewicz said; some popular mindfulness apps include Headspace for Kids and Stop, Breathe and Think.
And do what you can to keep your kids moving. “Physical activity has a track record as both a preventative and a treatment for depression,” said Dr. Gregory N. Clarke, Ph.D., a clinical psychologist who studies the prevention of depression at the Kaiser Permanente Center for Health Research. You don’t have to buy your kid a Peloton; just go out for regular walks or bike rides or do some Cosmic Kids yoga or GoNoodle. (Dr. Clarke noted that exercising outside may have added benefits compared with exercising inside, but that the activity itself is the most important thing.) My kids have roped me into playing freeze tag with them in the afternoons, which they find hilarious, probably because I’m a terrible sprinter.
Look out for the signs of depression and get professional help if needed.
When my son was moping around the house a few weeks ago, I wasn’t sure how to tell the difference between normal sadness and diagnosable depression. Dr. Luby said that when kids are clinically depressed, they lose interest in the things that they usually enjoy. They may no longer like their favorite foods, their favorite TV shows or their favorite games. “The inability to enjoy activities and play is one thing you can say with confidence that’s starkly abnormal for a child,” Dr. Luby said, so it’s “probably the most obvious symptom.” Other signs of depression are when kids begin eating a lot more or less than usual or start sleeping a lot more or less than usual. And of course, kids can seem quite sad or irritable.
My 9-year-old certainly seemed to have the loss-of-interest and sadness symptoms. He no longer wanted to play soccer outside, an activity he usually adores. But the psychologists and psychiatrists I spoke with emphasized another important difference between sadness and depression: Depression persists. “It’s about duration,” Dr. Koplewicz said. “If something lasts more than two weeks, and it’s occurring every day, that’s a red flag.”
If you’re concerned, consider getting professional help. The experts I spoke with said that the incidence of child depression is almost certainly increasing because of the coronavirus, so some kids are going to need extra support. You can start by contacting your pediatrician and asking for referral suggestions. Or reach out to a local mental health clinic, hospital, or academic medical center, which may be able to triage your child online and recommend appropriate help. (The Child Mind Institute, for instance, offers initial 45-minute remote consultations starting at $150.) Thankfully, most mental health therapies can be provided online, so kids can get the help they need from the safety of their home.
As for my 9-year-old: I’m relieved to report that his slump eased up after about a week, and the following week he seemed much better. He even began giving his little sister soccer lessons, which then made her so much happier, too. My son still has his mopey moments, of course. But right now, don’t we all?