Morgan, a 16 year old with generalized anxiety and a client of mine for the past two years, recently expressed that her favorite season was around the corner. “I love the fall. Everything about it. Especially the leaves, the apple cider, and my UGGs.” She paused and, changing topics, informed me, “You know my sister still hasn’t figured this out. I’m trying not to be rude to her, but she can’t manage to get a handle on how to plan her school day with Zoom and all. I tell my Dad she needs to learn better habits. He says, ‘as long as her grades are fine’. But they already aren’t this year, not like last year.”

Spotlight on children of frontline workers

…Not like last year. So much this year is not like it was last year. Certainly, not for Morgan. She and her sister had lived with Mom, an ICU nurse, and been at Dad’s on the weekends back then. Mid-spring, this living arrangement was reversed in light of Covid-19. Last year, Morgan’s conscientiousness and punctuality were balanced by plenty of moments of pure teenage fun and a bit of troublemaking. This year, she has found herself in a decidedly maternal role, while trying to navigate 11th grade, with a slew of honors courses and standardized testing around the corner.

While Morgan’s experience as the child of a frontline worker whose home life was upturned in the midst of the pandemic may be somewhat unique, all of us and our children are facing the stressors, uncertainties, and tragedies associated with living in the times of Covid-19. It is important to remember that many teens like Morgan won’t necessarily communicate, on the surface at least, how the pandemic is impacting them. And yet it most certainly does.

The emotional toll of Covid-19

Alongside the risk to physical health of coronavirus, the effect on emotional health is formidable. The latter is even more widespread, having touched all of us in many ways since this pandemic first got underway. It certainly has affected Morgan and so many children of frontline workers, whose experiences illuminate and echo much of the anxieties and uncertainties that persist at this stage of the pandemic.

Up to this point, some of us may have had unspoken personal negotiations with Covid-19. Morgan, for one, had handled the grief of having to lose much of spring and then summer by reminding herself of all the things she’d get to do in her favorite season. Months after Covid-19 became a household word, only now was she demonstrably feeling its impact.

Tools for parents

As a psychiatrist and therapist, a primary instrument in my ‘good listener toolkit’ is a filtering lens that highlights the unspoken. One discovers this silent narrative, this felt meaning, by following the roadmap of human emotional experience.

We are deeply connected by the universality of emotions. This is not to say that Morgan is not as strong and resilient as she appears or has not figured out how to adapt relatively well. Indeed, she is not fragile, but nor is she impervious.

Pediatric mental health providers recognize that displays of stoicism and near invulnerability can be authentic though also shielding the reality that a person can’t be sealed off from the events around them. Keeping this in mind when listening – as providers and as parents – to our children and teens allows us to be open, attuned, and non-judgmental in those moments when vulnerability is allowed to slip through the conversational cracks, in those instances when emotional expression is taking place.

For Morgan’s parents, I remind them of some helpful points:

• Don’t assume kids can’t sense your stress and anxiety in this time. Bottling up emotions has limited utility and most often has significant repercussions. A better strategy is to share your own concerns in a manner that kids can handle observing and could use as a subsequent model for their own emotional regulation.
• Try to keep normal routines and traditions as much as possible. Since a lot of events that filled calendars in prior years have been cancelled, it is that much more important to embrace those that remain. Ask your children what their memories are of this time of year and see what elements can still be recreated. At the same time, try to see and demonstrate this time as an opportunity to create new traditions.
• Pay extra attention to changes in kids’ moods or activities. Notice what they are doing differently and what they may have stopped doing. Encourage them to talk by creating an atmosphere for conversation; for some this is silence, for others, it requires a sufficient amount of background hum.
• Remember to take care of yourself too. When I have the opportunity to meet with parents of my clients, I often advise them to imagine the activities of their life in the form of a pie chart. I remind them that self-care is an essential piece of that pie. Neglect it repeatedly and the whole pie eventually suffers.

For Morgan, I remind her that this is a time of compassion, for others of course, but equally importantly for herself. And have some fun this fall I tell her. Still do enjoy a day of apple picking and eating cider doughnuts. Make some hot apple cider or a pot of chili. Go hiking. Carve a pumpkin.

Greywood Community

At Greywood, beyond taking Covid-19 extremely seriously for the health risks it poses, we are constantly attuned to the emotional disruptions it has caused or intensified. And, recognizing the special plight of children of front line workers, we have embraced a program specifically for them, opening our doors to them on a complimentary basis, aiming to bring a place of respite in the midst of trying times.

Tim Yovankin, MD
Medical Director, Greywood Health Center
www.greywoodhealthcenter.com

A note on privacy: I am grateful of Morgan for granting permission to share a portion of her story. While little creative elaboration was taken in the narrative here, in order to protect her privacy, her name and personal details were altered. Additionally, I have substituted and grafted equivalent circumstances where possible for further identity protection.