Managing Anxiety and Stress during the COVID-19 Outbreak

Mother sitting with her head on her knees

Routines can be essential for positive family functioning, such as maintaining daily school routines, participating in after-school activities, sharing mealtimes with family members, and getting adequate sleep. But, sometimes routines are disrupted, which can cause feelings of anxiety, stress, and insecurity (Spagnola & Fiese, 2007; Yoon, 2014).

The current national crisis surrounding the novel coronavirus, or COVID-19, has forced schools, gyms, and non-essential businesses to close and events to be cancelled in response to the pandemic. These changes can greatly impact individual and family daily routines (Centers for Disease Control and Prevention [CDC], 2020) and upset individual family members.

Adjustments to a daily routine can cause youth to experience sadness, to focus heavily on the details of the pandemic or avoid them all together, to encounter trouble concentrating, to become overwhelmed with emotions, to have difficulty setting priorities, to encounter conflict with family members and friends, to develop a loss of interest in activities, to become detached, and to experience problems sleeping and changes in appetite (CDC, 2018; CDC, 2019; Substance Abuse and Mental Health Service Administration [SAMHSA], 2013).

Below are some tips to help yourself and your children process changes that have occurred in our daily lives and remain healthy – mentally and physically.

Remain calm. Be mindful of your transmission of stress and anxiety relating to COVID-19 because children, especially younger children, can pick up on mood changes very quickly (Beyondblue, 2013). Children look at their parents as role models and try to imitate their parents’ behaviors.  Remember calm breeds calm. If you respond with anxiety, there is an increased likelihood your children will exhibit similar behaviors (Burnstein & Ginsburg, 2010). If you feel overwhelmed, take 10 deep breaths. Observe your child’s body language and verbal cues; these signals may show you if he or she is upset or how distressed he or she may be. Validate your child’s concerns and strategize solutions together (Shin, Quinones-Camacho, Karan, & Davis, 2018).

Ensure basic essentials are met.  Remind your family of the efforts that your family has already made to prepare for this pandemic, such as buying larger quantities of food items for later use; ensuring you have reliable transportation; and discussing some precautions, like washing hands frequently and using hand sanitizers, you are following. Share and develop a plan to have in place if one of your family members becomes infected (CDC, 2019).

Provide factual information to children. In an age-appropriate way, explain to your children the facts using reliable resources provided by the CDC and the National Institutes of Health (NIH). Limit exposure of information about the virus via the television, internet, and social media, and beware of the false information your children can be exposed to by their peers. Keep in mind that, during difficult situations, episodic depression and anxiety could pop up in your home (Kessler, Petukhova, Sampson, Zaslavsky, & Wittchen, 2012). Encourage your children to ask questions and continue to reassure them you are taking preventative measures to ensure everyone’s safety (SAMSHA, 2020).

Look for indicators in children.  Stress stems from a perception of fear. Fear of the unknown can be extremely complex (Carleton, 2016), and it is often coupled with anxiety and stress. For more information on warning signs for children and teenagers with depression, consult the U.S. Department of Health and Human Services (U.S. Department of Health and Human Services, 2019).

Mitigate Stress and Anxiety. Research has shown that preventative interventions to reduce externalizing and internalizing problems can increase positive family interactions (Sadler, Ingram, Wolchik, Tein, & Winslow, E., 2015). We are all maintaining close living situations during the COVID-19 pandemic.  Below are some ideas for how you can mitigate stress and anxiety in your household (Dillon, 2018; Edwards, 2016).

  • Boost positive behaviors by establishing a new daily routine.
  • Eat healthy meals together.
  • Continue to engage in 60 minutes of physical activity. The 60 minutes can be broken up into shorter blocks of time (U.S. Department of Health and Human Services, 2018).
  • Practice active listening to your children’s concerns.
  • Ensure everyone is getting enough rest.
  • Schedule breaks to relax, listen to music, and read, or find something that makes you laugh.
  • Use communication media to continue social interaction with family and friends.
  • Consider using mindfulness meditation. Insight Timer is a free application with guided meditation.

Additional Resources

Access to educational activities available during COVID-19: 

Storyline Online is available 24 hours a day. You can select your video streaming preference to stream the story of your selection for your child. Each book includes supplemental curriculum, developed by a credentialed elementary educator, that aims to strengthen comprehension and verbal and written skills for learners. https://www.storylineonline.net

Starfall is a language arts and math website for pre-kindergarten children to 3rd graders. Although you can register for a paid subscription for full access, simply clicking on the age range will take you to activities that are available for free to test their database.  https://www.starfall.com

International Children’s Digital Library. This library is available for children, parents, and educators and is offered in various languages. Registration is necessary to utilize the features found in this library, such as saving books, returning them, and searching for materials in the language of your choice. http://en.childrenslibrary.org/

ABCya is a resource of educational games for children in kindergarten to 6th grade. Math, Language Arts, Strategy, and Skill are the focus areas. Without a subscription, some of the games are unavailable. https://www.abcya.com/

Storynory provides free audiobooks for children. https://www.storynory.com/

National Geographic Young Explorer offers articles for children who are 6 years old and older in Scout and Voyager editions. To read previous issues, click the more issues tab. https://ngexplorer.cengage.com/ngyoungexplorer/index.html

Oxford Owl is an educational resource for children who are 3-11 years old.  https://www.oxfordowl.co.uk/for-home/

SimplyE app provides access to the New York Public Library. You must apply for a library card to gain access to the library. This is free. https://www.nypl.org/books-music-movies/ebookcentral/simplye

Greatschools.org worksheets provide free worksheets for learners in kindergarten to 12th grade. https://www.greatschools.org/gk/worksheets/  

Google Arts and Culture engages audiences in virtual tours of museums around the world. https://artsandculture.google.com/

Lunch doodles with Mo Willems is offered every day at 1:00 p.m. Eastern Standard Time. Join Mo Willems and draw with pencils, paper, and crayons with this Kennedy Center artist. https://www.kennedy-center.org/education/mo-willems/

Virtual Zoo Lessons and Live Streaming is available via Facebook and websites Monday through Friday at various times throughout the day:

Caribu is a video calling application that allows adults and children up to 7 years old to read books, color, draw, and complete other activities over the internet. During COVID-19, access is free for everyone. Additionally, anyone with a .mil email address can have free subscription access when their family is verified through Blue Star Families. https://www.caribu.com

Prodigy is a math curriculum resource for 1st to 6th grade students. Free and paid memberships are available. https://play.prodigygame.com/

Khan academy offers self-pace learning for children of all ages in various core subjects. https://www.khanacademy.org/

Mystery Science offers science lessons for kindergarten to 5th grade students. https://mysteryscience.com/school-closure-planning

History for Kids offers free history and geography lessons for children. https://www.historyforkids.net/

References

American Red Cross. (2020, March). How to prepare for emergencies. Retrieved from https://www.redcross.org/get-help/how-to-prepare-for-emergencies.html

Beyond Blue Ltd. (2013). How to reduce your child’s risk of depression and clinical anxiety: Strategies for parents of primary-school aged children. Retrieved from http://www.parentingstrategies.net/depression/

Beyond Blue Ltd. (2013). How to prevent depression and clinical anxiety in your teenager: Strategies for parents.  Retrieved from http://www.parentingstrategies.net/depression/

Burnstein, M., & Ginsburg, G. (2010). The effect of parental modeling of anxious behaviors and cognitions in school-aged children: An experimental pilot study. Behavior Research and Therapy, 48 (6), 506-515. doi:10.1016/j.brat.2010.02.006

Carleton, R. (2016). Fear of the unknown: One fear to rule them all. Journal of Anxiety Disorders, 41, 5-21. doi:10.1016/j.janxdis.2016.03.011

Centers for Disease Control and Prevention (CDC). (2018, March 19). Emergency responders: Tips for taking care of yourself. Retrieved from https://emergency.cdc.gov/coping/responders.asp

Centers for Disease Control and Prevention (CDC). (2019, October 11). Helping children cope with emergencies. Retrieved from https://www.cdc.gov/childrenindisasters/helping-children-cope.html

Dillion, C., McMahon, E., O’ Regan, G., & Perry, I. (2018). Associations between physical behaviour patterns and levels of depressive symptoms, anxiety and well-being in middle-aged adults: A cross-sectional study using isotemporal substitution models. BMJ Open, 8(1). doi:10.1136/bmjopen-2017-018978

Edwards, M., & Loprinzi, P. (2016). Experimentally increasing sedentary behavior results in increased anxiety in an active young adult population. Journal of Affective Disorders, 204, 166-173. doi:10.1016/j.jad.2016.06.045

Federal Emergency Management Agency. (2020, January 20). Plan ahead for disasters: Talk with your family. Retrieved from https://www.ready.gov/kids

Kessler, R., Petukhova, M., Sampson, N., Zaslavsky, A., & Wittchen, H. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods Psychiatry Research, 21(3), 169–184. doi:10.1002/mpr.1359

National Institutes of Health (NIH). (2020, March 23). Coronavirus (COVID-19). Retrieved from https://www.nih.gov/health-information/coronavirus

Sadler, I., Ingram, A., Wolchik, S., Tein, J., & Winslow, E. (2015). Long‐term effects of parenting‐focused preventive interventions to promote resilience of children and adolescents. Society for Research in Child Development, 9(3), 164-171. doi:10.1111/cdep.12126

Shin, E., Quinones-Camacho, L., Karan, A., & Davis, E. (2018). Physiological contagion in parent–child dyads during an emotional challenge. Social Development, 28(3), 620-636. doi:10.1111/sode.12359

Spagnola, S., & Fiese, B. (2007). Family routines and rituals a context for development in the lives of young children. Infants & Young Children, 20(4), 284-299. https://depts.washington.edu/isei/iyc/20.4_spagnola.pdf

Substance Abuse and Mental Health Service Administration. (2020, March). SAMHSA fact sheets. Talking with Children: Tips for caregivers, parents, and teachers during infectious disease outbreaks.. Retrieved from https://store.samhsa.gov/system/files/pep20-01-01-006_508_0.pdf

Substance Abuse and Mental Health Service Administration. (2013, July 31). Self-care for disaster behavioral health responders [Video]. Retrieved from https://www.youtube.com/watch?v=G957P6w1Xfs&list=PLBXgZMI_zqfRcTt9ndxkbieQ-pQslk-R6

The National Child Traumatic Stress Network. (2020, March 1).  Parent/caregiver guide to helping families cope with the coronavirus disease 2019. Retrieved from https://www.nctsn.org/sites/default/files/resources/fact-sheet/outbreak_factsheet_1.pdf

U.S. Department of Health and Human Services. (2019, January 15). Common mental health warning signs. Retrieved from https://www.hhs.gov/ash/oah/adolescent-development/mental-health/adolescent-mental-health-basics/common-mental-health-warning-signs/index.html

Yoon, Y. (2012). The role of family routines and rituals in the psychological well being of emerging adults (master’s thesis). University of Massachusetts Amherst.

U.S. Department of Health and Human Services. (2018, November 12). Physical activity guidelines for Americans. (2nd ed.). https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf

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