COVID-19 induced anxiety in children: Interview for Times Radio

Interview with Prof. Wulf Rössler, MD; MSc.

22.09.2020 - Interviews, Mental health

Professor Wulf Rössler, Chief Medical Officer at The Kusnacht Practice, recently returned to Times Radio to discuss anxiety affecting children due to the COVID-19 pandemic. He joined host Phil Williams to address the issues created by stress during the lockdown, the apprehension plaguing young people as they return to school, the difficulties facing parents and the methods to help alleviate them.

As many of our children return to school this week, a survey by Public Health England has found four in ten kids say they feel more lonely than they did back in March. A third of them felt more anxious or stressed in general; and one in four parents questioned said they don’t know what to do, or how to help their children to combat the anxiety. So let’s see if we can help. Professor Wulf Rössler joins us from The Kusnacht Practice. Wulf is a professor of clinical psychiatry.

Welcome back to the programme.

Wulf Rössler: Hello, hi, it’s nice to meet you.

Let me ask you first of all then just about the anxiety that’s specifically been related to this period of lockdown that they’ve experienced since March, and what would be your advice to parents on assisting their children with that first of all?

WR: Yeah, well, I mean I was not surprised to hear that people and their children are more anxious or more worried. I mean this is a normal stress reaction and focusing on a problem and trying to cope with it. But, I mean the real big thing is that parents’ state of mind is reflected by their children. That means if the parents are nervous, if the parents are anxious, their children will be anxious and nervous themselves.
I mean, what do we expect from our parents? We expect that they keep their overview, and if they lose their overview we get anxious. But if they keep their overview and stay quiet and calm, you know, I mean the children will not really be anxious for a long time.

Now of course that’s easier said than done, isn’t it? As a parent in this situation, many of them have lost jobs, which may be providing anxiety. Many of them might just be simply concerned about transmission or infection.

WR: Yes, well, I mean you are right. This, what I said does not refer to all parents the same way. I mean there are inequalities. It’s more difficult to deal with something like COVID-19 in a small flat with many people living in there. But on the other side, if you have your own room as a child, if you have high speed internet and things like that, it’s much easier to cope with it, you know. But, I mean the thing is, what parents have to tell their children, and calm them down, is that COVID-19 regularly is not very dangerous for children and also not very dangerous for parents- for younger parents. What changes the situation a little bit is if the children or the parents suffer from, let’s say some physical disease. You know, I mean there are children with diabetes, with asthma, and things like that which might increase the risk; and this is why parents have to take more precautions when they want to protect their children.

Now, just you mentioned a couple of things I want to follow up on with you if I may Professor. The first is the high speed internet. I’ve anecdotally, ‘cause our kids are four and one, and a lot of the, a lot of our friends who’ve also got four year olds, five year olds, are saying that they’ve been concerned about the amount of screen time that those younger children have been having. And that, you know, how will they wean them off that when it comes to returning to school this week. What’s your advice around that?

WR: Well first, I assume you won’t put your children just in front of the TV. There are parents who don’t seem to have alternatives to placing their children in front of the screen, watching TV or something like that from morning to night. But, I mean it’s a different, it depends very much on the age of the children. I mean if you have an infant, this is what I said previously, I mean they perfectly mirror the anxiety of the parents. I mean infants, one or two year old children do not know anything about COVID-19, but they can feel the parents are anxious. So, if they get a little bit older, but even up to the age of five, children are still very, very focused on the parents.

This is, so, this is what you have to do. And what I was really surprised about was how stressed many parents, young parents were, to care for their children during the day, over weeks. I mean this is clear, this comes alongside their job and things they have to do. There was home office and things like that, you know, but many parents are not used to caring for their children anymore. I understand you, in the UK, children go to school at the age of four, or something like that?

That’s right.

WR: That’s extreme, is that right?

That’s right.

WR: Ok, this is extremely early. I mean me as a continental European, I’m used to children going for the first time to school at six, like in Switzerland sometimes at the age of seven, or something like that. And I assume we are not doing much worse than you are. So, I mean this is a cultural thing in the UK that children are brought to school very early at that age. And you know, I mean just imagine the maturity of the brain of a four year old child. That’s, there’s a long way to go, and what I said before, they’re really still focused on their parents. So, I mean that’s, that’s a challenge for you as younger parents; what you have to do, how you can keep your children occupied, do something with your children during the day and things like that. And not only put them aside, you know, but I’m aware this is a challenge for all of us. But I’m afraid we will have to adapt to this because corona will occupy us another one or two years at least.

And something you said at the very, in your very first answer, you said it’s perfectly normal for their children to be experiencing anxiety. Is that the first thing a parent should say if a child displays any traits or behaviour, or even if they are able to articulate it to their mum or dad? Is it, is the first thing a mum or dad should say is “Listen, this is perfectly normal, what you’re feeling is perfectly normal. Don’t feel bad about feeling anxious”?

WR: Yeah, yeah well that’s, that’s what I would, that would be the first step to do. I mean just tell the child that this is a normal feeling to be worried about things, because I mean this is a part of our genes to get focused, to find, to put attention on something that seems dangerous, or something like this. And either you have to calm down your child by telling the child “Well, I’ll protect you, don’t worry, you know we’ll manage this and this will pass by, and we perfectly will manage and protect you during that time”. And what I wanted to say, I mean, it’s clear to have an eye on the worries and concerns of your child. But don’t make really, in the beginning, a mental problem out of it.

This might be different, I mean we are, we are talking now about, let’s say in quotes „normal children”. But naturally there are children, also at that age, who have already quite serious mental problems. Then the thing might look different. If there are children, even at the age of five, six, seven, eight, who suffer from anxiety disorders, and things like that, this gets much more dramatic for the parents, and this is the point of time when you should look for help or assistance.
This is also true, for example, probably there are quite a few kids with OCD, you know; and if you, if you make the child wash their hands, clean their hands all the time, you know, they feel confirmed of their anxiety, what they’re worrying about. So these are difficult situations to keep the child in balance.

Just one more, if I may Professor, and that is that with children starting school this week. I think mostly the older children, secondary, have started and they’re on normal timetables, but some of the younger children, I’m hearing some children are going in for an hour one day, two hours the next. I think when our son starts he’ll actually do two days, a Thursday and a Friday, and then goes to a full time week. Is there any merit to reduced hours for children? Is there any benefit in that or can it be a hindrance if it’s disruptive to their normal routine?

WR: Yes, I mean when a child first goes to school, school starters, they are very eager to go to school, and they are naturally disappointed at that point when they can’t go to school. I mean all the disappointment, and all what children say “I hate school” comes much later. You know when you have a five, a four or five year old child, you know they are really eager to go there. But on the other side, for example, it’s also clear that children have to get used to their friends in the classes, to their schoolmates, you know. And by the way, it depends on where you come from.

I know in the UK there are many people living there with different ethnicity, and for example, if you come from Asia, you might be exposed to bullying as a young person, as a child or adolescent. You know, this is not so unusual. This is what you have to think ahead, what might, you know, what might your child be exposed to. I don’t find it very dramatic if your child is only at school, in the beginning, for two or three days. But what you have to provide, and many parents can provide it, I mean it’s what do they do, they have homework to do and things like that; what you have to provide is a structure for your child when they return home.

Thank you very much for your expertise as always, always appreciated. Professor Wulf Rössler from The Kusnacht Practice who’s a clinical psychiatrist.