Radical Acceptance: Youth and Mental Health in 2020

In this episode of the HealthTalks NOW podcast, Kendra and Kerri are joined for a phone conversation by Katelyn Arvin, LPCC the lead navigator of the Behavioral Health clinic at Baptist Health Richmond.  In the midst of the COVID-19 pandemic, this conversation focuses on some ramifications of the situation.  Many parents have their hands full as they navigate work environments, finances, and health concerns, and it is easy to simply think of children as resilient and turn attention to other pressing issues.  However, this conversation presents an opportunity to pause and consider more deeply the effects of the COVID-19 pandemic on children.

Before turning to the topic at hand, Katelyn introduces herself to listeners by sharing about her background and work.  She is Kentucky born and raised (even joining the conversation from Louisville).  She currently works in the lovely community of Richmond and is an LPCC.  In other words, she is a licensed therapist, and she specializes in crisis management and psychiatric evaluation.  Katelyn works one-on-one with people who present in crisis.  She holds space for them, talks with and provides guidance for them, and makes clinical recommendations.  This work is her passion, and she loves to be able to give back to the community in this way.

As a brief aside, Katelyn also dives into what it means to “hold space” for someone.  She understands the phrase to indicate allowing a person to come in crisis, approaching the individual with no judgment, and allowing for genuine and raw expression.  Holding space entails support without reactivity or stigma, empathizing, and only then helping a person to find a way forward.

Transitioning to the main topic of the conversation, the host asks Kateyln about how isolation and quarantine have impacted children’s mental health and specifically wonders whether or not Katelyn has seen an increase in depression and anxiety among young people.  With the pandemic being difficult even for adults with fully developed brains to process, no doubt it has also been a challenge for children.  It will take time for the full ripple effects to be evident, but right away, some effects have been clear.  These effects are in part shaped by the fact that a number of basic resources – even as basic as housing and food – were altered or rendered inaccessible as the country adapted to the pandemic.  School, activities, daily structure, and peer interaction have been compromised for young people.  These factors have all led to an increased incidence of anxiety among children.

One major theme that Katelyn has been highlighting is that of the importance of routine in the lives of children.  Now, she focuses on this subject, clarifying that the lack of routine has the potential to disrupt a child’s functioning.  Teens in particular, who are learning to navigate the world, thrive on structure and routine, and are negatively impacted by a lack of predictability in the world around them.  This lack of predictability can produce an internal feeling of uncertainty, and to combat this, it is important during the season of the pandemic to practice radical acceptance of the inevitability of disruptions to routine, while at the same time creating new routines as it is possible to do so. 

Turning her attention to parents listening to the episode, Katelyn offers insight on determining whether or not a child is struggling with mental health difficulties.  If parents notice that their kids are withdrawn and lack interest and motivation, when should they be concerned?  How can they distinguish between the common experience of teenage apathy and something more serious?  Katelyn has these conversations often with concerned parents, and the concerns are especially troubling because the average onset of a mood disorder is at the age of 14.  Katelyn recommends knowing one’s children and their baselines well and watching for deviations from baseline mood.  She also suggests parents develop close relationships with their kids’ friends and other caregivers in order to gain insight from them.  Parents should watch for signs of self-harm, as well as rapid cycling of mood swings.

But these are not the only symptoms parents should watch for that may indicate a serious problem.  Stress and anxiety manifest differently in kids than in adults, and so parents need to be sure they’re watching for the right symptoms.  With regard to the previously mentioned symptom of withdrawing and losing interest, Katelyn clarifies that parents should specifically watch for this in relation to a child’s typical activities and social circle.  Parents should also watch out for a change in school performance and such physiological symptoms as sleep disturbance and appetite changes.  They should have deep and open conversations with their kids during this season, and be on the lookout for an overall picture of mental health trouble, not an isolated symptom that is most likely a normal experience for a young person.

Katelyn clarifies that there are differences in how an older versus a younger child will manifest and process a mental health problem.  Younger children do not have as much ability as older children to verbalize their mental lives, so parents should look for behavioral changes such as tantrums, aggression, and crying spells.  Young children also sometimes turn to things like art for expression, so observing a child’s creative outlets may prove enlightening.  Katelyn explains children’s capacity for complex thought, as well as the way their communication capacity develops over time.  It is important for parents to model good communication skills, give space for expression and questions, help children with processing, and aid children in understanding that their feelings are okay and that conversation is safe. 

When it comes to talking with high school- and college-aged kids about mental health, there are different challenges than there are with younger children.  Older kids tend to be more resistant to a conversation with parents even when not struggling with mental health trouble, so parents should be resilient in their attempts to talk with their children.  They can plant seeds over time, working little by little at helping their children to become more comfortable with the conversation.  They should watch their language in starting conversations, communicate that their kids’ feelings are okay, give moments of power when kids can own and talk about their experiences, designate a time of day to try to talk, and – over time – give space for their kids to open up to them.  It is also helpful for kids to have adults other than parents in their lives with whom they are comfortable talking.

Next, the conversation turns to the topic of technology, most specifically focusing on social media.  Social media is known to contribute to some mental health problems, and so the question understandably arises as to whether or not increased screen access during quarantine is harmful to children’s mental health.  Of course, Katelyn clarifies, social media opens the door for bullying, and so increased access brings with it increased opportunity for this behavior that is a detriment to mental health.  However, at the same time, increased technology use in this season can be helpful in that it provides a connection to both peers and possibly clinical treatment.  If parents monitor their kids’ social media and other technology use, the increased screen time could prove a positive thing.

Moving towards the conclusion of their conversation, Katelyn addresses the topic of kids going back to school from a mental health point of view.  How can we deal with the uncertainty of this situation, and what coping skills might we employ?  Katelyn reminds listeners of the human desire for control, and she recommends following an intentional practice of radical acceptance by taking one step at a time controlling what can be controlled and shifting focus from the uncontrollable (which the media highlights) to the controllable (such as a new routine).  This will offer to ground to children.  Further, parents should talk through school options with their kids, and build in time for self-care, joy, and relaxing. 

Regarding self-care, Katelyn points out that children need the same kinds of self-care that adults need.  So, parents have the chance to model healthy self-care for their kids.  Self-care should involve routine and a schedule, with built-in time to address personal wellness.  Factors such as sleep and diet should be addressed, and kids should be encouraged in healthy relationships and community.  Parents can also help children by providing them with de-stressing techniques such as physical activity, relaxation methods, or such creative interventions as art and music.  All of these things are pieces of an overall healthy puzzle. 

In concluding the conversation, Katelyn and the host consider the topic of disappointment.  This season is a time of disappointment for many, and Katelyn affirms that this disappointment may be aptly considered collective grief.  And again, in light of this fact, new routine is important, as is decompressing and processing.  We must accept that there will be sad days, but continue to press through them and realize that only represent a passing wave.  

Key Takeaways:

[0:49] – Listeners are introduced to Katelyn and the conversation topic.

[1:33] – Katelyn shares about herself and her work at Baptist Health.

[2:42] – The host asks if Katelyn can break down the phrase “holding space” for listeners who may not be familiar with it.

[3:46] – Next, the host transitions to the main topic of the conversation, questioning how isolation and quarantine have affected children’s mental health.

[6:35] – Katelyn and the host turn to the subject of routine and its connection to children’s functioning.

[8:29] – The conversation partners switch gears to address parents about how to gauge whether or not their kids may be experiencing mental health difficulties requiring professional help.

[11:11] – As stress, anxiety, and depression are not just adult issues but also plague children, the host wonders what other symptoms parents may notice in their children that would indicate a problem.

[13:55] The host asks Katelyn if mental health symptoms vary by a child’s age.

[15:27] – The conversation takes a slight turn to consider children and complex thought.

[18:55] – Katelyn and the host discuss how parents can begin a conversation with their child about how that child is doing with regard to mental health.

[22:29] – The conversation switches gears to address technology – most specifically social media – and its impact on kids during the pandemic.

[24:31] – The episode host would now like to discuss the issue of kids going back to school, looking at from a mental health point of view.

[27:03] – Katelyn provides self-care tips for children.

[29:10] – This season is one marked by much disappointment, which can be aptly called grief, and which we must learn to navigate in helpful ways.

Links:

Learn more about Baptist Health.

Find a Baptist Health provider.

Connect with Katelyn Arvin and her Behavioral Health team at 859.544.8171

If you are having a mental health emergency or thoughts of suicide, don’t wait.  Call 911, go to the emergency room, or call the National Suicide Prevention hotline at 1-800-SUICIDE.

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