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The Silent Pandemic: Depression and Anxiety

While so much attention has been focused on the global COVID-19 outreak over the past several months, another type of pandemic has been silently creeping into the lives of our children: depression and anxiety. Here's what you should know and how you can help.


Mental health disorders among children and adolescents have been steadily rising over the past decade. The onset of the COVID-19 pandemic has escalated these numbers far higher than ever before. School closures, loss of structure/routines, social isolation, absence of traditions and "rites of passage" that celebrate life's milestones (ex. graduations), and general sense of unpredictability and insecurity have all led to record number of children and adolescents struggling with low mood, loss of motivation, high anxiety, panic attacks, and self-harm thoughts and behaviors. It is imperative that you recognize the signs of this silent epidemic and get help for your child as soon as possible.


Signs of depression include:

  • Depressed mood expressed by the child herself or observed by those around her.

  • Extremely irritable mood with frequent outbursts, meltdowns (more common in children and adolescents than adults)

  • Decreased interest or enjoyment of activities that used to bring them joy

  • Changes in appetite (either under-eating or over-eating) and/or unintended weight loss or failure to grow as expected or weight gain

  • Insomnia or excessive sleep

  • Feelings of restlessness or of feeling slowed down

  • Fatigue or loss of energy

  • Feeling worthless or inferior to others or excessive guilt

  • Decreased ability to think or concentrate or difficulty making decisions

  • Recurrent thoughts of death, active suicidal ideation ("I want to hurt myself"), passive suicidal ideation ("I wish I wasn't around"), suicidal plan or attempts


These symptoms must be present consistently for at least 2 weeks and occur on most days and most of the day. These behaviors and thoughts should be a change from previous functioning. Not all symptoms have to be present to be diagnosed with depression.


Signs of anxiety include:

  • Excessive anxiety and worry about a variety of events or activities

  • Difficulty controlling the worry, even after acknowledging that it is unrealistic or improbable

  • Restlessness or feeling on edge frequently

  • Fatigue or loss of energy

  • Difficulty concentrating

  • Irritable mood

  • Muscle tension

  • Sleep problems (especially difficulty falling or staying asleep)

These symptoms must be present consistently for at least 6 months and occur on most days and most of the day.


What can parents do to help?


If you are observing such behaviors and thought pattern in your child, the first step is to validate how difficult it must be for your child to be shouldering such negative emotions. Many young patients share the relief they feel when someone they are close to acknowledges that their struggles are real, legitimate, and hard. Brushing aside their negative emotions as a "phase" or over-dramatized can worsen the sense of isolation and frustration that your child is already experiencing.


The next step is get your child connected with a counselor, therapist, or psychologist to help him or her develop helpful, healthy coping strategies. Discuss the need for all of us, not just your child, to have tools in our emotional toolbox to handle life's big and small stressors. These skills may involve reorienting one's thinking to be more positive and realistic, a mantra that can repeated to reassure and encourage, or a habit that can be practiced to both physically and mentally relieve stress. As each person is unique to what strategies they respond to, it will be helpful to work with a professional who can help discover and nurture your child's coping strategies.


Encouraging healthy self-care habits is also important. It is well established that taking care of one's body lead to benefits that extend beyond just physical health. Being healthy physically leads to increased serotonin levels in the body which can help elevate the mood, decrease anxiety, and improve self-esteem. Focus on areas that are within you and your child's control including nutrition, sleep, exercise, and screen time. Nurturing the important relationships in your child's life (with family members, friends, romantic partners) is also crucial as feeling connected with others enhances the mood. Please see the separate section on "Self-Care Ideas" for examples of ways your child can improve his or her health.


It will also be important to inform your child's pediatrician of you and your child's concern about his or her mental health. Some children may benefit from medications that help improve mood and decrease anxiety for a period of time. Medications may provide additional support so that your child can get back on his or her feet faster and on to the path toward recovery. Please reach out to your child's provider to discuss this option if you are not observing a significant improvement with therapy and self-care alone or if you feel that your child's depression and/or anxiety are worsening.


What should you do if your child is expressing self-harm thoughts and/or engaging in harmful behavior such as cutting or suicidal attempts?


Sometimes when people feel depressed or anxious, thoughts about wanting to hurt themselves can arise. This can be due to a desire to “escape” from their current negative feelings and replace it with more tangible physical pain. Sometimes, patients seek out a way to feel “something, anything” if they have been experiencing emotional numbness. These feelings are real and potentially dangerous and should be taken seriously. If patients are feeling urges to hurt themselves, the first thing to do is to be with them in the same physical space and not left alone. Physical movement (ex. walking, running in place, jumping jacks) as well as a hot/cold shower can also relieve such an urge. Holding ice in their hands or drinking an iced beverage can also distract their senses to focus more on the coldness rather than the urges to hurt themselves, allowing time for those thoughts to cool off. If these feelings remain strong or become more difficult to resist, patients MUST seek emergent medical care right away.


If your child is in crisis, you can always take him or her to your nearest emergency room or call 911 (ask for the Psychiatric Emergency Response Team or PERT). Having strong suicide or self-harm thoughts are considered medical emergencies! Additional resources are listed below:


California Mental Health Line

Phone/Text 855.845.7415

Mon-Fri 7 am – 11 pm

Sat 7 am – 3 pm

Sun7 am – 9 pm


Access and Crisis Line

888-724-7240

Trained and experienced counselors are available 7 days a week, 24 hours a day to provide support, referrals, and crisis intervention.


Crisis Text Line

741741


National Suicide Prevention Lifeline 800-237-TALK (8255)

Provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week.


Rady Behavior Health Urgent Care

Appointment and walk-in clinic staffed by psychiatrist, psychologist, clinical social workers and a case manager. Translation services are available

4305 University Ave, Suite 150

San Diego, CA 92105

858-966-5484

Mon-Fri 9 am – 4 pm (appointment only)

Mon-Fri 4 pm – 8 pm (walk-in)


New Alternatives

Crisis Action and Connection

730 Medical Center Court

Chula Vista, CA 91911

619-591-5740


New Alternatives

North County Behavioral Crisis Center Intervention and Response Team

225 W. Valley Parkway, Suite 100 760-233-0133


Aurora Mental Health

11878 Avenue of Industry

San Diego, CA 92128

858-487-3200

888-565-4228 [24 hours intake line]


Sharp Mesa Vista

7850 Vista Hill Ave

San Diego, CA 92123

858-836-8434

Open 24 hours, 7 days a week


Rady Children’s Hospital Crisis Center - Oceanside

3605 Vista Way, #258

Oceanside, CA 92056

760-730-5900

Mon-Fri 4-8 pm

Sat-Sun 1-8 pm


Emergency Screening Unit (ESU)

Hillcrest Neighborhood

4309 3rd Avenue

San Diego, CA 92103

619-876-4502



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