And now psychologists have evidence that kids’ brains do indeed look different after living through it. In a study published December 1 in Biological Psychiatry Global Open Science, researchers compared self-reported mental health symptoms and brain imaging scans from a group of adolescents (ages 15 and 16 on average) who experienced the pandemic shutdown with a group of adolescents (matched by age, sex, puberty, exposure to early life stress, and socioeconomic status) who underwent the same assessments before the pandemic. The children assessed after the pandemic shutdowns (128 individuals) self-reported more severe internalizing mental health problems (such as depression) and signs of accelerated brain aging compared with the control group (163 kids), per the MRI scans. The research joins a wealth of other evidence that when it comes to mental health, kids are struggling. Here’s what Amanda Craig, PhD, a licensed marriage and family therapist and author of Who Are You and What Have You Done With My Kid: Connect With Your Tween While They Are Still Listening, says parents and others who work with kids should know to help kids cope. Everyday Health: Let’s start at the beginning. What made living through the COVID-19 pandemic so challenging for so many children? Amanda Craig: The longevity, first of all. In the short term, the pandemic offered (for many of us) more time for family. For some, life moved at a slower pace. In March 2020, it was like, okay, everybody stay home for two weeks. The virus will pass, and then we will all come back out and go back to life as normal. That did not happen. It has been nearly three years, and we’re still not back to normal. Then kids were flooded with news about chronic sickness and a potentially deadly illness, which translated to the fear that if you get COVID, you die. So, there was the shock of leaving life as they knew it and suddenly hearing about a pandemic like we’ve never had before. That resulted in a lot of fear for kids. There was also uncertainty around school education protocols. Some kids seamlessly went on to online learning with no problem. Others struggled. Many school systems didn’t have the infrastructure or the financial ability to support complete online learning for different learning styles. A lot of people lost their jobs during the pandemic. So, there was also fear and uncertainty related to financial stability. Overall, it felt like there was no end in sight. To some extent, it still feels that way. So, there was (and is) a lot of fear around: Will this ever end? EH: Given what we know about tween brain development (a topic you’ve studied and written about), are the article’s findings about how the experience of living through COVID-19 affected kids’ brains surprising or not? AC: Ages 9 to 13 are usually a time for self-discovery. The brain goes through a period of huge neurological pathway growth. During this time, the brain starts to look at relationships differently. Children at this age become more emotional because of changes to the amygdala (the emotional control center of the brain) and the hippocampus (where memories are stored). The amygdala also tells us when there’s danger or when we’re secure. Those parts of the brain are more active. But, at this age kids’ prefrontal cortex is smaller. So, their critical thinking and decision making is underdeveloped. When COVID hit, with uncertainty, isolation, and an inability to get out and explore the world in a meaningful way, fear subsequently hit, too. Kids’ amygdalas were screaming “danger.” And the pandemic and associated trauma have lasted for two years and counting. So, it makes sense that their brains are completely stressed out even as we attempt to gain some sense of normalcy. Their brains are injured, and they are trying to figure out how to get back to normal. EH: That’s terrifying. Is it as bad as it sounds? What are some ways those effects might come out in kids’ behavior? AC: We put them back into life. Schools and businesses started to reopen. We began to take our masks off; we got vaccinated, and so on. But has the brain healed from the trauma of the beginning part of the pandemic? That could show up in the form of fight-or-flee behavior because of how the amygdala was affected. So, now we are seeing an increase in certain behaviors like acting out, overeating, self-harm, and increases in anxiety, which could be related. Examples of fighting behavior in children can include having more tantrums, yelling more, and appearing angrier. Fleeing behaviors are more internalizing, like staying in their room, being withdrawn, not being able to think as fast, and everything feeling hard. This is the brain’s way of saying, “I’m not healed, and this is all going too fast. I haven’t caught up yet.” EH: As a clinician, are there specific issues that you’re seeing coming up with your patients or their kids that might be connected this? AC: I’ve been in the industry for 20 years, and always said I love my work. It flows, and the pandemic broke the flow because people felt deeper, and it wasn’t as easy to pull them out. Treating patients has become more challenging. The symptoms of depression and anxiety are much more severe. People who never went to therapy or considered seeing a therapist felt deeper discomfort. For many kids, going to school for a full day suddenly feels like moving a mountain. There’s academic difficulty among kids who are struggling with focusing in the midst of their psychological trauma. Kids are talking about increased hopelessness. The current cultural climate with politics and the war in Ukraine has also impacted kids. It has all made them feel like they have no control over anything that happens in their lives. I have been hearing a lot of dread language. Kids are talking about experiencing increased paranoia. A lot of kids are worried about everything, which is a stress response. The other thing I am seeing are changes in eating habits among some of my patients. Kids are either overeating because of emotional eating or eating too little. EH: This is all pretty bleak. What can parents (and others who work with kids) do to support healing for their kids? AC: In my book, I talk about emotional connection. It fits well into this discussion about brain growth and how the brain experiences trauma. It’s feeling close to somebody and securely attaching to the people we are in relationships with. When this happens, our body feels calm and has more energy because we know somebody is there who has our back. In contrast, when we are around people who we’re insecure around or feel anxiety around, our systems become dysregulated. In that context, how we connect with our kids is important to helping their brains heal and accomplishing this through emotional connection. One of the things parents can do is give their undivided attention to their children when they’re interacting. For example, inquiring what is it like for them to be in life again post-pandemic and asking them what they need. They may not even know what they need, but it’s important to recognize kids’ nonverbal cues. Many younger kids will talk about physical symptoms like headaches, stomachaches, or fatigue. And offer authentic support. If I understand what it’s like for my kid, I can offer them better support, whether it’s support in the home, medical assistance, or support or accommodations in the school system. Clearly express to our kids that we’ve got their backs, that we understand them, and will help them get through what they are experiencing. Also, encourage kids to move their bodies and exercise to get dopamine and endorphins pumping. That’s when we start to feel happy again. And create safety for our kids. This sometimes comes with some challenging conversations and decisions. Consider if a child might need to change schools, get an accommodation at school, or seek counseling services. Seeing a therapist for preventive purposes can be very helpful. But we have to ask them tough questions: Do they need more care? It’s ultimately a way to keep our kids safer and to heal their brains from this trauma they have experienced.
