Almost 30% of confined children suffered from anxiety and depression

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Natalia's parents have noticed that for weeks she has been blinking incessantly; In addition, she wakes up every day at dawn, exalted and between sobs. Something similar is experienced in Berta's house, her two young daughters go from joy to crying in a matter of seconds , neither the movie Frozen consoles them, no matter how many times her mother puts it on.

"The confinement started well, I telework and they did not go to school, they liked being together all day, but then the problems began, drastic mood swings, tantrums and nightmares . Before they were very calm," says Berta while on the phone , one of the girls screams for her attention.

And is that one in four children suffers from anxiety due to confinement as Save The Children published a few weeks ago. In another study published in the medical journal JAMA Pediatrics , they measured the mental impact that the confinement of Covid-19 has had in China. The data reveals that there was an approximate 5% increase in the number of symptoms of anxiety and depression . "If under normal conditions 17% of the child-youth population has symptoms, in this case we are talking about up to 22-23%, this being an increase of 5% more or less in primary school children," explains Celso Arango, head of the Child and Youth Psychiatry service at the Gregorio Marañón Hospital in Madrid.

The months of confinement and the difficulty for children to assimilate such a complex situation can affect the emotional state, causing more sadness and sensitivity, greater anxiety and irritability with blunting of problematic or disruptive behaviors, more fears and even behaviors of great concern, among other psychological problems. In addition, they may also respond by holding on to caregivers, feeling nervous , fearful, angry or agitated, having nightmares, wetting the bed and frequently changing moods.

Not all children are experiencing confinement in the same way or in the same circumstances, it will depend on both their ages and the socioeconomic situations of their families . "Some have experienced symptoms from the beginning of the quarantine and others have not, which does not exempt them from suffering them in the future. In addition to all the changes they are undergoing at the moment (anxiety, stress, insomnia, fears and irritability), sequels still to be determined are also added ", clarifies Marta Gago, psychologist and director of the ITA Madrid Day Hospital center.

It should be borne in mind that there are previous studies on the impact of isolation in pandemics and after natural disasters or major catastrophes. These indicate that there is a four times higher ratio of post-traumatic stress in children in quarantine than in children who have not been in this situation. "Although we must be cautious, children have a great capacity to adapt to all circumstances, so it is probable that the consequences in many cases, if they exist, are minimal," says Gago.

Children with previous pathologies, the most affected

"In some children these symptoms may be visible from the first days of isolation, while in other cases, these effects may appear weeks later or not appear.

In addition, it is very important to know that the psychological consequences could become a trauma for the most emotionally unstable children and manifest as very diverse alterations, "says the director of the ITA Madrid Day Hospital center.

The problems and consequences derived from this exceptional situation due to the Covid-19 crisis are clearer in the early stages of development, since they are the most sensitive, and therefore must be the most protected. Above all, confinement is more dangerous in children with previous underlying pathologies . Those with behavioral disturbances or disruptive behaviors are much more vulnerable to routine changes.

"Children with developmental disorders, with intellectual disabilities, attention deficit hyperactivity disorders or autism are the ones who find it harder to be indoors. Firstly, because they have more compulsive need, which is treated with sports and exercise, on the other hand, because they have more difficulty understanding why they have to be locked in . A child with an intellectual disability does not understand that there is a risk because they cannot assess it or know what a virus is, and the same thing happens with many children with autism, are minors to whom the change of any routine affects them greatly, "explains the head of the Child and Youth Psychiatry service at the Gregorio Marañón Hospital in Madrid.

That all the extracurricular measures have collapsed has greatly influenced children with previous pathologies. School education, therapies and treatments in these cases are virtually impossible to provide. There are therapies designed for a specific moment in the development of these children that due to the exceptional situation we are experiencing have not been able to offer.

"The more time passes, the greater the impact on the mental health of these children. For this reason, the Ministry of Education must consider that the first to return to class are those with special education . They are classes with four or five students who can maintain physical distance and whose classes cannot be filled in electronically, "explains Celso Arango, calling on the Ministry to minimize long-term harm to special education children.

Communication, routines and affection

The attitude of parents is very important to mitigate the psychological impact generated by this pandemic, emotional contagion towards children is a fact that should not be overlooked, something that is even more acute in small spaces or with few resources .

"In addition to the drawings and the games, there are more options to spend the day like reading together, seeing old photos, a movie session with popcorn or board games. And, above all, giving them great doses of affection through physical contact, kisses and hugs, which is the best natural medicine for our mental health and that of our children ", highlights the director of the ITA Madrid Day Hospital center.

guidelines to guide parents

Diego Solano, director of the ABB Seville Day Hospital, refers to them as a decalogue in this exceptional situation and, in addition, he explains some tips to normalize the situation with the little ones.

• Minors are often relieved if they are allowed to express and communicate their feelings of fear in a safe and protective space. Keep in mind that sometimes, focusing on creative activities like painting or drawing can facilitate this process.
• A sensitive and safe environment should be provided around the minor.
• It is important to keep regular routines and schedules as normal as possible or to create new routines in the new environment that include learning, play and relaxation.
• If possible, the duties of school, studies or any habitual activity that does not endanger children or public health should be maintained.
• It is convenient to provide data on what is happening and give clear information, always in terms that children can understand. Teach them how they can be kept safe (eg teach them effective handwashing).

Relaxation exercises

In cases where children are very anxious, parents can use the Koeppen relaxation exercises , designed to be done as games. The child will have to imagine different animal situations and behaviors to relax different areas of the body.

First you will imagine squeezing a lemon to relax your hands and arms , then you will imitate the behavior of turtles when they are scared, tightening necks and shoulders. For the legs it will try to make its way through imaginary mud and for the back it will have to stretch like a lazy cat . The abdominal area will work by imagining that an elephant places a leg on its stomach (tightening the area) and that it has to go through a narrow area (shrinking the abdomen). He will work his facial muscles imagining that he chews a giant chewing gum and that a fly is posing on different areas of his face.

Surely we will not forget this period, but not necessarily in a way that can harm our lives. It is important to talk to the children about the fears they have, the sadness they feel for not being able to hug their friends, giving them tranquility and above all hope ; Explaining that they will play with their friends again, go to school and see their relatives.

In accordance with the criteria of The Trust Project

• Science and health
• Covid 19
• Psychology

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