Learn the signs and how to help your child cope with anxiety brought on by a return to pre-pandemic activities.

The COVID-19 pandemic has been hard on everyone—but especially kids.

From the sudden shift to remote learning and few or no play dates to no (or restricted) visits with extended family and lots of safety rules, children had to quickly adjust.

As some areas reopen and a few rules are relaxed, some children can experience re-emergence or re-entry anxiety.

With everything COVID-19 related, there is no clear roadmap for finding your way through these challenges. Every family will have different comfort levels with re-entry. 

Signs to Watch For

Signs of re-emergence anxiety will vary depending on a child's personality and age. Children in the same household may display different signs or levels of anxiety. Below are some potential signs of "post-pandemic" anxiety in children.

Eating and Sleeping Changes

• Classic signs of anxiety in children are issues about food and appetite or sleep. A loss of appetite, fussiness in eating, or extra comfort eating are signs something is amiss.

• Sleeping patterns may shift with sleep disturbances, nightmares, waking in the night, and insomnia. Children may also have trouble falling or staying asleep or end up sleeping more during the day.

Withdrawal and Avoidance

• Another common sign of something wrong is when a child withdraws from or avoids activities they once enjoyed. If your child enjoyed time with friends or school, and now says he’s not interested, take note.

Irritability, Temper, and Regressive Behaviors

• Has your child suddenly become moody or easily irritable? Are they displaying regressive behaviors like wetting their pants again, thumb sucking, or throwing a tantrum? These behaviors in younger children can signify anxiety and result from their inability to express their feelings.

Nervousness and Worry

• An increase in nervousness and worry is another sign of anxiety. Children face several uncertainties about the return to school. Will we wear masks? Will I get sick? Will school be interrupted again? And many may worry about being behind in school, seeing old friends and making new friends, and about being separated from their family after spending time at home.

Fear of Separation

• With parents working from home and children remote learning, many families have spent much more time together than in the past. Some children—especially those who enjoyed staying home—may find it overwhelming to go back to school or be alone in a group of children. This anxiety could come from being in an unfamiliar social situation, a fear of illness, or feeling unsafe outside of the home.

Declining Academic Performance

• Now that children are back in school, check on their academic performance. A lack of engagement in the classroom or bad grades may indicate your child is anxious at school. They may be feeling like they didn't learn as well as some classmates did with remote learning, or they could be uncertain about the social capabilities following the time away.

Ways to Help

Talk About It!

Start by creating an open and supportive environment where children and teens know they can ask questions and express their worries. Acknowledge your child's anxiety while focusing their energy on aspects of life that they can control. Name the emotion and normalize the experience to clarify that their feelings aren't "bad" but may be uncomfortable and challenging. This exercise will help a child understand that their feelings are valid and normal.

Establish Coping Mechanisms

Once you have helped your child name the emotion, talk about what they can do to feel better.  Knowing how to cope with an emotion lessens the power it has over them.

Here are a few suggested coping strategies:

• reading a favorite book

• writing in a journal

• drawing pictures

• doing other art projects

• listening to calming music

• being physically active (high-intensity activity is especially great for regulating hormones associated with anxiety)

• Finally, limit children's exposure to the news and media. Even if they are not "paying attention" to it, they pick up on more than parents realize.

Don't Make Unrealistic Promises

While it may be easy to tell your child things will get better, don't make promises you cannot keep. Give comfort and support but keep things simple and straightforward. Honestly answer questions using words and concepts that your child can understand.

Include Teachers and Other Caregivers

Talk with your child’s teacher or other caregiver about the concerns or worries your child may have. Elicit their support of your child. Let them know what you are doing to support your child at home. 

Distinguish Caution from Anxiety

It can be challenging to separate caution due to legitimate fears from unnecessary fear. Remind your children of how you have stayed safe and continue to stay safe, even as the intensity of the pandemic changes.

Maintain Positive Changes from the Lock-down

Continue those helpful habits and practices you picked up at the start of the pandemic. Keep incorporating new routines and traditions your family has enjoyed even when things resume to a more "normal" pattern. Decide what matters the most to you and your family, and prioritize accordingly.

Be Patient

Be gentle during this process. It is okay if your child or family is slower (or faster) than other families in your re-entry planning. Do what’s comfortable for all involved and give each other grace.

Prepare to Pivot

Even as you help your child prepare for going back to in-person activities, keep in mind the possible need to return to remote or virtual options. Is the number of COVID-19 cases surging where you live? Do what you and your family can do to limit your potential exposure, even if that means making a choice that others are not making.

When to Seek Professional Help

If your child’s anxiety interferes with daily life in major ways, proactively seek professional support.  It’s better to get help sooner than later.

Start with your child's pediatrician or primary care provider, who can recommend other professional services, if necessary.