Covid-19 prompted the rapid mobilization of health services and medical science in the face of unprecedented challenges. When Covid-19 emerged in 2020, medical science delivered rapidly and with great success. Mental health, however, has not been part of this success story. With Covid prevention measures relaxing across the nation, many researchers worldwide have begun examining the impact that pandemic-related devastation — millions of deaths, economic strife, and unprecedented curbs on social interaction — has had on youth’s mental health. “Pandemic-related lifestyle changes have wreaked havoc on teens’ lives, with many experiencing disruptions to their normal routines,” says Gary L. Freed, professor of pediatrics at the Division of General Pediatrics, University of Michigan, Ann Arbor. “Just as young people are at the age of being biologically primed to seek independence from their families, Covid-19 precautions have kept them at home.” A forthcoming comprehensive review paper from Dr. Jianghong Liu, professor of nursing at the University of Pennsylvania analyzes literature regarding the implication of social distancing on pandemics. The paper identifies a link between social distancing and the deteriorating psychological well-being of youth, including increased anxiety, emotional exhaustion, distress, and depression. In this article, I will be summarizing key takeaways from the paper. 

For many teens and their families, school closures significantly disrupted the everyday functioning of families. Pandemic restrictions meant months of virtual school, less time with friends, and canceled activities like sports, band concerts, and proms. These enforced social distancing measures have cut off many teens from major means of psychological support, making them susceptible to anxiety and depression. In a national poll conducted by the C.S. Mott Children’s Hospital, 46% of parents say their teen has shown signs of a new or worsening mental health condition since the start of the pandemic. Notably, parents of teen girls were more likely to say their child had a new onset or worsening of depressive symptoms and anxiety than parents of teen boys. One in three teen girls and one in five teen boys have experienced new or worsening anxiety, the poll suggests. More parents of teen girls than parents of teen boys note an increase in anxiety (36% vs. 19%) or depression (31% vs. 18%).  Parents observed an increase in their teen’s aggressive behavior in virtually equal proportions (8% vs. 9%). 

Freed writes that “Peer groups and social interactions are a critical part of development during adolescence. But these opportunities have been limited during the pandemic,” He adds that “Many teens may feel frustrated, anxious and disconnected due to social distancing and missing usual social outlets, like sports, extracurricular activities and hanging out with friends.” A national poll from the American Psychiatric Association appears to substantiate these findings. The results show that more than a quarter (26%) of parents have sought professional mental health help for their children due to the pandemic. However, more than one in five parents said they had trouble finding a mental health specialist with available appointments. "This poll shows that even as vaccines become more widespread, Americans are still worried about the mental state of their children," Jeffery Geller, former ​​president of the American Psychiatric Association, said in a news release. "This is a call to action for policymakers, who need to remember that in our COVID-19 recovery, there's no health without mental health.” 

Professor Liu’s review also suggests that some teens were affected by the impact the pandemic had on their parents or caregivers, such as unemployment, financial or emotional stress, and fear of Covid-19. Teenagers may have been forced to spend more time isolated in abusive or dysfunctional homes due to social distancing and quarantine requirements. A study conducted in seven European countries found that over 40% of parents reported increased stress, worry, social isolation, and domestic conflict. A small number of parents reported increased parental alcohol and drug use. These effects undermine a parent’s ability to be supportive caregivers and to respond appropriately to their children’s needs. As a consequence, trauma-related mental disorders such as PTSD have been on the rise. During the H1N1 outbreak, parents and children who had been quarantined reported more symptoms to warrant a diagnosis of a trauma-related mental disorder. Although current studies have not yet reported the rate of PTSD associated with Covid-19, one study in China found that 14.4% of youths had PTSD symptoms during the pandemic.

 In extreme cases, social stigmas, isolation, depression, anxiety, emotional imbalance, fear of infection, and economic concerns have engendered suicides. It is worth noting that people with a history of mental health problems or diagnosed psychiatric illnesses are more likely to experience suicidal thoughts during the coronavirus pandemic. These effects were observed across different age groups and nationalities. A study in China reported 35% of men and women of all ages experienced psychological distress during the Covid-19 outbreak. Likewise, a qualitative study in the United Kingdom found that people generally experienced low self-esteem, lack of self-control, and emotional exhaustion.

Liu’s review also indicates that social distancing is associated with increased rates of addictive behaviors, particularly the development and relapse of substance use disorders. For example, as social distancing measures in Australia were implemented, alcohol sales increased by more than 36%. Online gaming has increased by over 70% during the pandemic, with similar social networking and television viewing increases. This can be partially attributed to the increase in leisure time from school closures. A survey in South Korea found that 81% of parents reported an increase in their children’s screen time following closures. Auer and Griffiths (2021) found the number of active online casino gamblers significantly increased from January 1, 2020, to May 31, 2020. 

So how can parents combat the onslaught of mental health issues brought about by the pandemic? Liu’s paper advises adults to provide stability and support to their adolescent children by promoting a healthy and consistent sleep schedule, engaging in physical activity during the day, and limiting the usage of electronic devices before sleeping. Moreover, interventions to increase social connections are important. Adults can help adolescents stay connected by reaching out to friends and family via phone, video chats, and social media to optimize stress responses.