As weeks turn into months, the COVID-19 pandemic has taken its toll – both physically and emotionally. Teens especially are keenly aware of the severity of the situation, as they face changed routines and more limited interactions with friends and other social supports. For some, this has become a real struggle.

Dr. Cheryl Al-Mateen, medical director of Virginia Treatment Center for Children, explains the signs of anxiety and depression in teens and how parents can help.

Is it fair to assume rates of depression and anxiety are going up in this age group?

Overall, yes. There is a lot happening in the country and throughout the world related to coronavirus.

In addition to social isolation and changes in routines, teens may be concerned about parents who work in the medical field, grandparents getting sick, etc.

Then, we couple this with the social unrest in our nation. Kids of color may be having different kinds of conversations with their friends and learning that perhaps they have different attitudes than they previously thought.

Relationships, even among close friends and loved ones, are becoming strained. It’s a lot for teens to digest and address.

On the other hand, what I’m seeing — and what I’m reading is consistent throughout the country — is that many teens who previously had some levels of anxiety and depression related to specific social stressors are feeling some relief in this time of social distancing and virtual learning. Kids who were struggling with social skills or victimized by bullying at school may be more comfortable in the home environment.

The exact effects of the pandemic are of course dependent on the person, but it’s safe to say that almost everyone is facing unique challenges right now.

What are some signs parents should be aware of that may indicate a teenager is experiencing anxiety or depression?

What we look for are changes. When we have a young person who is depressed, we often see changes in sleep, appetite, social interactions and mood — increased sadness or irritability. Anxious teens tend to become more withdrawn, perhaps spending more time in their room. They may increase talk about worries or fears.

Most people can manage two or three different stressors simultaneously, but COVID and the current atmosphere in our country come with many related stressors. We can’t always predict which one will be the tipping point for a person.

How should a parent go about discussing their concerns with their child?

Parents shouldn’t underestimate what they think they see. Share your concerns with your teen in a loving way as you would with any situation. “I’ve noticed you aren’t quite yourself lately. Can you tell me, are you okay?” “A lot of people are overwhelmed right now. How are you feeling?” Let them know it’s perfectly fine to talk about feelings and that you want them to. Share how you are feeling, too, so they understand they’re not alone.

When is medication indicated? When is therapy indicated? When might both be a good idea?

With most anxiety disorders, psychotherapy should come first. This is true in many cases of depression as well. Very often, this intervention may be the only thing that is needed. A psychotherapist will often recommend that you seek a referral to a prescriber (primary care provider, psychiatrist, nurse practitioner) if they feel psychotherapy is insufficient. This is a conversation you can start with the therapist as well.

For severe anxiety or depression — such as if the teen is losing or gaining weight, participating in self-harm or having suicidal thoughts — therapy and medication may be started at the same time.

The answer to this question will not be the same for everyone. A trained mental health professional is needed for a full assessment and determination.

How can parents go about finding help for their teen?

Connect with your teen’s pediatrician or primary care provider. They can provide an initial assessment, even via telehealth in many cases, and recommend next steps. Our Cameron K. Gallagher Mental Health Resource Center helps families navigate and access services for their children’s mental health needs — either with our providers or others throughout the community or state. Community mental health centers or services boards can provide information and resources as well.

What should a parent do if their teenager refuses help?

If your teen is reluctant to talk with a mental health professional, consider resources such as a pastor, school counselor, favorite teacher, troop leader or other trusted adult. Normalize the need for emotional support and encourage them to try it. They may not realize they need the help until they receive it.

If there is a concern for maintaining safety of self or others, the emergency room is always available. Emergency mental health hotlines are available 24/7 as well.

Could your child or teen benefit from mental health support? Learn more about the services we offer.