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Helping kids cope with reentry anxiety

The world is reopening, and adults everywhere are dealing with reentry anxiety. After more than a year of wearing our masks and keeping our distance, activities that would have felt totally normal and safe pre-pandemic can provoke feelings of nervousness and apprehension now, regardless of what the CDC or MIT Medical might say.

Illustration of a small child with a worried expression standing at the edge of a swimming pool and wearing several flotation devices

But adults are not the only ones dealing with these emotions. It’s important to recognize that the pandemic has had a significant emotional and developmental impact on children of all ages, say experts at MIT Medical.

“Reentry anxiety is not, in itself, a mental health disorder,” emphasizes MIT Psychologist Maryam Khodadoust. “It’s a natural reaction to a traumatic event — the pandemic. After we’ve spent more than a year impressing on our children how dangerous the world outside is, it’s only natural for some of them to be hesitant about stepping right back out.”

But what reentry anxiety looks like, and how parents can help, depends, in part, on your child’s age and other factors, say Khodadoust and others.

Preschoolers

Very young children often have no memory of pre-pandemic life, notes Pediatrician Rosemarie Roqué Gordon. She recalls a not quite three-year-old patient reading a picture book with his mother, looking at an illustration of a child riding a bicycle, and exclaiming, “The boy forgot his mask!”

“For me,” Gordon says, “this highlighted that, for very young children, there hasn’t been a time that they can remember not seeing people wearing masks or being afraid of an invisible infection. This business of mask wearing is their fundamental reality, not a blip of 16 months. For them, the events of the pandemic have been a foundational experience.”

Gordon advises parents to introduce these very young children to the experiences of post-pandemic life in the same way they would introduce them to any new situation. And although these youngsters will experience post-pandemic life as a series of completely novel circumstances and environments, Gordon is optimistic that most will adjust with relative ease. “Very young kids are much more flexible than adults or even older children,” she notes, “and after a period of adjustment, most of these kids will be just fine.”

For slightly older children, it’s important for parents to be both “transparent and reassuring,” says Mental Health Clinician Joy Yang, LICSW. “This is a time when children look to their parents, caregivers, and the environment around them for approval and cues about how to respond to various situations. Some children may be excited and looking forward to going back to daycare or school, for example, while others may be feeling anxious and overwhelmed. Pay attention to how your child is responding to various situations, and provide support by validating their feelings and staying calm.”

Older children

School-aged children have strong memories of pre-pandemic life and, like adults, many have expressed the desire for things to “get back to normal.” But now that things are getting back to normal, says Pediatrician Edward Levy, these children are also dealing with adult-like levels of reentry anxiety.

For some, it’s anxiety about their personal safety. After more than a year of being reminded to keep their distance from other people, keep their masks on, and wash their hands, it’s not surprising that some children continue to feel excessive concern about catching the virus, Levy notes. “They may also have heard adults express similar fears,” Levy notes. “If parents are still anxious about safety, kids will pick up on that.”

For other children, Levy says, anxiety may be triggered by the prospect of navigating social interactions after a more than a year-long break. “Social skills, like other skills, get rusty when we don’t practice them,” Levy says. “Even as adults with many years of social experience, lots of us are feeling some awkwardness around post-pandemic face-to-face interactions.”

Social reentry can be especially difficult for children who had some social anxiety before the pandemic, he adds. “Those children have had 15 or 16 months of opportunity to avoid difficult or challenging situations. Reentry is difficult for many children, but kids who were already struggling with anxiety have become even more anxious.”

Levy’s advice is to take it slow. “Increase normal experiences in a safe and developmentally sensitive way,” he advises. “Try to increase your child’s comfort levels gradually. For example, go on little forays into stores with masks, or schedule some brief, outdoor playdates. And for kids who are having trouble separating from parents after months of togetherness, start encouraging independence by practicing small periods of separation.”

Now, more than ever, routines are crucial, Levy notes. “Predictable routines around bedtime, exercise, eating, and screen time can help children feel more secure,” he says. “It’s important to validate children’s feelings and give them space to express fears, Levy adds, “but try to set a positive, encouraging tone, and don’t forget to celebrate even small wins.”

Tweens and teens

For adolescents and teens, reentry anxiety may be linked to their individual experiences of the last year and a half, says Khodadoust. “Some will be more than thrilled to get back into the swing of being outside the house and hanging out with friends,” she says. “But reentry will likely be more difficult for those who lost loved ones, who experienced a change in their family’s financial status, or who had more intense exposure to emotionally charged information — for example, through social media.”

Khodadoust also echoes some of the concerns Levy expressed with regard to younger, school-aged children. “Adolescents and teens with underlying mental health conditions, especially anxiety — general, obsessional, social, or health anxiety — are facing special challenges now,” she says. “For example, teenagers who were already finding the social hierarchy within their friend group stressful pre-pandemic, and who haven’t had to deal with it for the past year, may feel extra anxious about going back. Almost all of us are experiencing social fatigue at this point, but for teenagers, it can be especially anxiety provoking to feel so exhausted after even short bouts of social interaction.”

Let your kids have as much control as feasible over the pace and course of reentry, Khodadoust advises. “Let them choose when they are ready to go back to certain extra-curricular activities like sports or music lessons. It’s okay to take it slow,” she emphasizes. “And even if you have begun to have people over at the house, don’t necessarily expect your kids to be excited at the prospect of visitors. Give them permission to stay away from gatherings or to participate only in short spurts.”

In addition, Khodadoust encourages parents of teens and tweens to:

  • Maintain routines. “As much as possible, try to keep the same routines post-pandemic, as you did during the pandemic,” she says, “whether it’s having dinner together, playing scrabble after dinner, or family movie night.”
  • Stay connected. “This means communicating about the reentry process on a regular basis,” Khodadoust says, “not just when your teen is visibly upset — those times may not be as helpful, because they may shut down or be too upset to talk. Ask open-ended questions: ‘What did you think of X, Y, or Z activity?’ or ‘How did you feel about that outing?’” Some teens might also find it helpful to keep a journal where they can write about their activities and concerns.
  • Validate. Then educate. “When you get pushback from your child about a reentry activity, start with an empathic inquiry rather than a lecture on the CDC guidelines,” Khodadoust says. “Support, validate, and normalize anxiety reactions first. There is room to educate and reassure teenagers about their safety while still respecting their feelings and their boundaries — ‘What we are asking you to do is safe, but it’s also important to us that you are comfortable. There is no rush.’”

Finally, Khodadoust points to research showing that having fun can reduce negative symptoms of stress and anxiety. “Make sure to schedule activities that your adolescent/teenager would perceive as both fun and safe,” she says.

In this together

With time, patience, and support, all four clinicians agree that most children will successfully navigate the transition to a post-pandemic normal. But it’s also important for parents to know when to seek help for their children, Khodadoust says. “You should consider reentry anxiety to be a problem if you notice that it is significantly affecting your child’s functioning in one or more areas of their life.”

“We are here to help,” Levy emphasizes. “MIT Medical pediatricians are available for support with in-person or virtual visits, and we can make referrals for mental health assessment and treatment as needed.”

But don’t forget about YOU! Our clinicians agree that parents need to pay extra attention to their own wellbeing during this time. “Take care of yourself,” Yang urges. “If you are anxious, your kids’ anxiety will likely be exacerbated as well.”

This news story has not been updated since the date shown. Information contained in this story may be outdated. For current information about MIT Medical’s services, please see relevant areas of the MIT Medical website.