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Ask an Expert: Managing Mood Disorders

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For nearly two years, we have shared the experience of navigating the COVID-19 pandemic.  We weathered the same storm, but in different sized boats.

We know that children and youth have been affected by the pandemic through the transition to virtual learning, the loss of extracurricular activities, and for some – missing out on major milestones like graduation and prom. These missed moments and losses have resulted in significant stress, anxiety, and sadness for many children and adolescents. Although things are starting to feel more normal, the impacts of the pandemic, if left unaddressed, may have long term effects on children and adolescents’ mental health.

 

Hear from an expert

 

We connected with Dr. Jared Berger, a clinical psychologist at York Hills Centre for Children, Youth and Family Services to discuss how the pandemic has affected the mental health of children and youth and signs that one might be progressing into more serious mental health concerns.

 

When observing a change in your child’s behavior, it’s good to use a baseline – comparing your child’s moods and behaviours pre-pandemic, to the ones your child might be exhibiting. This baseline is helpful when determining if the differences you’re noticing might need to be addressed with support from a mental health clinician. Acknowledging your child may have a range of reactions and emotions along a continuum is key. Your child should be encouraged to verbalize their thoughts and feelings openly about the pandemic including what they enjoyed and were disappointed about during this period of time. It may also be helpful to have a conversation with your family physician who knows your child prior to the onset of the pandemic and may decide if any underlying physical health concerns are also contributing to their low mood.

 

Read more on how to recognize your child needs mental health support 

 

What are some mood disorders you might be noticing?

 Depression is when a child, youth, or adult, experiences severe and persistent low moods, profound sadness, diminished interest or pleasure in activities, or a prolonged sense of despair. Depression can be a standalone diagnosis, but it can also be co-diagnosed with another mental health disorder. Depression is a medical condition that occurs over a prolonged period, and it is important to seek out support. A more chronic form of depression, called persistent depressive disorder (dysthymia), may be considered when a child’s mood symptoms persist for over a year. It is also helpful to acknowledge that short term periods of sadness can be an appropriate response to receiving bad news, disappointment, feelings of fear, or a reaction to a sudden event. When looking for signs and symptoms in your child or youth, it is important to acknowledge your child’s baseline – as mood swings can be a normal part of adolescence, but if they begin to interfere with their day-to-day activities, it could be time to seek help.

 

Mental health conditions like depression, may appear different in child and youth compared to adults. Your child might be displaying a lack of interest in activities they used to love, or have greater feelings of irritability, a sense of worthlessness or hopelessness. They could be experiencing an inability to concentrate, have trouble sleeping, feel lethargic, be socially withdrawn, and have trouble having energy to get through the day.  This is when it’s important to check in with their baseline; if you’re noticing these prolonged changes in behavior (that cannot be accounted for by another medical condition) it is important to reach out for help.

 

How to start the conversation with your child

Encouraging open communication with your child starts with creating a space where they feel safe to share. Here are some ways as a parent or caregiver, you could start the conversation with your child:

 

  • How are you feeling?
  • I see that you are struggling/you are not your usual self/you seem to be sadder these days.
  • Maybe we should look to get some help with that, we can go together to check it out.
  • How was your day? Is there anything we need to talk about?

 

Safety First: If somebody says or seems to be sad regularly, ask them if they are thinking about suicide. Call 9-1-1, visit local hospital emergency room, or use community support phone lines if you ever have safety concerns. Walk-in clinics and crisis lines are also available in your community. Find one using our Find Help tool

 

What to do if your child isn’t open to getting help

This can be a common challenge for parents and caregiver and there are a few ways to approach it.  With children who might be unwilling to seek support, parents/caregivers might consider getting support themselves, to help better support their child. Peer support groups through Parents for Children’s Mental Health can be a helpful place to start receiving education. When parents get support, they learn new skills to engage with their child or teen which can sometimes lead to the child realizing the benefit of getting support and want to attend themselves.

 

In some cases where a child might be willing to do an initial appointment, a mental health clinician could conduct a motivational interview with your child or teen, to work through their specific goals for therapy and co-create a pathway forward. Read more on what to expect from a child and youth mental heath centre https://www.family.cmho.org/children-and-youth-mental-health-support/

 

Mood Management Tips

Here are 10 mood management tips – the C.H.E.E.R.I.N.G. U.P.  acronym, which you might find helpful to work on with your child or adolescent as we begin to consider life beyond the pandemic. There is no particular order, and these tips can be used alone or together:

 

  1. Coping Thoughts – Create a list of positive affirmations, to help your child identify things they are good at in their lives. This comes in handy when youth recognize that they are getting stuck in a pessimistic or negative thinking trap – they can use this list to reframe their thinking traps to coping thoughts. It is also helpful to discuss a more balanced or hopeful thought.

 

  1. Hobbies and Leisure Tasks – Without distractions children, youth, and adults, can sometimes find themselves dwelling on unpleasant thought patterns or experiencing recurring sad or anxious thoughts. Proactively scheduling activities can be helpful. Work with your child to plan a few activities throughout the course of the week to fill in their idle time. To start make a list of previously enjoyed activities and try to find pandemic-safe workarounds to incorporate these activities in their schedule. 

 

  1. Eating – Many people, particularly youth, struggle without structure to their daily life. Without set routines, some youth find it hard to remember to eat three meals a day and stay hydrated. Having a mealtime schedule is one way to continue healthy structures as healthy eating and drinking habits lend themselves to a boost in mood.

 

  1. Exercise – One positive to the pandemic is that it introduced tons of free online programs offering guided exercise that fits different needs. Many options remain available post-pandemic, even 15 or 20 minutes of movement can significantly improve one’s mood.

 

  1. Reconnect with Family and Friends – Seeing friends and family members is important even if it is virtually. Whether that means having a virtual dinner together or a FaceTime conversation or playing a board game or an online game or activity. Gatherings (in all forms) involve participatory conversation, which can help uplift moods and reduce feelings of isolation.

 

  1. Inspiration Board – Create a list of things your child is looking forward to doing. It may be easier to start off the list by adding new things that you have done as a family, that your child might have enjoyed during the lockdown periods, such as making bread, watching a movie, or doing a puzzle and then move toward things your child specifically has done. Building this list can be a great reminder of your child and family’s resilience.

 

  1. Nighttime Routine – Maintaining a healthy bedtime routine is important. Sticking to a regular sleep routine is an important part of maintaining structure and predictability for children and youth, by keeping relatively consistent bed and wake up times. Setting up nighttime rituals such as reading before bed can also contribute to healthy sleep habits.

 

  1. Give yourself some self-care and self-compassion – This is an important note for parents and caregivers. Be sure to take time for yourselves. By caring for yourself and remaining compassionate with your thoughts and feelings, you’re able to better self-regulate, and model healthy self-care behaviors for your children.  

 

  1. Understand that it is ok to ask for support – Many community child and youth mental health agencies have a support line where you can call in to talk about the mental health needs of your child. Clinicians are available to speak through your concerns, family needs and come up with helpful resources.

10. Plan for safety – It is helpful to have a safety plan in place, that is regularly kept up to date. Safety plans include list of trusted individuals your child should feel safe talking to (e.g., an adult, a caregiver, a teacher, a family doctor etc.) It should also include a list of safe spaces in and outside of the home, which could include a neighbor or family or friend that lives close by.  In some cases, a safety plan also includes making the home environment safe for children and youth who might be self-harming. Finally, a safety plan should also include a list of numbers and resources in case of emergency – 911 and address of the closest local emergency room. When creating a safety plan, it is important to include your child in the process so that they know how to recognize when they need support, and how to ask for it. It might be helpful to practice this script as well as review the plan with your child so that they become comfortable with it and could use it on their own if needed.

 

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