​EMMANUEL OLGUÍN ON UNSPLASH

We have endured so much in the past year. As things are slowly opening back up, kids and teens may be feeling uneasy and uncomfortable with this return to ‘normal’. Many kids still remain virtual with school and have been isolated from friends and from organized activities. Their routines have changed and many have become comfortable with this. They may feel anxious going back to school or to social gatherings where they have to interact with others. These skills have not been practiced for over a year. This can be even harder for kids who experience anxiety and especially social anxiety. In addition to these worries, there could be worries about safety and uncertainty.

1. Listen and Validate. Help understand what your child may be experiencing and feeling. What are they most worried about? Listen to them. Acknowledge and validate their feelings and emotions even if you don’t fully understand them or relate to them.

2. Take small and gradual steps. Gradual exposure is the best approach to things that are uncomfortable and scary. Total avoidance may seem comfortable in the short term but it will actually make the anxiety worse. Eg. start with smaller gatherings or have your kid get together with a few close friends first. Go to places during times where it may not be as crowded. See if your school can work on ways to help ease the transition back. This may look like shorter days or fewer days/week to start.

3. Focus on activities that are meaningful to your kid. What are some things your kid misses the most and is eager to get back to? Do they miss playing their favorite sport, music classes, working, hanging out with friends? After assessing safety and overall level of comfort as a family, start with those activities first. Do a stepwise approach as discussed above.

4. Have a close friend or “buddy” join. Most kids will feel more comfortable doing things with a friend they are close to. Have your kid walk into school or meet up with a friend in the morning to make it more comfortable going to school. This can be implemented for most social situations too.

5. Get back to healthy routines. Many healthy routines have fallen off in this past year. Start implementing; going to bed at a reasonable time and waking up early, eating nutritious foods, exercising and reducing screen time (especially before bed).

6. Provide reassurance and seek additional support. It is normal to feel uneasy and anxious about going back to ‘normal’. There has been so much uncertainty, fear and change during these times. Provide realistic but supportive reassurance. Share with teachers and family what your kid is going through so they can help support him or her. If your child needs additional support and help, reach out to your pediatrician, school counselor or seek the help of a child therapist or psychiatrist.

7. Be patient and kind to yourself. Model the behavior you want your kid to see but also be patient and kind to yourself. We have gone through an extremely difficult and challenging year. This is hard. Adjusting and transitioning will take time and patience. It should not be rushed and there is no right or wrong way to approach it. Also, remember that kids are resilient!

Dana Reid, D.O.

And just like that, it’s August and time for school to start back up. Usually, this season is buzzing with excitement and anticipation, as students gear up for another hectic school year. Stores are selling pencils, notebooks, and backpacks everywhere you look, with big, bright “BACK TO SCHOOL” signs all over the place. Malls are teaming with families picking out what clothes their child will need this year and what shoes they will grow into.


As a child psychiatrist, the weeks leading up to the first day of school are spent working closely with kids and parents to prepare for a successful year. We talk of returning to a regular sleep schedule after staying up late and sleeping in all summer, as well as addressing the various concerns that come with being back in a mentally, emotionally, and socially demanding environment. “Will I have a nice teacher? Will my friends be in my class? How will I keep up with all the homework?” I collaborate with my patients and their families to navigate these anxieties, and how to implement the strategies necessary to stay on the path to success.
​
​
Due to Covid-19, it comes as no surprise that this school year will look quite different than what any of us are accustomed to. We are now forced to address worries we may have never had to think about before. Suddenly, not only are we stressed about getting all the right textbooks and the special calculator for algebra, now we are actually having to assess health concerns.
​

​This past month saw parents, teachers, school board members, as well as local government officials all weighed down with the responsibility for creating an idea of what the 2020–2021 school year would look like in their neighborhood. The resulting plans and academic options vary drastically from state to state, city to city.
​
​
One thing I’m sure we can all agree on is that these decisions are like nothing we have ever encountered before, and are overwhelming at times. Most of us have probably been wondering, “Am I making the right decision for my child? How will I ensure my child doesn’t fall behind? How will my child do without the extra support of a normal school environment? Will I be able to keep my job while also trying to watch my kids during the day? What if I can’t afford the tutors or to have my child in a learning pod?”
​

Below are 7 tips for easing anxiety during this time

1. Flow with change and accept uncertainty. Since the onset of this pandemic, we have been forced to give up so much of our own control, but we have learned to adapt. I think we have even grown accustomed to existing with a heightened amount of uncertainty. Some of these adjustments have been very challenging, but we have been able to do it. If the last few months are any indication, we should know by now to expect the unexpected. We need to understand that any hard and fast expectations we have for this school year can change at a moment’s notice. If your school anticipates in person classes, there may be longer breaks or an abrupt switch to online learning depending on virus surges and local outbreaks. Anticipating change and being flexible with circumstances beyond our control will help us stay positive, motivated and lessen our disappointment.​​
2. Stay optimistic about this year. Remind yourself of all the effort teachers and staff have put into designing a curriculum that will be as effective and engaging as possible under the present circumstances. With e-learning this fall, there will be more active and “live’ teaching. If you have the option of attending physical school, instead of focusing on what has been eliminated or redesigned as precautionary measures, think about how great it is for your child to be able to see their friends and teachers. Granted, it is not what we had hoped for, but there still remains a lot of good with either option.
3. Maintain a consistent structure and routine. If you have children who will be going virtual this year, keep the most “normal” schedule you can. Have your child get up at their regular time and get dressed and ready for school. Prepare a hearty breakfast so your child can start the day with energy and focus. Set up a designated study area whether it be a desk in their room, or maybe the kitchen or home office. Keep it sunny and bright, and free from clutter and distractions. Add some colorful decorations or motivational signs to make it feel like a real classroom! It is not recommended that students study while sitting on or lying in their beds as it can lead to loss of motivation and feeling more sluggish.
4. Know what to expect with school work. It is important very early in the semester, even before school begins if possible, to be familiar with where assignments are posted online and how you plan on ensuring your child completes them. Think about what helped your child stay on top of their online coursework in the spring, and what didn’t quite go so well. What organizational strategies can be implemented to help? Some ideas may be visual hanging calendars, whiteboards, or schoolwork apps like Google Classroom. Also, check to see what the school has available, if there is an app they recommend or other scheduling tools they are offering. Procrastinating or falling behind in the first few weeks can add significantly more stress and have you and your child feeling frustrated and defeated right away. If your child has an IEP or 504 Plan in place at school, establish strong communication with the advisors and teachers right away, and make sure you there is a clear understanding of how the accommodations and needs of your child will be met.
5. Find outlets to help your child stay connected. If your child is going to school in person or staying home for e-learning, they will likely be missing some of their after-school activities. Find ways for your child to stay active. This could mean bike rides after school, outdoor sports like tennis that allow for distancing, or playing with neighbors outside. Some dance and karate studios are taking precautions such as masking to provide a safe outlet for kids. Look at signing up for virtual art or music classes. Talk to friends and neighbors to get ideas on what they are planning for their kids, and maybe you can work together on to come up with some activities.
6. Give yourself grace and be kind to others. These are very trying times and be assured that if you had to make a tough decision about your child’s education, you made the right one for YOUR family. No decision is right or wrong, it is simply what is best for you and your family. Don’t let others judge you or make you feel bad for what you have chosen, and don’t judge others for theirs. We all have had different personal factors to consider in making a selection of in person or online school. You are not alone in these hard times. Reach out to friends and family for both emotional support and also for help in ways like picking up your kids if you need or helping them get set up with school work if you are working. Don’t be afraid to ask for help and let go of any guilt if you can’t be present or don’t feel like you can help your child with all their work. Remember it takes a village, and this may be the year we have to get extra creative to make school successful
7. ​Take care of yourself. You can’t pour from an empty cup — You can’t be everything your family needs you to be if you are not taking care of yourself. Make sure you are getting adequate sleep, eating healthy meals, incorporating movement into your day and staying connected with friends. I also love mindfulness, yoga, and meditation to help with sleep, especially if it has become disrupted due to the excessive stress. Some good meditation apps are Calm, Headspace, 10% Happier and Insight Timer.

Dana Reid, D.O. 

Are you experiencing “FOMO”, or fear of missing out, when scrolling through social media and seeing an endless stream of photos of your friends having fun together while you are stuck home in quarantine?

Are you left wondering why other people seem to not be taking this virus seriously and why they are going about their lives as if we are not in the midst of a global pandemic?

Are you feeling frustrated or angry by the actions of others as the numbers of people infected surge throughout the country threatening a devastating impact?

Are you questioning if you are being too cautious or “paranoid” for turning down invitations to gatherings, maybe even feeling judged or mocked for your precautions?

Responses to this pandemic vary from one extreme to the other, as we all have seen. This has created a significant divide in our society, even some friendships and relationships have come under strain as a result. My own friends have expressed the thoughts mentioned above, as well as many of my patients. Numerous times I myself have had similar feelings. “Am I overreacting? Why isn’t anyone else here wearing a mask? Am I being too cautious?”

When this illness first began sweeping the nation, Stay at Home orders were implemented, and FOMO was not as common an occurrence. There may have been FOMO about not being in certain virtual gatherings or happy hours, yet it was lessened. We were all too busy baking banana bread, finishing a 1000-piece puzzle, creating endless crafts and doing projects around the home to make the time pass. THIS is what you saw as you scrolled through social media. People were staying connected virtually and checking on one another. We banded together as we all shared in this collective experience.

As states started to slowly reopen, each person realized their own level of comfort with resuming the “norm”. Some were eager to return to their routines, while others were not so sure about what felt safe. As the cases of coronavirus began climbing once more, a fear of going out intensified for many. But not everyone. Some who did not feel threatened proceeded to attend parties, go to crowded bars, take trips with groups of friends. Now photos of events like these began circulating online. Those who have been staying cautious, perhaps even isolating, were now left questioning if missing out on these events was really worth it and second guessing their decision to remain vigilant to possible exposure.

Feelings like these are not unique, and are actually coming up for a majority of us as we try to navigate this new territory. This entire situation is completely unprecedented, and we are now expected to make decisions we have never had to make before. How do we figure out what is right, best, and safest for ourselves and also our community? How can we maintain friendships with people who hold polarizing views from our own, and make choices we do not agree with? How do we balance our mental health needs while social distancing and protecting others?


Here are a few tips for how YOU can approach these situations

Acknowledge your Feelings
It is okay to feel sad, upset, or frustrated when seeing pictures of people getting together and feeling left out. Your feelings are valid and deserve to be acknowledged. Feel them, tell them to a supportive friend, and do not minimize them.

Recognize why you are making these decisions
Every decision we make regarding our response to COVID must be a calculated one based on assessing potential and probable risk. Generally, we each go about evaluating risk differently. Due to our personal circumstances, some of us may be wary, while others may be content to take on more liability. Factors such as the spread of coronavirus in our area, the state of our own health, and the health and vulnerability of those we come into contact with, all warrant our serious consideration. We are aware that the lowest risk of virus transmission is in a well-ventilated, outdoor space, no more than ten people, all a distance of at least six feet apart. COVID-19 is a severe, and at times, fatal illness that poses a threat for people of all ages. No one is immune, and there is no way to guarantee if you will have a “mild” case. Reports are now breaking of coronavirus patients developing lung, heart, kidney, and neurological complications even after being deemed “recovered”. If the time comes that you begin questioning why you are declining an invitation to a crowded event or gathering, remind yourself of your reasons. And remember, those who make different decisions from you also have their own reasons, so try not to judge.

Limit your use of social media
FOMO is only worsened when you are constantly confronted with pictures of a function you were not a part of. If seeing post after post has you feeling down, take measures to decrease your time spent on social media. Take breaks from it on weekends or evenings, and block or unfollow certain accounts as needed.

Share your thoughts with friends
Your true friends will understand if you are not feeling quite safe yet to spend time in close quarters and less social distancing. Tell them you miss them! Express to them how much you look forward to more time together when this is over, even if it means in several months or a year. Share your excitement to go to that concert next summer. Get creative with how you hang out. That could mean more Zoom or FaceTime meet ups, doing more small outdoor gatherings, playing a game of tennis, or going for a distanced hike. Try to find safe ways to socialize to balance your mental health needs and maintain social interactions.

Focus on what makes you happy and practice gratitude
There are many activities that can bring joy into your day, even during a quarantine. Some ideas may be exercising, learning a new hobby and trying new recipes. Think of what you can engage in, instead of what you can’t.

Let go of some friendships
It is perfectly okay to dismiss any toxic or unhealthy friendships where there exists much divide and misunderstanding. This pandemic has made it clear which friendships are a priority to us, and those are the relationships we nurture.
​
Remember this is temporary
These times are unprecedented and we are all in this together trying to get through. Everyone is exhausted, scared and experiencing COVID fatigue. We are all missing our “normal”. But remember, we cannot get there without making decisions that keep ourselves and our communities safe. We have to embrace delayed gratification and look out for the greater good.

by Dana Reid, D.O.

Senior year is usually an exciting time for most seniors and their families. Teens look forward to this special time and anticipate it for so long. Many memories and milestones such as prom, state championship games, final performances, senior trips and graduation ceremonies are created. Due to the global Covid-19 pandemic, senior year for students all over the country came to an abrupt halt in the middle of March. Students were informed that schools would be closed for the rest of the year and that schoolwork would be resumed from home. The last few months with friends and the planned celebrations have been stolen away. Graduations were becoming virtual and traditional ceremonies were cancelled or postponed to a later date. ​

Despite these circumstances that are out of our control, it is important that seniors celebrate their accomplishments and enjoy these moments as best as they can. Here are a few ways as a senior you can do this. ​

By Alexis Craft, Staff 

May is mental health awareness month. The facts are that mental illness is very common and affects all age groups. Do you know that 1 in 5 US adults experience mental illness each year and 1 in 6 youth ages 6-17 experience a mental disorder each year. 50% of all lifetime mental illness begins by age 14 and 75% by age 24. Suicide is one of the top leading causes of death and is the 2nd leading cause of death for kids ages 10-13. Suicide rates have increased by 31% since 2001. It is important that we talk about mental health, raise awareness and break any stigma around it. Stigma for many can be a barrier to seeking treatment. 

The stigma surrounding mental illness is a tale as old as time. Although there has been more awareness about mental health through the years, the stigma still exists. Many individuals struggling with mental illness continue to find themselves facing ostracism, prejudice, and discrimination. Why does this stigma remain? There is lingering misunderstanding around mental illness and that translates to fear, then stigma. When someone strays from the average, there is a label of “otherness” cast over that person. It’s a way for the majority to disassociate themselves from what they do not understand, and to rise to a superior position.

The impact of this stigma is far reaching and devastating. Some internalize this stigma and become so ashamed of themselves and embarrassed of their condition that they may hesitate to seek treatment, and untreated mental illness can lead to broken relationships, work or school dissatisfaction, substance abuse, decline in physical health and even suicide. Others may find themselves in a constant fight to prove their credibility as a person after their illness is found out by those who do not understand. Even well-meaning friends and family members perpetuate this stigma by saying things like “You aren’t trying hard enough”, “Just be happy”, or “It’s not that bad! You are just seeking attention”. You wouldn’t tell a diabetic person “Just produce more insulin!” would you? Comments like these trivialize and invalidate the experiences of those battling a mental illness, and only worsen what is already a challenging topic.

We must recognize as a society and a culture that mental illness is just as real as physical illness. This stigma is costing some extremely vulnerable people their peace and sometimes their lives. We are each responsible for doing our part to make this stigma disappear.


So what CAN we do to get rid of the stigma? Here’s just a few ideas.

• Have kindness and compassion for others. It costs nothing to be a friend, but it means everything to someone who needs it. Check in on your friends and family. If a friend seems more distant or withdrawn ask them what they may be experiencing.

• Talk about it. The best way to break the stigma is to talk about mental health openly. You will come to find that when you share your experiences, others will open up too and you will find support and feel less alone.

• Educate yourself and others. If you or someone you know has a mental illness, read about it and learn more. Talk with others who may have a similar diagnosis. Become familiar with it so it is no longer a foreign concept. If you hear someone making negative comments about someone experiencing mental illness, educate them.

• Keep an open mind. Understand that other people’s experiences are going to be different than yours.  Everyone is going through something and has their own unique story.

• Listen! Let others express themselves openly and honestly and listen without judgement.

​

​During this time of great uncertainty, most of us are feeling the entire spectrum of emotions. Fear can swallow us when there is a disruption to our world as we know it and as the unknown looms out before us. It can feel very scary not knowing what may happen to us or our loved ones and not knowing how things may change or how long this will last. The feeling of having no control over the situation can be very unsettling. 


Additionally, we are ALL grieving. We may be grieving the loss of a loved one, the loss of our sense of stability and security, the loss of our freedom to do what we want when we want, the loss of our jobs or businesses, the loss of big celebrations like graduations, weddings, planned trips, playing in a state championship game or the loss of time spent with our dear loved ones. Even as we are feeling uncertain or even lost, it is imperative that we prioritize self care and our mental health. Stress can substantially compromise our health and immune systems, and the spiral of anxiety will exacerbate our fear. Although we might be tempted to numb out these uncomfortable emotions, it is necessary to allow ourselves to feel them. It is important that we try to maintain a strong sense of normalcy as best as we can. We need to focus on what we can control if we are to find any stability in these trying times.
​

Here are some tips that can help you care for your body and mind during this difficult time: 


1. Keep a consistent structure and routine. Wake up at the same time every morning and try to go to bed at your usual bedtime. Get up and get ready for your day as if you were going to school or work. I know you might want to, but do not stay in your pajamas. You will be surprised by how much better you feel after you take a shower and get dressed. Keep meal times the same and for those in virtual school or working from home, work during the day and during similar hours. Open the blinds to get some sunshine and don’t spend your whole day in bed under the covers. 


2. Eat nourishing meals and snacks. Stay focused on fueling up with nutritious foods, and include a variety of fruits and vegetables, lean protein and healthy grains to help your body feel its best. Options might be limited now due to factors beyond your control, but do the best you can.  Stay hydrated and limit alcohol and too much caffeine. 


3. Stay connected with friends. Physical distancing and staying inside  can cause more social isolation which is not good for our mental health. Get on a Netflix Party and watch a movie with your friends, get a Zoom game night together, connect on video game platforms. There are so many avenues to stay connected by utilizing the available technology.  Reach out to your friends and check in on them and see how they are doing. 


4. Get out in nature a couple of times a day. Sit on the patio, go for a walk/run, go on a family bike ride.  It is therapeutic to escape the four walls of our house from time to time. Just remember to keep a 6-foot distance between yourself and others. If you are unable to get outside, open the windows! Sunlight is pure vitamin D, and vitamin D is a natural mood booster.


5. Make family memories. With more time together as a family, this is a great opportunity to create new memories and bond. Play board games or watch movies together. Cook meals and bake together. Try a new hobby together. Someday, you may look back at these times and be thankful for these memories and times together.


6. Limit your news. Limit how much time you spend watching the news or reading social media posts about the pandemic. It is important to stay informed so rely on 1 or 2  news sources that share accurate information. Absorbing the 24/7 news cycle is unhealthy. Stay informed but don’t spend all day everyday refreshing the coronavirus updates. Also, be careful watching too much news around kids. 


7. Exercise and move. Daily movement is a keystone of physical and mental health. Working out from home is gaining tremendous momentum, and all you need is a living room floor or another small space to move. If you belong to a gym, see if your gym is streaming classes or has on demand classes. YouTube has free workout videos and  some companies like Peloton are offering a free 90-day app for everyone during this time. Instagram has a number of free at-home workout videos for every experience level. The workout does not have to be perfect or pretty or use the latest and greatest equipment. All that matters is you get your heart rate up and maybe even a little sweat going.


8. Show compassion and kindness. When we take the time to help another person it makes us feel good and allows us to stay connected to others. Offer to pick up groceries and medications for a neighbor or someone who is elderly. Have an extra roll of toilet paper? Give it to someone who needs it. This whole situation gets a little easier to bear when we are looking out for one another. We might be physically distancing, but we are all in this together. 


9. Be creative. Creative outlets can be very therapeutic and is a great distraction from what is going on around us. Try your hand at painting a canvas or doing fun crafts. Start journaling, writing or blogging. Decorate a small area in your place. Try a new hobby or learn a new instrument or language. Sign up for an online classes like photography or cooking.  With more free time, this may be the opportunity to discover those interests you always wish you had the time for. 


10. Show gratitude. When it seems like we are surrounded by negativity, it is paramount we shift our perspective and appreciate every small ray of light in our lives. Start that gratitude journal you always thought about starting. Write out 2 or 3 things every day that you are grateful for. Try to be specific.  It might be easy to come up with a whole list, but if you are struggling to come up with even one, remember it can be simple. The kids may have drained you, but aren’t you grateful for the afternoon spent chasing them around the yard or laughing with them? What about that beautiful sunrise that you woke up or that cup of coffee that you enjoyed?
​

11. Yoga and meditation. Meditation and yoga reduce anxiety and improve sleep. There are several meditation apps like Calm, Headspace and Insight Timer. You can do yoga videos on YouTube. Spotify has numerous guided meditations for when you need to ground yourself in the present moment. Something as simple as listening to calming sounds or music for a few minutes a day can relieve a tense mind. 

I hope you have found these tips helpful and are able to incorporate them into your days ahead. Remember to stay in the moment, be present and stay connected with others. We are all in this together!

Dana Reid D.O.