My focus for today’s post is stress and anxiety and ways to support young people; children, teens and young adults, specifically those with developmental and cognitive disabilities, who are experiencing anxiety in response to the COVID -19 pandemic. But in gathering my thoughts and ideas on this topic, I realized that zeroing in on coping strategies or stress management interventions specifically for this population of young people may not be the most effective approach. Whether you are a young person with a cognitive or
developmental disability, or the parent or family member of a young person with a cognitive or developmental disability, the teacher or friend of someone with a cognitive or developmental disability, or even someone with no connection to anyone with a developmental or cognitive disability – chances are you are feeling pretty stressed and anxious right now. And, as in any situation, each individual’s stress and anxiety is impacted by the stress and anxiety of those around them. It seems much more impactful to address anxiety from a somewhat broader perspective.
It’s helpful to bring to mind the airplane oxygen mask analogy here: “In case of an an emergency, put on your own mask first, before assisting others.” As parents we have to be able to help ourselves first, to be able to manage our own stress and anxiety, before we can help our children. We can’t help someone else to regulate if we’re feeling unregulated ourselves. Children and teens react, at least in part, to what they see and perceive in the adults around them. When parents and caregivers deal with stressors calmly and confidently, they are more capable of supporting their children.
Helping our children to self-regulate via co-regulation strategies is an important concept that we’ll discuss further below.
Luckily, the things that impact the level of stress and anxiety we feel, both negatively and positively, are pretty similar no matter who we are. And although right now we may be experiencing and exhibiting it differently, the bottom line is: we are all stressed.
Let’s start by talking about stress and anxiety. One of the many things we know to be true about stress and anxiety for all human beings is that these feelings increase significantly as a result of stressful situations that are unpredictable, uncontrollable and chronic or ongoing. Obviously all three criteria are present in our current worldwide situation. So not only are we all stressed, but we’re also likely anxious and a bit scared.
It’s extremely important, however, to keep in mind that stress and anxiety are reasonable and rational responses to our current situation, reasonable and rational responses to being besieged by a danger that is hard to predict, difficult to control and where there is no obvious end in sight. There is no way to completely free ourselves or our children of worry and anxiety in relation to the current pandemic. And to be honest, being completely worry free would not necessarily be a good thing right now, as fear and anxiety help to keep us safe in times of danger. Fear and anxiety signal us to take notice, to be aware, to stay safe. So on some level, not only is anxiety reasonable and rational, but when managed effectively, it can also be helpful. On the other hand, too much fear, anxiety and stress can lead to feeling overwhelmed and frozen, resulting in inaction or overreaction. Finding that all important balance, as always, is key.
Use Proactive Strategies
So how do we learn to embrace, or at least tolerate and manage, our anxiety so that it works for us and not against us? First we need to accept that we will all feel some level of anxiety and stress throughout our lives. It will look and feel different for each of us but it’s there. Next is to understand that although we may not be able to control all that is going on in the world around us, we can learn to better control what is going on within our own small piece of this world and to better control what is going on inside of us.
For this we turn to proactive strategies. Proactive strategies are things we do proactively – to help manage a potential situation, in this case anxiety – rather than waiting for the anxiety to be out of control and then using “reactive” strategies to attempt to get it under control. Proactive strategies require preplanning and forethought and some upfront energy, but they hopefully lead to long term and ongoing results.
Here are some proactive strategies you can try to help keep your child’s anxiety form exploding out of control.
Normalize Change and Support Flexibility
Like most of us, young people with developmental and cognitive disabilities feel an increased sense of safety and security when there is structure and predictability in their lives and at least to some extent, in their daily routines. But right now almost everything is different. No matter how much we try to provide predictability, familiarity and structure for our children, almost every part of their day is different than it used to be. Normalize discomfort with things that are new and different. Remind kids what great problem solvers they are. Say things to them like: “Remember when _______ was new and so hard for you? But you kept working at it, and you got used to it, and today it’s not hard at all.”
Ask your kids to share about other times that they solved a big problem. Share similar experiences about yourself. Children and teens react, at least in part, to what they see and perceive in the adults around them. Anxiety is contagious. We all know that to be true. That’s why toilet paper has become such an unexpectedly hot commodity! Overly anxious adults convey to their children that the world is a dangerous place. And although to some extent that is true, perhaps more today then ever before in most of our lifetimes, our homes, our own small piece of this world, must be the safe refuge that we can all rely on.
Help your child or teen to develop their problem solving skills. Problem solve with, not for, your child. Resist the impulse to jump in and fix everything. Remember that anything your child can do for themselves, they must do for themselves. When we do for our child we are communicating that we believe they are not competent. We are telling our children that we don’t believe them to be capable and we are reinforcing their sense of fear and self doubt. Instead allow your child to make a mistake and find the right answer on their own. Model effective problem solving in the way you respond to difficult situations.
Limit the amount of news and social media that you allow to bombard your home and your child’s world. Children and teens may misinterpret what they hear and can be frightened about something they do not understand. If your child is on social media with friends it’s especially important right now to be monitoring things like texts, video chats, video game play, etc. Be sure that your child is communicating with peers and others in a safe and appropriate way. Many young people experience a great deal of stress and anxiety related to online media conversations with peers. Also be aware of who your child is communicating with and make sure that they are all individuals known to you and your child.
When watching movies or TV shows try to watch things that are uplifting or funny. If you enjoy drama, adventure, horror etc., try to avoid movies or TV shows that depict pandemics or end of the world scenarios. Nothing good will come of that.
Sometimes crying and pushing our limits emotionally can be cathartic. If you need that experience watch a more typical tear jerker, preferably with a happy ending.
Establish media-free times for everyone. For example no screens during meals, after a certain time in the evening and most importantly at night in bedrooms.
Help your child to create self supports. These are tool kits that they can go to when they need to self calm. Again do this with, not for, your child. Help your child to create a calming box or list. Brainstorm together and come up with things that are soothing, distracting, comforting in some way and list them or load them into a box or basket where they’ll be immediately available when needed. Why not make one for yourself as well?
Likewise, help your child to create a “calming” or “feel good” play list. Have your child choose 4-5 songs that immediately calm them or make them feel good. Create one for yourself as well. Music is magical in that way. Think of those songs that immediately calm you or bring about feelings of joy. Your choices will likely be quite different from your child’s, which is as it should be.
We continue to hear the term “social distancing” all over the news. I prefer the term “physical distancing” which refers specifically to the amount of physical distance we have to keep between ourselves and others. We can socially connect without physically connecting. Regular virtual social connection helps us combat loneliness and the sense of sadness related to social isolation. Establish ways for you and your child to continue to communicate with friends and family. Be social virtually. Talk to friends via phone and text. Connect via Skype, FaceTime, Zoom, etc., as seeing those we love and care about helps us to feel connected. Schedule times to celebrate special occasions, play games or watch a movie or TV show with friends or family on-line.
Do something fun with your child every day. Play, laugh, dance, sing, stretch, run, jump, have conversations, organize old photos while you reminisce. Indoors or out, find new ways to experience joy or bring back some old ways. Stay busy with meaningful activities. Board games, puzzles, crafts, home repairs, and gardening are all ways to keep close and stay connected.
It’s easy when doing school work and/or working from home to fall into irregular sleep patterns – going bed too late, sleeping in too late in the morning. There’s nothing wrong with having a little bit more flexible schedule, but be sure that you and your child still get an adequate amount of sleep each night. Children and teens should get 8-9 hours of uninterrupted sleep each night. Most never do. Adults would benefit from the same. Even small amounts of sleep deprivation will negatively impact our mood, ability to focus, level of energy and patience. For those who already have issues with anxiety or depression, lack of sleep is even more problematic. So do your best to go to bed and wake at around the same time each day as this will increase the likelihood of getting enough sleep.
Get up and move every day. Many, many studies have unequivocally shown that physical activity is a vital and highly effective way to reduce and manage anxiety and depression, and positively impacts overall wellbeing. Move by doing things you enjoy every day. Get outside if you can, and walk, bike, play – while of course being careful to respect the required six feet of physical distance. If you can’t get outdoors, move indoors – stretch, find fun workout videos, have indoor scavenger hunts. A beach ball can be great fun for ball play even indoors.
If you already meditate, good for you! Try to commit to daily practice. If you don’t already meditate, this is a great time for you and your family to learn.
Meditation is not related to any religious practice unless you choose to make it so. Meditation is simply a way to calm the mind and body. If you’d like to try it, here are four easy steps. Start with five minutes and increase over time if you like.
Sit comfortably in a chair, or on a pillow or mat on the floor.
Close your eyes or lower your eyes by looking down at the floor.
Breathe naturally, in through your nose, out through your mouth.
Focus your attention on your breath. With each inhalation and exhalation focus your awareness on on how your breath moves through your chest, into your belly and back up again. If your mind wanders, simply return your focus back to your breath.
That’s it! You can play calming music while you meditate or just sit quietly.
If meditation is not your thing try mindful practices such as:
Slowly inhale and exhale while counting to ten or twenty or backwards from ten or twenty.
Slowly tense and release hands while counting to ten or backwards from ten.
Doodle or practice Zen Doodling to music
Tightly hug self and release while inhaling and exhaling and to a count of ten.
Just try – that’s all I can say about that! Try to avoid stress eating. Instead eat the things you love in reasonable amounts and allow yourself to enjoy it. Do keep in mind that too much sugar and caffeine can cause the same types of problems as sleep deprivation.
Be a Role Model
Set a great example for your child. Take breaks, get plenty of sleep, eat well, play, exercise, be mindful of your own “screen time” as well as what you are watching.
Try your best to manage your own anxiety. Find ways to connect with your friends and family members and talk about things other than the Coronavirus. Be especially kind to others in word and deed. Our children are watching and learning from us.
Respect privacy. Although we need to try our best to stay connected, everyone needs a place to withdraw at times and an opportunity to retreat to a private space to be alone when needed.
Focus on the Here and Now
Try your best to maintain focus on the here and now instead of focusing on what might happen, what could happen, etc. Plan ahead but avoid getting stuck in “what if” scenarios. And avoid catastrophizing, especially in front of or within earshot of your children. Remember, anxiety is contagious.
If you are lucky enough to be “Safer at Home” with family members or others that you care about, remember the importance of human touch. Hugs, cuddling, physical touch are human needs that help us to feel safe and calm and regulated and loved.
Learn and Practice Controlled Breathing Together
This is a great stress reducer but it’s important to learn and practice in advance so it’s available to use when needed. Explain that when we inhale our lungs expand to take in air.
Start by practicing:
Breathe in - for count of 5
Hold breath - for count of 3
Breathe out for count of 6
Try to do this at least 3 times if possible. You can add seconds and repetitions as it becomes easier or shorten if this timing is too difficult.
Next add some activities:
Bubbles: Dip bubble wand and hold as you breathe in for 5, hold for 3, breathe out to blow bubbles for 6. Repeat aiming for larger and larger bubbles.
Pinwheels: Breathe in for 5, hold for 3, breathe out to blow pinwheel for 6.
Slinky: Do this sort of like you would using a concertina (a sort of small rounder accordion.) Holding one end of the slinky in each hand, breathe in for 5 as you expand your arms and the slinky as wide as you can, hold for 3 and breathe in for 6 as you bring the slinky back together.
Responding to and Helping Your Child to Manage Anxiety
As noted above, anxiety is not something we can or should seek to eliminate completely. No matter what we do we and our children will experience anxiety. The best way to manage anxiety is to use proactive strategies like those noted above. If anxiety rages out of control anyway, here are some co-regulation strategies to try.
Most of you probably know the term “self-regulation” which refers to managing thoughts, feelings and behavioral responses. Improving self-regulation is often a goal on an IEP or Behavior Plan. The best way to help children, teens and adults with or without developmental and cognitive disabilities to learn to self-regulate is to practice co-regulation. We use it all the time, as parents, in schools, in therapy – we just might not use the term “co-regulation”.
Co-regulation typically involves an adult emotionally supporting a child, teen or adult. Co-regulation does not include punishment, consequences, yelling, threatening, bribing, isolation, restraining, or physical aggression of any kind. Co-Regulation involves teaching and/or coaching within a warm, responsive relationship, in a physically and emotionally safe, predicable and supportive environment.
In co-regulation the focus is not on the behavior but rather on the emotions that motivate the behavior. It involves staying in the moment, in the here and now. It may involve practicing controlled breathing together as noted above. It may involve using strategies such ask a child to name items in a room, list favorite Pokemon or Mario Kart characters or Disney princess or villains, sing a memorized song, rock (with or without a rocking chair), progressive relaxation, swing together on swings, bounce on stability balls or throw a ball back and forth in a close space (beach balls are great for this; they’re easy to catch). Co-regulation allows young people to calm, to feel a sense of control and safety and to reduce feelings of stress and anxiety.
In this challenging and difficult time I hope this information is helpful to you and your family. Remember to keep connected to those you love and care about and to add moments of joy to every day.
Sending love and support and wishing you all health and peace.