“One of my friends said once, that once the pandemic is over, we’re not going to remember how to hug anymore,” Pozgay said Tuesday.
A pandemic that abruptly shut down in-person school early last year has reshaped the lives of Portland-area kids and teens. It isn’t just academics they have missed for nearly a year, it’s activities, sports, making and dissolving friendship, the entire in-person physical component of their social lives.
During the last 10 months, students across the state have reported feelings of isolation and a sense of loss over the personal connections to both their peers and educators. A Newport teen who flourished in social settings honed her chatterbox tendencies on her mother. An elementary schooler in Portland said, simply, “I miss my teacher.”
This destruction of the social part of kids’ lives is having a multitude of consequences and Portland doctors are concerned about trends towards unhealthy coping mechanisms they are seeing in young patients.
Dr. Rodney Reid, a child psychiatrist and medical director of the Providence St. Vincent’s Eating Disorders Partial Hospitalization Program, has seen “a significant increase in people suffering from restrictive eating disorders, binge purging behaviors.”
As soon as schools shut down last March, there was an increase in referrals for partial hospital treatment, he said earlier this month.
“A significant increase and that was immediate,” he said, adding he soon discovered this was a nationwide phenomenon.
Reid is careful not to speculate or oversimplify the complex causes of eating disorders, but, he said, the loss of structure is a big factor.
For kids who are already anxious and have obsessive perfectionist tendencies, he said, “You go from having all of these ways to externally manage your anxiety and obsessive traits and now you’re at home and you’re looking at the wall.”
“Another way to think about an eating disorder is just it being an unhealthy coping strategy,” Reid said. “It’s one of many unhealthy coping strategies.”
While anorexia is a complex illness, he said, one way of helping someone work through it is by helping them develop healthier ways to manage unwanted thoughts and feelings.
The stressor of the pandemic and its fallout has put pressure on everyone’s coping mechanisms, Reid said.
“So those that had a vulnerability for an eating disorder,” he said, “you just saw an increase in that being expressed.”
The difficulty of managing stress is showing up for kids and teens in a multitude of ways.
Dr. Kyle Johnson is a professor of child and adolescent psychiatry at Oregon Health and Sciences University who directs the service that sees kids who need psychiatric consultations at Doernbecher Children’s Hospital.
The good news, Johnson said, is that they have not seen an increase in the number of kids coming to the emergency room with suicidal ideation or suicide attempts.
That said, he added, “We have seen more total kids and I think that speaks to the impact of chronic stress on the management of medical problems.”
One of the most consistent things Johnson hears from patients struggling during the pandemic, he said, is: “I can’t hang out with my friends.”
“We’ve seen more kids that have medical symptoms that stress is impacting,” Johnson said, “which could be kids that get worried about vomit or vomiting and then aren’t eating much and then they don’t eat enough and they get malnourished and they have come into the hospital.”
And the issues go beyond kids suffering acute issues that require hospitalization.
Dr. Lisa Denike, chief of pediatrics for Kaiser Permanente Northwest, has seen what she called “a pretty alarming rate of weight gain” in kids coming into her clinical practice, with patients gaining up to 10 or 20 pounds.
“We’re really worried,” she said, noting these gains put kids “at risk for obesity-related diseases as they get older.”
Denike believes there are multiple causes of this weight gain — a more sedentary life because of online school and canceled sports and activities, the ability to graze on snacks all day, and stress.
“One of the ways that a lot of people cope with stress is to eat,” she said, “especially comfort foods because those, unfortunately, release feel-good hormones.”
The effects of this kind of weight gain can have long-term implications, Denike said.
“The fear is, especially for the tweens and the teenagers, as they get older it gets even harder to lose it,” she said.
Going into adulthood, extra weight can lead to high blood pressure and diabetes, as well as increase the risk for certain cancers, she said.
Whether the issues are acute or potentially long term, the future is not hopeless for these kids.
“Kids and teenagers are remarkably resilient,” Johnson said.
For parents who want to help their kids navigate this difficult time, the doctors all suggested different ways of creating a healthy lifestyle,
Denike recommended not focusing on the scale, but instead encouraging 30 to 60 minutes of “sweaty” exercise a day.
“I’m a big believer in educating parents,” Johnson said. “The kids might see me once a week for therapy, but they are living with their parents.”
So, he tells parents to learn how to manage their own anxiety and seek their own support. Johnson also encourages parents to share their anxieties with their children.
“Being able to share your emotions in a healthy way is powerful,” he said.
Johnson also recommends letting kids see each other in person using proper social distancing, including masks. That will give them a reminder that their friends are all still here.
For Reid, a major concern is the online world that has filled the social vacuum.
“The entire advertising, attracting-eyeballs, attracting-clicks world we live in doesn’t care one iota what that does to the developing brain,” Reid said.
Instead, it creates an impossible ideal to measure up to and doesn’t teach kids how to deal with real problems.
“There’s not a trip or a trick” to protecting your kids, Reid said. “It’s engaging at every step of development of a child. It is avoiding the isolation and atomization that modern society is moving people to.”
Sometimes, Reid said, that means “realizing that if you’re going to do the right thing for your kid you’re probably going to really, really upset them as your kids try to fit in with the brainwashed masses.”
“Otherwise,” he said, “you are accepting essentially letting algorithms program how your kids think and behave.”
Some families have weathered the stresses of the pandemic together, Reid said, by playing games together, turning off the TV, taking walks and spending time together.
Still, he said, the impact this pandemic will have on young people is not likely to disappear.
“These are critical times — you can’t get these times back,” Reid said. “The longer this goes on, the more accumulative damage you’re going to get that isn’t reversible.”
Eder Campuzano contributed to this report.
— Lizzy Acker
503-221-8052, lacker@oregonian.com, @lizzzyacker
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