My nine-year-old daughter recently told me she wanted to curl into a ball and roll away. She also often complains of tummy aches, for seemingly no reason (anxiety in children often shows up as belly aches). Like many other kids, she has not physically been in school for more than a year. She misses her friends and her teachers. She’s experienced one disappointment after another, and real-world worries have infiltrated her innocent bubble. Her experience is not unique.

Children are some of the true heroes of the pandemic; they’ve shown us grace, patience, and resilience. But they are suffering too. According to the Centers for Disease Control and Prevention (CDC), emergency room visits for mental health-related issues increased by 24 percent for children ages 5-11 and 31 percent for children ages 12-17 in 2020.¹ Even before the pandemic, children and teens were experiencing skyrocketing rates of anxiety, depression, and other mental health issues, but the pandemic has compounded the problem. Many of the things that are integral to children’s and teens’ mental wellbeing have vanished over the last year and a half—being with their peers, feeling safe, taking part in social/extracurricular activities, spending time with extended family—and while we seem to be moving toward a semblance of normality, the mental effects could linger. Here’s what we can do to support our kids’ mental health right now, and for the long term.

1. Re-evaluate Their Diet

A global pandemic has made it all too easy to cave to our kids’ requests for unhealthy food (guilty as charged), but a healthy diet is absolutely critical for mental wellness. A study published in the journal PLOS ONE examined the diets and mental health of nearly 3,000 adolescents between the ages of 11 and 18 over the course of two years and then again two years later. Even when accounting for socio-economic status, gender, and physical activity, the kids with healthier diets had better mental health. The researchers qualified a healthy diet as two or more servings of fruit per day, four or more servings of veggies per day, and eating food from home versus restaurant/fast food. The unhealthy diet included frequently eating cookies, chips, french fries, candy, soft drinks, and food bought outside of the home. The researchers also found that when the kids’ diets improved, so did their mental health, while reductions in diet quality were associated with “declining psychological functioning” over the follow up period.²

2. Supplements Lend a Helping Hand

Because all parents know that it’s impossible to follow a perfect diet all the time (and because there are just some nutrients we can’t get optimal amounts of from food), supplementing with a quality kids’ multivitamin will round out any nutritional gaps in your child’s diet. In addition to a multivitamin, the following supplements help support mental wellness:

• A fish oil supplement containing DHA and EPA is a must for children’s and teens’ brains. These fatty acids are essential for normal brain function and support learning, focus and attention, and healthy moods. It may also help if your child is challenged with aggressive behavior: A study conducted at the University of Pennsylvania found that an omega-3 supplement (containing 1 gram of EPA/DHA combined) reduced aggressive and antisocial behavior in children, as well as improved symptoms of depression and anxiety. Virtually no child eats enough fatty fish to obtain optimal amounts of these brain nutrients, making it a vital supplement. ^{3 4}
• Magnesium is a wonderful supplement for promoting calm, and is especially good if your child struggles with anxiety, feeling stressed, or has trouble with sleep. Magnesium is a must-have mineral for the nervous system and common symptoms of deficiency include anxiety, irritability, and insomnia or other sleep issues. Magnesium comes in a variety of kid-friendly forms, including powders and gummies, or try a relaxing Epsom salt bath for your child before bedtime (bonus points if you add a few drops of calming lavender essential oil).
• We know that the gut microbiome directly affects mood via the gut-brain axis. Probiotics help maintain a healthy balance of bacteria in the gut, supporting healthy moods and a healthy digestive system (stress and anxiety can manifest as digestive issues like constipation, bloating, and belly aches in children). Supplementation with probiotics is especially important if your child has ever taken antibiotics. 
• The herbs lavender, lemon balm, and chamomile are calming and soothing to the nervous system and are gentle enough to safely use in children. These herbs can help bring calm, ease nervousness and anxiety, settle upset bellies, and promote sleep. ^{5 6} You can find them in teas (having a cup of calming herbal tea with your child before bedtime can be a delightful routine) and in supplements formulated specifically for children. You can also find them as essential oils to use in a diffuser or in the bath (never use essential oils internally).

3. Reducing Screen Time Is Key

Kids and teens were already spending a lot of time on screens before the pandemic, but with distance/remote learning the new norm, screen time has gone through the roof, and it’s not good for our children’s mental health. A study published in 2018 investigated how screen time affected the mental health of kids between the ages of two and 17, and confirmed what we already knew—as screen time increases, mental wellness decreases. Among the 40,337 kids the researchers evaluated, those that spent more than an hour on screens each day (including phones, computers, video games, and TV) were determined to have lower self-control, were more easily distracted, had less emotional stability, and were more difficult to care for. Among 14 to 17-yearolds, those that had seven or more hours of screen time each day were more than twice as likely to have been diagnosed with depression and/or anxiety and to have been treated by a mental health professional or taken medication for a psychological or behavioral issue in the past year.⁷ Seven hours may seem like a lot, but it’s the average time most teens spend on screens (eight to 12-year-olds spend a little less, at 4 hours and 44 minutes daily).⁸ We know that screens are never going away, but as the saying goes, everything in moderation.

4. Embrace The Great Outdoors

While our kids are spending endless hours on their screens, they are spending virtually no time playing outside. According to the National Recreation and Park Association, on average, children spend less time playing outside than any other generation—only four to seven minutes a day. That may have shifted for some kids during the pandemic, in which escaping outdoors has been one of the only changes of scenery we have been afforded, but in relation to screen time, there is a lot of room for improvement. The connection between nature and our mental wellbeing is so striking that scientists have begun to study it, and the research proves just how important outdoor time is for kids (and adults too), with children who spend more time outdoors tending to be happier, more attentive, and less anxious than kids who spend more time indoors. One recent study found that spending 20 to 30 minutes a day outside reduced levels of the stress hormone cortisol by 21 percent. The time of day or specific setting didn’t matter—yard, park, or other green spaces all led to a cortisol drop. Other recent research has found that more nature exposure in childhood leads to better mental health in adulthood.^{9 10 11}

5. Let Them Feel Their Emotions

Kids and teens have missed out on so many special events and activities in the last year… they have a reason to feel sad and frustrated. One of the best pieces of advice I’ve heard regarding this is to normalize (and expect) sadness. Let them know it’s okay to feel sad, frustrated, angry, disappointed, etc. and support them through it. In that same vein, giving them the gift of presence goes a long way in nourishing their mental health. Sometimes all our children need is a little extra attention, some one-on-one time with their parents, or just a good old-fashioned hug.

References

1.  Leeb RT, PhD, Bitsko RH, PhD, Radhakrishnan L, MPH, et al. “Mental Health-Related Emergency Department Visits Among Children <18 Years During the COVID-19 Pandemic—United States, January 1-October 17, 2020. Centers for Disease Control and Prevention Weekly, Nov 13, 2020;69(45): 1675-1680 https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a3.htm
2. Jacka FN, Kremer PJ, Berk M, et al. “A Prospective Study of Diet Quality and Mental Health in Adolescents,” PLoS ONE. Sept 21, 2011;6(9). https://journals.plos.org/plosone/article?id=10.1371/journal.pone.00248…
3. Amen Clinics. “New Evidence on Omega-3s for Behavioral Problems in Children,” Oct 12, 2020. https://www.amenclinics.com/blog/new-evidence-on-omega-3s-for-behaviora…
4. Raine A, Portnoy J, Liu J, et al. “Reduction in behavior problems with omega-3 supplementation in children aged 8-16 years: a randomized, double-blind, placebo-controlled, stratified, parallel-group trial. Journal of Child Psychology and Psychiatry, 2015;56(5): 509 https://acamh.onlinelibrary.wiley.com/doi/abs/10.1111/jcpp.12314
5. Low Dog T, MD. “Three Herbs for Kids,” Sept 9, 2019. https://drlowdog.com/three-herbs-for-kids/
6. Koulivand PH, Ghadiri MK, and Gorji A. “Lavender and the Nervous System.” Evid Based Complement Alternat Med. March 14, 2013 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612440/
7. Twenge JM and Campbell WK. “Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study.” Prev Med Rep. 2018 Dec; 12: 271-283. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6214874/
8. Siegel R. “Tweens, teens and screens: The average time kids spend watching online videos has doubled in 4 years.” The Washington Post, Oct. 29, 2019 https://www.washingtonpost.com/technology/2019/10/29/survey-average-tim…
9. Wells NM and Evans GW. “Nearby Nature: A Buffer of Life Stress Among Rural Children.” Environment and Behavior, May 1, 2003. https://journals.sagepub.com/doi/abs/10.1177/0013916503035003001
10. Preuss M, Nieuwenhuijsen M, Marquez S, et al. “Low Childhood Nature Exposure is Associated with Worse Mental Health in Adulthood.” International Journal of Environment Research and Public Health, 2019 https://www.sciencedaily.com/releases/2019/05/190521193735.htm
11. Hunter MR, Gillespie BW and Chen S Y-P. “Urban Nature Experiences Reduce Stress in the Context of Daily Life Based on Salivary Biomarkers.” Front Psychol. April 4, 2019. https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00722/full