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The Lasting Effects of a Pandemic on Adolescents

Dr. Rebecca Zarko some of the ways that the pandemic can affect adolescents.
The Lasting Effects of a Pandemic on Adolescents
Featured Speaker:
Rebecca Zarko, MD
Rebecca Zarko, MD is board-certified psychiatrist on the Medical Staff at Southwest General.

Scott Webb: As we enter year two of the COVID-19 pandemic, its restrictions can be felt across the board. For young children and teenagers, restrictions have meant almost an entire year of virtual learning, isolation from friends and family and the cancellation of many important milestones and social activities such as sports, school performances, graduations, proms and more.

But as individuals 16 and older begin to receive the COVID 19 vaccine, a glimmer of hope at the end of this long COVID tunnel can be felt. And joining me today is Dr. Rebecca Zarko. She's a child psychiatrist with Southwest General. And this is Southwest General Health Talk. I'm Scott Webb.

Doctor, thanks so much for your time. As I was mentioning to you, I have two teens myself. So what are some of the ways that we can help kids during these challenging times, even though there's a glimmer of hope and there's light at the end of the tunnel? What can we do to help prepare them for what's next?

Dr. Rebecca Zarko: I think it's been a challenging time as you mentioned for everyone. And some of the things that I've been reading about are framing the whole COVID experience, so to speak, as a prolonged crisis or a trauma that our entire nation has been through together. Not only just dealing with the COVID part of it as far as people dying or people getting sick, but also the effect on the social life, I think you mentioned, with your teens and even the financial impact, parents or people having to find different work or being furloughed or whatever. So it's been a prolonged crisis or prolonged stressor for entire families, our entire nation and teens and adolescents are a big part of that who I primarily work with and see.

My observations from this past year and a half or so have been that kids are struggling, maybe more so than others. And that the entire family has been affected, the family unit has been affected. And when parents are affected, their kids are affected no matter what age they are. And it's been challenging.

I think it's interesting that when we're going through a crisis or stress, a lot of times the focus is just on getting through it. And sometimes the aftereffects when things start to settle down is when things really hit you and you start to go, "Okay, what do we do now?"

I think that during the shutdowns and such, one of the biggest things that I saw happening was a lack of structure and schedules. And a lot of that had to do with being forced to do the online learning. And so a lot of my kids and parents do have that feeling of like, "Well, what day is it today? Is it Monday or Sunday? Or is it Wednesday?" Because they didn't really have that structure of, okay, you get up and you go to school and then you go to your basketball practice and then you come home and you do your homework. And then you go to your part-time job or whatever it is.

So all of that kind of went away, right? And so everybody became very lax in their schedules. So kids were staying up all night, sleeping all day, doing their schoolwork online at all hours of the day if it wasn't structured, if they even did their online schoolwork. And then they didn't have the things that they would normally have to do, their sports, their job, their social stuff.

And so I think that with getting back into things being more normal or going back to the old way of normal, I guess, one of the things that I would say is really important is sort of slowly, but surely implementing those structures and those schedules back into place. And it's going to naturally happen, right? With schools opening and being in person and sports opening up and people going back to work, even the teenagers doing their teenage jobs and stuff. So things are naturally moving in the direction of like the expectations are going to be what they were pre-COVID, as opposed to like during COVID where maybe the expectations were a little bit different, what you needed to do was a little bit different. So I think that part, saying, "Okay, we're not going to be staying up all night anymore. You've got to go to bed at a certain time. You got to get up at a certain time. There's certain expectations that we have for you" I think will be helpful.

One of the things that happened a lot during all this downtime and stay-at-home time is like screen time went up a tremendous amount. So when they looked at how kids and teenagers spend a ton of time on their devices and in front of screens, I believe it almost doubled in the amount of time spending on their screen. So a lot of kids can benefit from having limits to their screen time. And that might be a slippery slope because parents may have gone a little too far, have been a little bit more lax about the screen time. And now that things are getting a little bit more back to the way they were pre-COVID, limiting that and putting structure on things I think it will be very helpful as the kids move forward and getting back into kind of how things were before.

Scott Webb: Yeah, I think you're right. And as I'm listening to you thinking back, you know, to our house, and I know that there were times I found myself just wandering around the house in the middle of the night and eating a lot of comfort foods and just generally being more lenient with my kids. Eating in their bedrooms is something that we never did before. "But well, I've got to get to class. I've got class in five minutes. I don't have time to eat lunch down in the kitchen, dad." And so we said yes to a lot of those things, both because we wanted them to do well in school. We wanted to be sort of cool parents during a difficult time and so on. So I think you're so right, that now trying to pull back a little bit, set some limits, have some structure. And I'm sure a big part of this is just sort of establishing good communication with our kids, right? We may have had it before the pandemic and we may have struggled during, but we need to try to get back to that probably as much as possible, right?

Dr. Rebecca Zarko: Sure. Of course. I mean, communication is really always an important thing in any relationship, especially with your kids. And it's more challenging a bit with teenagers, because they are in that transition period going from being a child to being an adult. And you want to give them some autonomy and have more discussion with them and negotiate things with them as opposed to being overly directive as you would be maybe with a smaller child. So I think that's important to keep in mind too.

I think that this whole shut down and being away from the normalcy of the things that teenagers would do anyway, as we talked about, school, extracurriculars, jobs, whatnot, they didn't have the opportunity to do that sort of growth away from the family, which is developmentally what they're supposed to be doing at this time. Part of the developmental task of a teenager is to figure out how to like separate and become an individual separate from your family unit. How do I interact with people outside my home, whether that's peers or teachers or bosses or coaches? How do I organize my time?

Teenage brains are still developing and growing into their mid-twenties. And so that executive function development of having to figure out, "Well, how do I schedule my day? How do I plan to do all of my activities and my homework and make sure I have time for my friends?" And so all of that kind of got taken away, the ability to do those things, because we didn't have the option to do those things. And so they've lost some, they 've lost a bit in that developmental process through this past year and a half of not having the opportunity to do those things.

I think the other thing I would say is that everybody got a little bit stunted. Everybody went a little bit backwards in a way, as far as like some of those developmental challenges, because they weren't having the opportunity to practice how to organize their lives or practice those social interactions with people outside of the family in person, dealing with peers, bosses, other adults, those kinds of things.

So I think it's also important to realize that there was a little bit of a loss. But it's not like you get to do a redo, you just have to move forward. So I was thinking about this today. If you're a 10th grader going into 11th grade or whatnot, I mean, maybe it wouldn't be as much of a challenge to adjust to, "Okay. I'm in 11th grade. Okay. My 10th grade year was a lost year" as opposed to like, if you were a freshman or a senior where you really didn't know have that experience that you would normally have with typical freshman year, a typical senior year. And you're just moving on. So if your senior year was all online and you didn't really get all of the benefits of being in in-person learning and now you're just going on and you're going on to college and you're just going to hopefully figure it out, you know? So I think those are some things that I see as challenges.

I've had a lot of kids, seniors who delayed starting college, because they didn't want to do online or virtual college. They wanted to have in-person classroom learning. And so you have to decide where you're going to apply and decide where you want to go midway through your senior year, right? And so a lot of the seniors at that point said, "Well, I don't know if my college that I want to go to or if the colleges are going to have in-person learning or if it's going to be online. So I'm not going to apply this year. I'm going to do a gap year. I'm going to wait and see, and maybe I'll start late second semester or whatever." So that's a huge impact, like when you think of how this has affected kids and their trajectory, like I said, maybe if you're in 10th grade going into 11th grade, not so much. But a lot of the seniors that I've had, that was an interesting thing that I noticed talking to my seniors, that a lot of them didn't want to commit to the college if it was going to be virtual.

Scott Webb: Yeah. I'm both ends of the spectrum there. So I have a seventh grader who's going to be an eighth grader. And as you say this is sort of a laot year, but it's right in the middle of middle school. I think she's going to be okay. You know, my son, on the other hand, he graduated this year and he is going away to school because they are going to have in-person learning where he's going, and so I'm kind of experiencing it on both ends where one of my kids I think is going to end up being fairly unfazed by most of this. Whereas the other one, it's going to be a big shock being back in the classroom after more or less missing this entire year.

And I guess I wanted to ask you how do we help them not to think of this as a lost year? We all say that and we all feel that way, like we just basically lost an entire year of our lives. But we didn't, you know, because we lived through it and we had to find a way of dealing with the new normals, if you will. Is there a way for us to help our kids not to feel like they've just lost an entire year of their lives?

Dr. Rebecca Zarko: I think to frame it as a challenge that you overcame or an opportunity to build resiliency, patting everybody ourselves on the back and our kids on the back saying, "Hey, you did it. It was a challenging year. A lot of things were different. There were a lot of unknown. I mean, think about how much we didn't know what was happening or when things were opening or what was going on. Even with the virus itself, "Are we going to be okay? How bad is this?" So there was a lot of uncertainty and a lot of unknown and a lot of, as you said, a complete break from what we're used to. And so maybe framing it in the sense of it was an opportunity for us to build strength, build resiliency. We did it. We got through it. We managed. We're going to keep going forward and moving on and getting back to our pre-COVID norm as much as we can. So thinking of it like a success rather than, "Wow. We just lost everything and didn't get anything out of it." Maybe we learned how to be more resilient, learned how to cope, learned how to maybe find other things to do when we didn't have so many things to do, so many activities. So I think that there's definitely some positives that came out of the crisis. It's not all negative. Certainly, that's how I would approach that.

Scott Webb: I think that's great advice and you're so right, you know, that yes, we sort of lost a year of our lives, but we also lived through it. And this is something that is so unprecedented, is unlike anything that any of us, most of us have ever been through or will ever live through, hopefully knock on fake wood.

Dr. Rebecca Zarko: Yeah.

Scott Webb: And so it's something maybe, you know, to be proud of, that we accomplished something, that we made it. Our family, like we're still standing. And we've all been vaccinated and we're ready for the future. That's really great advice.

As we get close to wrapping up, how do we let our kids know that our door is always open? How do we check in with them without them feeling like we're hovering, like we're the worst helicopter parents in the world? How do we find that balance of letting our kids know that we're here if they want to talk to us without, as they might say, you know, being up in their business all the time?

Dr. Rebecca Zarko: Yeah. I think what comes to mind is the old adage of like listen more and talk less kind of thing, where I think we as adults have a tendency to want to talk and lecture and give our thoughts and ask a lot of questions. And so I think with teens, that approach of just saying a couple things, saying one thing, and then backing off; doing those little touches as opposed to like sitting down and ending up on lecturing them or ration of your thoughts and feelings and where they're tuning you out.

Scott Webb: Yeah. The big talk at dinner table, right?

Dr. Rebecca Zarko: Yeah. They'll tune you out really quickly. So I think just having those little touches where you're just checking in, "How are you doing? How are you?" Even saying, "Hey, I'm here for you if you need anything. But just know that I'm here." Even if they blow you off and say, "Okay. Whatever," it's still really important to have the invitation there, right? It doesn't necessarily mean that you have to go talking for 20 minutes about whatever, but just having that invitation. And then I would also say just having your eyes open, right? I think observing, like I said, listen more, but observe more. You can get a lot of information just from looking or observing. So just being observant and more aware of, "Am I noticing any changes? Is anything seems strange? Maybe it's something I can ask about." Those kinds of things.

Scott Webb: Yeah, so many good points there. It's not easy being a parent as we all know. And it's not easy being a kid. It's not easy being an adolescent. It's hard enough to be an adolescent and then live through a global pandemic and come out the other side and you can finally play sports and see your friends, and you're going to go back in the classroom. And so, I was saying, you know, these sort of new normals we got used to living with over the last year plus, things are going to back to, as you say, pre-COVID, but it's all going to be informed by COVID. And so it's a lot to take in, a lot to process. Many things to be proud of, still some things to work on.

Dr. Rebecca Zarko: Yeah. And still some unknown. And we don't know exactly where things are going. And I think thinking about how you frame this in a positive way, right? Dealing with unknowns, right? That's part of life. We all have to learn how to do that. This was a kind of a crash course dealing with the unknown, right? And having to do that, thinking about the positives or things to point out that we've learned or that we've gained from this collective experience is maybe a little bit of that as well.

Scott Webb: What would be your takeaways? Just generally speaking, for those of us with kids and adolescents, what's your best advice, let's say?

Dr. Rebecca Zarko: I guess my takeaway would be to recognize that while we've gone through this past year and a half and are still going through it to some degree. It's been, like you said, unprecedented and very challenging and a crisis and a stressor and traumatic for all of us. And it's important to point out the strengths and the things that we've learned and that we've made it through, but also be able to recognize that some people are still struggling. They're going to be struggling. It's important to be aware of all of those struggles and get your kids help if they're having trouble adjusting back to, you know, the old normal, or the new normal, or however we want to it.

Scott Webb: Whatever we call it, right?

Dr. Rebecca Zarko: And then those little things that we talked about as far as trying to implement the structure and the schedules and getting kids back into doing the things that they were doing before will help them tremendously. All kids need that structure. They're not there yet. Emphasizing coping skills that you've learned over the year, use it as a teaching point of ways to get through tough times. Recognize that we've got a ways to go and we may not just bounce back completely. But we certainly can all work together to make that happen.

Scott Webb: Yeah, and I hope we do that. And one of my favorite parts about being a parent is just seeing how resilient my kids are. I don't really remember what it was like to be a kid, but I do love seeing how they bounce back, how they are able to sort of put things behind them, just how truly resilient they are. And I think that that's true of most kids. And you've given us some great advice today about how to help them through this. And as you say, as we all work together, as we tackle these unknowns, as we figure out what the future, the new normal or old normal or whatever it is, we're all in this together. So thank you so much for your time today and you stay well.

Dr. Rebecca Zarko: All right. You as well. Thanks so much.

Scott Webb: To learn more about Southwest General's Oakview Behavioral Health Services, call (440) 816-8200 or visit And we hope you found this podcast to be helpful and informative. Please share it on your social channels and check out our full podcast library for topics of interest to you.

This is Southwest General Health Talk. I'm Scott Webb. Stay well.