November 23rd, 2020

According to the CDC, from April to October of this year, the proportion of children’s mental health–related emergency department visits as compared with 2019 rose significantly. Mental health–related visits for children aged 5–11 and 12–17 years increased approximately 24%. and 31%, respectively. (MMWR 10/27/2020) Couple this with the child abuse incidence increase this year and we are seeing the beginnings of an adverse childhood event or ACE wave that could and likely will have lasting ramifications for many decades to come. The rise is simple to see.

The problem is much more frustrating to tackle as these issues are often silently occurring in stressed out homes where social services are not available as COVID is straining all resources.

If you are finding that you as a parent are short fused, sad or without an energy reserve, this is a great time to check in with yourself and make some changes. This is also important for your children.

Consider the week as a structured event where you plan out all of your lifestyle choices that keep you sane. Stick to your plans unless you have to deviate based on unforeseen events. Give your children both structured and imaginative unstructured time. The latter is time for you to complete tasks or preferably relax.

Are you sleeping enough first and foremost? Are your children sleeping? Are you trying to do too much while your children sleep leaving you exhausted when they awaken and demand your time? This is a great time to reassess your priorities and self care around sleep. Limit your activities to what is necessary to free up more time for you and sleep. Is your sleep environment for sleeping only? Your sleep environment should be cool, 65 to 70 degrees F, dark and devoid of screens or devices. It should be comfortable and your brain should expect to want to sleep when you are in bed. Keeping your sleep start and wake up times relatively static is probably the most useful choice that you can make. This keeps your brain locked into a sleep pattern that is functional. Moving your sleep time all around definitely causes sleep onset dysfunction. Consider white noise machines if you struggle with waking to little noises. These sleep recommendations are the same for your children. Don't exercise within 4 hours of sleep onset and avoid caffeine after noon. It is a good idea to keep naps to less than 30 minutes and before 3 pm. For your children, I would encourage regular sleep times based on age needs:

Ages 4-12 months: 12-16 hours (including naps)
Ages 1-2 years: 11-14 hours (including naps)
Ages 3-5 years: 10-13 hours (including naps)
Age 6-12 years: 9-12 hours
Age 13-18 years: 8-10 hours

Are you encouraging your children to play independently and/or with each other and without screens? You do not and should not be a 24/7 playmate. Set specific times for play as a family as well as specific times for your work and rest. Reading together as a family is a great way to de stress and unify the family. Expect your children to go through periods of boredom and self discovery. Expect them to move and play outside where and when possible. This is both okay and good. Screens are a passive baby sitter that will stifle imagination and growth - avoid them as much as possible and completely below age 2 years. Self regulation is a key to self growth.

Are you eating well? Stress and frustration often lead to poor eating choices compounding stress and poor feelings. Maintain a family focus on whole unprocessed foods 90% of the time. Sundays are great days to cook a lot. Encourage your children to be a part of the shopping and cooking process. Make soups and dishes that can be frozen in single or multiple serving dishes. Then they can be reheated for fast in week meals saving massive amounts of time. Planning your meals can save a ton of time. I love shopping at Costco and Trader Joe's because they have prepared high quality dishes that can be frozen and rapidly reheated for my children.

Consider de-stressing activities like meditation, prayer, yoga. These can all be performed with your child or children. The long term goal is to practice this activity multiple times per week to groove in a relaxed nervous tone which is very beneficial to immune activity as well as self reactive behaviors.

In the winter time, vitamin D levels can slip to insufficient levels as the lack of sun exposure reduces natural production leaving us feeling the blues. I take Life Extensions vitamin D and K supplement 5000Iu daily for the winter season before I head back out to the glory of the Carolina sun in April. I encourage you to get a blood vitamin D level and supplement accordingly. Contact your provider for doses that are appropriate for your family.

Read positive mindset books like the Daily Stoic, The Biology of Belief, Don't Sweat the Small Stuff, The Power to ground your thinking. Remember that all things shall pass and tomorrow is neither guaranteed nor expected but living in the moment is worthy.

Finally, if you find that you are on edge and out of control, please seek out professional help. I have said many times before that we all get teachers and coaches for school, sports but never mental stress. It is absolutely not a sign of weakness to get professional help.

Dr. M

For more on this topic read the recent article By Dr. Koster here.