How to reduce anxiety during the coronavirus

We asked the clinical psychologists Megan Tudor and Breanna Winder-Patel from the UC Davis MIND Institute to talk to us about anxiety during times of uncertainty, such as this current COVID-19 crisis, and ways to reduce anxiety for families with children on the autism spectrum.

Q: How can parents talk to their children about COVID-19 (coronavirus) without raising anxiety levels?

A: Right now, children are getting a lot of mixed information that can sound very scary to them. Fortunately, there are things that we can do and say to help children feel more secure and informed.

Watching the news can be very overwhelming and difficult to understand. Children need to receive brief and fact-based information. It might help to say things like, “People get viruses all the time and are just fine, but we want to make sure not too many people are getting it at once, so that is why we are not going to school or work right now.”

Also, be sure to answer your children’s questions, dispel any inaccurate information and then move on to a movie or something fun. Coronavirus is not something we need to talk about all the time.

Q: Since schools are closed and there is an important focus on social distancing, what would be helpful for parents to include in their home schedule?

A: Structure and routine are very important. At first, children might be excited about being at home, but the lack of structure and routine can set the stage for anxiety. Children and teens need to be sure their minds stay occupied and on a schedule. This provides children with certainty and control in an uncertain time. Here are some ideas:

• Keep a set bedtime and wake up time.
• Get dressed for the day.
• Have a schedule of mealtimes, school-related activities and recreational activities.
• Designate an area of the house that is just for work and other areas that are just for play so children can associate different areas with different parts of their routine.
• Electronics can be offered after other work is finished

An important part of our mental health is physical activity. While we are social distancing, we can still go outside and play, go for a walk, ride bikes, have family dance parties in the living room, and the list goes on! Becoming a couch potato will contribute to feeling restless and can lead to negative thinking. So be sure to keep kids active and exercising. Finally, we know many parents are expected to work from home right now while taking care of children and being their teacher. There is so much about this that is unrealistic, so flexibility is key for the well-being of everyone.

Q: If children are worrying about the possible bad outcomes of this virus, what can parents do to support them?

A: We recommend realistic coping thoughts. If a child is having “what ifs” about the possible bad outcomes of the coronavirus, we would encourage them to look for “proof or evidence” to determine whether the anxiety is “telling the truth.”

For example, if the child’s thoughts are about them or loved ones possibly getting very ill or dying, you can pretend to be a “detective” with them and look for proof. Is anybody sick yet? What information do we have about how this virus is affecting children? Are we following the plan for social distancing? Are we washing hands? It is easy for parents to say “Don’t worry” or “It will be ok.” Looking for proof is a little more concrete and specific and results in coping thoughts such as, “I don’t have any proof I’m in a real danger right now so I’m going to change the channel in my mind to think about what fun activity I’m going to do today.”

Parents are also experiencing uncertainty right now. It can be helpful to share with your children how you are solving problems and using your coping skills. These great skills we could all boost at this time.  

Q: Is there anything specific you can suggest for children with autism to help them cope during this time?

Our recommendations during high-anxiety periods:
• Provide fact-based information
• Keep structure and routine
• Maintain physical activity
• Look for proof for what anxiety is saying
• Choose to change the channel in your mind
• Model problem solving and healthy coping
• Perform relaxation strategies
• Drawing to describe and explore emotions and thoughts

Children and teenagers with autism may be more likely to become fixated on negative or fearful thoughts or images. In addition to the strategies discussed above, it is important to keep-up with the behavioral strategies in place through therapies. One can also integrate characters or special interests into understanding the pandemic but refrain from having many visuals related to the virus accessible to the child. One child reported that the visual depiction used to represent the coronavirus was the most disturbing because it was scary, prickly red, and looked evil.

It is common for children to display anxiety in situations like the current one where there are realistic, health-related fears and discomfort related to changes in routines. However, if your child with autism is typically very anxious and always displays some of the anxiety symptoms we have discussed, you can check The Specifying and Treating Anxiety in Autism Research (STAAR) Study at the MIND Institute or contact Teryn Heckers at theckers@ucdavis.edu. At this time, they are conducting phone screening and will be enrolling participants as soon as it is safe to come for clinic visits.

For additional information

— Watch a Facebook Live with Breanna Winder-Patel talking about reducing anxiety during uncertain times

— Watch Murat Pakyurek - division chief for child and adolescent psychiatry at UC Davis Department of Psychiatry and Behavioral Sciences – on KCRA talking on switching therapy to telehealth