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Psychological Issues due to COVID-19 Lockdown.pptx

  1. Psychological Issues due to COVID-19 Lockdown Diana Milillo, PhD, MHC Nassau Community College July 9, 2021
  2. The Lockdown • Where were you?? • What happened?? • How did it make you feel??
  3. Global Statistics
  4. Heightened Anxiety • The repeated exposure to mortality was all around us…. • Coupled with: unclear understanding of transmission, efficacy of safe- guarding behaviors, and duration of how long we were to live with this
  5. Personal and Collective Trauma • Personal and collective trauma Trauma is: “an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual’s functioning and physical, social, emotional, or spiritual well- being” -SAMHSA, 2012
  6. Trauma Memories • The brain creates rich, emotional, sensory memories of an event Classical Conditioning ~ • Our body encodes the physiological feelings together with the sensory input of an event or period of time • Our responses (“feelings”) are triggered whenever the sensory cues are experienced at a later time
  7. Adult’s Mental Health During the Pandemic • Increase in anxiety, depression, & suicidal ideation*: • Over each age group • Women, parents • Those with lower incomes • Those who live alone • Those with previous history of mental illness *US based statistics
  8. Abraham Maslow’s Hierarchy of Needs
  9. What does this mean for children’s experiences?
  10. Building Schemas • For each new experience, children attempt to fit it into a cognitive category they have already created based on previous experience (assimilation) • Or else they create a new cognitive category (accommodation) • But when there is trauma, there is often no mental template for what is happening
  11. Early Efforts at Creating Routine
  12. Children Take On Adults’ Energy and Perspective….
  13. Safety and Security • Children (especially young children) need adults to make them feel calm, safe and settled • Children learn emotion regulation from others • Children who are chronically scared or anxious stay in a heightened physiologically aroused stated….and a state of diminished cognitive resources
  14. Dr. Bruce Perry’s Neuroaffective Model
  15. • Higher-level cognitive functions depend on the brain / body feeling safe and secure • If not, the brain stays at a stress-arousal response
  16. What Can Anxiety & Depression Look Like In Children? • Sadness • Numb or flat affect • Lack of motivation • Distraction, inability to focus • Detachment, dissociated • Sleepy, tired • Wired, restless • Fear of making mistakes • Being “good” or “helper,” not being a problem or burden • Acting out, being “bad” • Irritability • Sudden changes in mood
  17. Q: In the midst of a global pandemic, how do we help children feel safe?
  18. Some General Tips For Adults • Be honest. Feel your feelings. • Regulate yourself first. • Breathe • Journal • Social support • Release feelings as they come up • Limit intake and exposure to news. • Focus on what you can control
  19. Some General Tips For Parents & Children • Allow space for open-ended and honest expression of feelings • How are you feeling? • What are you thinking? • Do you have worries? • Model expression of feelings and coping • “I get scared sometimes too.” • “Sometimes I feel miss things we used to do.” • “When I get scared, I ______.”
  20. Some General Tips For Parents & Children • Not all expression of emotion is verbal • Allow kids to draw, sing, dance, play, create for expression of emotions • Time outside, in nature, with animals is a great form of therapy • Give kids a sense that you (the adult) will carry the worry for them • “Your job is to focus on _____. I will take care of _____.” • Instill belief in adults and professionals to lead through
  21. Some General Tips For Parents, Teachers & Children • Create ritual and routine • Stick to a similar sleep / wake / eating schedule • Create time and space for movement and breathing before learning • Establish routines in academic learning / class schedules • Give kids special jobs and roles • Keep in mind “bottom up” needs • Basic physical needs, safety, security, belonging • Lower expectations
  22. Some General Tips For Parents, Teachers & Children • More serious situations: • Pay attention to changes in behavior and non-verbals • Screening in schools for heightened mental health needs • Awareness of what anxiety or depression can look like in children for teachers, staff and parents • Institutional increase in mental health services for children and parents
  23. Children are incredibly resilient!
  24. Thank you!

Notas del editor

  1. For me – Friday, March 13, 2021, the day the schools closed. I remember where I was, who I was with. In the subsequent weeks --- finding or making masks, scared to go outside, up in the middle of the night worrying if we would run out of food, washing down groceries with gloves on and bleach, watching the news daily or hourly for information about what was happening to our world, following the increasing death toll country by country, state by state, town by town, not sure what would happen to my children if I got sick, had to quarantine, or worse….
  2. As of yesterday, there have been over 4 million global deaths from COVID. Leading the rates of confirmed cases are the U.S. and India.
  3. What we went through in 2020 and beyond was most certainly both personal and collective trauma. Psychological organizations have defined trauma as something like this:…… In the past decade, the American Psychological Association has altered the more traditional idea of trauma as “one event that puts an individual in close proximity to death or near-death” to an experience that can also go on over an extended period of time and be threatening though not near-death.
  4. During the first few weeks of our pandemic in the US, many of us have visceral, bodily memories…..trauma memories. Encoding and storing trauma is really at its core your basic classical conditioning. Our body…. I have reactions of the streets being eerily quiet and then hearing the frequent sounds of a siren, wondering if the person in the ambulance was someone I knew. I have memories that are connected to smells of the time – the sanitizer I was able to salvage at home, the first mask that I was able to buy. When we later experience these sights, sounds, smells and other sensory experiences, it brings back the emotional and bodily feeling.
  5. Over the next year, since our first wave in the US, adults certainly saw an increase in anxiety, depression and even suicidal ideation…. Each age group, from young adults to older adults, had their own sets of circumstances that contributed to their anxiety and depression. Other demographic groups that various surveys have found to suffer more were: Women, those with children under 18, those with lower incomes, those who live alone, those who identify as more than 1 race, and those with a history of previous mental illness. These statistics are based on surveys within the US, though research finds that US adults seemed also to have among the highest rates of anxiety and depression compared to other industrialized countries as well; though this could also have been due to the heightened sociopolitical unrest that was simultaneously happening in our country as well.
  6. I spent a lot of time over the past year thinking of Maslow’s conceptualization of hierarchy of needs. While we were in lockdown, there was no (or little) expression of meeting our highest needs or living our best lives. We were figuring out together, on a daily basis, how to best survive. For some, it was as critical as how to take their next breath. For others, it was how to keep their most vulnerable loved ones safe.
  7. The reason we are here today – What has this all meant for children? Children have been deemed to be, in general, at lowest risk of severe effects from COVID-19, although we are still unsure of what the long-term physical and psychological effects may be. Children were abruptly pulled from life as they knew it, and days seemed very different during and after the lockdown. School-aged children were subject to learning and experiencing “school” in very different ways that we could not have imagined – from the early days of no concrete schedule to various forms of hybrid, synchronous, or asynchronous learning. Reintroducing children back into in-person learning has come with mixed emotions, especially in some US states; some parents have vigorously pushed for full-time, in-person, maskless school days, while other parents have protested the too soon return, especially for still unvaccinated children. What does this mean for children’s lived experiences through this chaotic and ever-changing time?
  8. Navigating the world post-COVID has been ambiguous, confusing, and uncertain for adults. We don’t know how to make sense of it, we sometimes don’t know what to anticipate -- and as humans, we rely on anticipation. We need to be able to predict things. And children especially need to predict what will come next in order to feel safe.
  9. Social media was abuzz
  10. This is a picture that guides a lot of my thoughts about trauma and the brain…. And specifically how the brain develops from a bottom-up fashion (in some ways, mirroring Maslow’s Hierarchy of Needs). At the bottom, our hindbrain or brain stem, is responsible for regulating the very basic of our human functions, paving the way for the motor and emotional regulation in our limbic system, which finally allows for us to be able to then do higher level concrete and abstract thinking in our cortex.
  11. What Perry’s conceptualization posits is that when the brain is stuck in a fragile, fear-response state, it shuts down the capacity to do higher-level cognitive functions. What we know about children who have gone through early childhood trauma is that their norm, or baseline, of physiologic functioning IS a state of fight-or-flight. Their body has not been given the signals that they are safe to calm down, and reduce their body’s readiness to react for survival. They carry this hyper-arousal or hyper-awareness throughout the day with them. When they are expected to sit down, concentrate – and in front of a screen (which takes even more focused attention), this is just not what the body is, in that moment, primed to do.
  12. So, we are “between a rock and a hard place”….. Given the very real threats of living through a global pandemic, what do we do to help our children feel safe (and dare I say, normal)?