The COVID-19 pandemic turned everyone’s lives upside down — especially those of children and teenagers. Disrupted routines and prolonged isolation away from friends and activities took a toll on their emotional well-being and social development. While more physically safe at home during the pandemic, many have struggled emotionally.

Pediatricians are noticing the pandemic’s lingering effects on children’s mental health.

“We’re seeing huge increases in anxiety, depression and eating disorders in kids,” says Kelly Troiano-Buckman, M.D., a pediatrician at Palo Alto Medical Foundation. “A lot of parents may have noticed changes in attention and motivation as well.”

How can you identify childhood’s normal ups and downs versus an underlying mood disorder such as anxiety or depression? Here are three red flags:

1. Persistent withdrawal or irritability — An off-day here and there is normal, but if you see your child withdraw and seem to lose interest or enjoyment in normally fun activities, they may be struggling with a mood disorder. Another sign is when a typically motivated kid now has trouble maintaining attention or completing simple tasks. For younger children, a dramatic arrival of tantrums or new sleep issues may signal emotional upset.
2. Lingering physical symptoms — Especially in younger kids, depression and anxiety can show up as physical symptoms — such as chronic stomachaches or headaches — that are unusual, vague or don’t resolve in a typical timeframe. Keep an eye out for patterns or anything out of the ordinary.
3. Changes in appetite or weight — For older children and teenagers, noticeable shifts in appetite or abrupt weight gain or loss can be an indication of emotional troubles.

Once you identify the red flags here are a couple of helpful tips on how to safely intervene:

Let Your Child Know It’s OK To Talk

The most important thing you can do is to get comfortable asking your kids about mental health.

“So often we tiptoe around the issues of depression and mental health in kids,” says Troiano-Buckman. “But if you summon up the courage to ask, you’d be surprised how many kids will actually let you know.”

Encourage ongoing conversation by letting kids know they can approach you if emotional issues — big or small — come up.

“Even if your child is reluctant to talk about their mood or mental health, just bringing it up can open the door,” she says. “You can say, ‘You may not want to talk about it right now but know I’m here and you can talk to me if something comes up.’”

Troiano-Buckman suggests parents don’t sidestep scary and difficult subjects like self-harm or suicide.

“We have to feel comfortable bringing up issues like this. Saying directly, ‘Sometimes when people feel really sad, they may think about things they normally wouldn’t, like hurting or even killing themselves. I want to be sure you’re safe: Have you had any of those thoughts?’” Troiano-Buckman says. “We have to use those words and ask those questions because there will be kids who’ll be thinking about it and may just not know how to say it themselves.”

And you can honestly tell your kids: I’m checking because I love you very much and want to protect you.

“You’re planting a seed, just letting your kids know you want to keep them safe,” she says.

Start With Your Child’s Pediatrician

A good starting place is to talk to your child’s pediatrician. Most pediatricians can help assess the severity of a child’s mood disorder and have referral lists of counselors or therapists who specialize in working with children.

A child or teenager might talk more freely to a trusted doctor or be able to reframe their emotional struggle as a treatable health issue, rather than as a personal failing.

Other resources include innovative digital tools like Scout by Sutter Health™. Scout is a digital experience that delivers evidence-based tips, tools and activities to help teens and young adults manage their everyday mental health.