The pandemic of 2019 only heightened in 2020 and bled into 2021. Society had turned on its head. As a pediatrician I noticed what should have been a temporary adjustment or transition period for my patients turn into full blown anxiety and depression. During these periods of extreme uncertainty with constraints of daily living, it all made sense. We sheltered in place to keep safe from a virus, and what was lost was a sense of community, vitality, and connection.
Especially affected were the pre-teens and young adolescents. Developmentally expected milestones revolving around peer socialization, self-identity formation, and independence were abruptly halted or drastically turned on their heads. And maybe the significant sacrifices these teens made by sheltering in place is overshadowed because we still provided our children & adolescents with everything they could possibly need from food, shelter, unconditional love and pampering. What teens lost was the spark and joy of embarking and discovering their own paths.
I will pause for a moment because here is where I get a lot of questions because the concept of identity formation is abstract. So come take a walk down memory lane and review some other concrete forms of milestone development and remember when…
…at approximately 4 months, remember how sweet it was when your child smiled back at you. All the hard work and sleep deprived nights of early infancy now suddenly seemed worth it. By 9 months your child may have been pulling up to stand. Which was both terrifying because you feared he/she would jump out of their crib and also so exciting you knew walking would come next. Oh how proud every parent is when their baby takes their first steps. Do you remember your child’s first words? Dada, Mama, truck, ball, the rest would follow suit. By three years of age they were asking questions and it was unbelievable. “What’s that” and “why” would soon be anticipated and you felt the pressure to be a walking encyclopedia and teach the bright eyed child everything about the world they faced….
Early childhood milestones are clear and straightforward and your pediatrician went through the progress with you. “Phew my child is on track.” A lot of parents are relieved after filling out those “Ages and Stages Questionnaires.” Yet for those who need extra help with speech or fine motor skills, I see parents turn into superhero advocates getting their child the services that will best suit them.
With teens and adolescents, the concrete checklists stop and doctors perform something called a “HEADS” asseessment. This is an shortened acronym for home, education, employment, eating, exercise, activities, drugs, sexuality, suicide/depression, safety, spirituality. Since the start of the pandemic, we have witnessed huge structural changes to almost every category on that checklist: I heard the stories of schools shutting down, sports practices canceled, teenagers eating alone in their rooms, dating becoming ever more complicated or non existent. In the backdrop of all the anxieties came with the existential question, are we safe when we leave the house?
The teens of 2019-2021 were meant to flourish outside their home and discover their passions, but the pandemic way of living had created huge barriers around them. Picture this: If a toddler is late to walk, or a child cannot put words together, we speedily enroll them into services that will help them. So what do we do now about teenage development?
First, we can validate what happened. I offer the phrase, “What happened is not normal, your reaction is.” Each teen had their own experience and even those who more readily adapted still faced challenges and adjustments. Allow teens to share the stories they carry within them. Telling their stories is a healing practice.
Second, we need to mark the end of the existential crisis. This is important so we can create distance between what happened during the initial lock down and what is going on now. Yes the pandemic may stick around, but now we have facts and figures, experience and knowledge. We know to avoid peak holiday travel when cases are the highest, the vaccine works to mitigate severity of illness, masks help prevent spread inside, and it is safe to be outside unmasked.
Third, we need to advocate for adolescents. It is imperative they attend school, get outside the home, and be silly with their friends. The development of their independence is important and needs to be continually supported. Let them know we see this and will do everything we can to help them. I know so many families who already have.
Perhaps most importantly is to maintain a sense of compassion. We all have made sacrifices and compromised our ways of living which has affected each and every person in a different way. As we all come out from our homes and shelters it would be miraculous to see how this shared experience lends itself to connection.
I end on a hopeful note because on a warm sunny day in January of 2022, on the drive to my office, I watched as the kids and teens gathered in the parking lot of Roberts Market giggling and scheming after school let out. To paraphrase Kurt Cobain, 2022 is starting to smell like teen spirit. Finally, they are living, and we can all cheer on their rambunctious lead ahead.
The team at the Village Doctor has an experienced team of doctors with specialities in pediatric and adolescent medicine and are here to help. This piece is written as an op-ed and not to be taken as medical advice. Each individual and family is encouraged to discuss personal medical decisions with their physician.
Ava Satnick is a pediatric integrative medicine specialist and her practice, Holbrook Health, is located at 130 Portola Rd Suite F in Portola Valley. You can reach out to her by email [email protected] or text (650)514-5990
Ava Satnick, MD, February 9, 2022