Increase in children presenting with physical anxiety symptoms since start of pandemic

Increase in children presenting with physical anxiety symptoms since start of pandemic

Dr Niamh Lynch, paediatrician, Bon Secours, Cork.

A CORK consultant has witnessed an increase in the volume of presentations of children with physical symptoms that are caused by anxiety since the beginning of the pandemic.

Dr Niamh Lynch, a paediatric consultant at the Bon Secours Hospital in Cork said that while she has not seen many children with Covid-19 in recent months, the pandemic is impacting children in other ways.

“I’m seeing it two ways. I’m seeing it in terms of children’s health; both their mental health and their physical health, and I’m seeing it in terms of children’s development,” Dr Lynch explained.

The Cork doctor said that the recent inclement weather coupled with restrictions has meant children cannot get out as much as they usually would and this is affecting their fitness.

“This winter, because we’ve all been in confined [situations], children are definitely less fit and certainly I would have noticed that some of my patients have gained quite a bit of weight and lost a bit of fitness… physical fitness is definitely on the decline I would say,” she said.

The impact on children’s mental health is also significant.

“I am seeing increased anxiety in children and also increased presentation of physical symptoms that are caused by anxiety,” Dr Lynch said.

The Cork consultant said that anxiety can be seen as creating “a kind of energy” adding that “at the moment that energy has nowhere to go”.

“If you think about a child, the alarm goes off in the morning and everyone gets up, there’s a great rush to go to school. Uniforms are all over the house and lunches have to be made and there’s a bustle and everyone’s out. Then they are in school and they are learning and they’re interacting with their friends and they are playing in the yard.

“And then there’s something on after school, like music or GAA, and all the energy is burned up and they come home and they sit down in front of telly, they eat their dinner, everyone is tired and they all go to bed. Now, it’s just a wasteland. There’s nothing. There’s no rush to get up in the morning, there’s nothing to do, it’s lashing outside, it’s dark, it’s incredibly tough,” Dr Lynch said.

The consultant said parents should be aware of symptoms of anxiety.

“Every parent knows their own child the best, but things to look out for with children in terms of anxiety is poor sleep, changes in appetite, they might be eating more or less, not really able to enjoy anything, constantly checking things, asking ‘is granny alright, is grandad alright, is the dog alright’.. more tearful, more short-tempered - things like that,” she said.

Dr Lynch said that these symptoms do not necessarily need the intervention of a health professional, but there may be some steps people can take at home to address it including parents asking themselves how they are feeling themselves.

“It is well recognised that anxious parents make children anxious and anxious children make parents anxious...Parents need to take a step back and ask ‘how am I feeling?’ — ‘what kind of energy am I bringing to this?’, ‘what am I projecting?’, ‘what’s my child potentially picking up from me?’

“Of course parents are anxious at the moment - a lot of people have lost their job, or their job security, or they are trying to get by on the PUP, or they’re worried about their parents, or they’re worried about getting Covid themselves — there’s any number of reasons for parents to feel anxious at the moment,” she said.

The paediatric consultant said trying to stick to a routine of children going to bed and waking up at a certain time, and finding ways to use up their extra energy could be beneficial.

“Physical activity is incredibly important,” she said adding that a bit of laughter also goes a long way.

“Something like simple games - playing a game of snap, of charades — a bit of fun, a bit of levity. A bit of laughter goes a long way to alleviating the anxiety as well. not trying to cover things up but trying to make things a bit more normal,” she added.

In some cases, she said, signs and symptoms of anxiety do need to be checked, in particular physical signs of anxiety.

“We’re seeing a lot of [physical symptoms]. The top symptoms would be tummy pain — that would be a big one — and dizziness and headaches and developing tics and twitches — we’ve seen a lot of that. That kind of thing needs to be checked out by the GP.

“We’d never dismiss anything as anxiety without investigating it but I think parents should bear in the back of their mind that if all the tests are normal then it might be anxiety because it often happens to kids who don’t necessarily articulate their anxiety particularly well — it’s more that they feel it and they are not able to express themselves,” she said.

Dr Lynch also expressed concern that the longer the pandemic continues it may impact on children’s development.

She noted that young children are not able to socialise in the way they normally would.

I’ve noticed when I am interacting with toddlers, they are terrified of me. Where they would normally stomp into the room, and take off the coat and wander around, and ask who are you and what’s your name, they are clinging to their mums and dads. They are not used to interacting with people that are not their immediate family. Their socialisation, I think, has suffered.”

She added: “With each stage of development you have a fairly wide window, but if this goes on much longer that window will be closing for a lot of children - we are a year into this now.”

She also said the closure of special schools has had a significant impact on children who attend them.

The impact of the pandemic has not all been negative though, and Dr Lynch said that children with asthma and tonsillitis are doing better and she has also witnessed a significant decline in cases of respiratory syncytial virus (RSV) bronchiolitis, a virus that usually leads to significant hospitalisations in young children.

“The big blessing from the pandemic is that we haven’t seen a single case of RSV bronchiolitis - not one case,” she said.

“A lot of families have been spared that absolute trauma of having their really small babies [unwelll], thousands of children have been spared that.

“That’s one big positive that’s come out of this,” she said.

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