Dr. Whitney Fulton: Pandemic musings of a child psychiatrist

Published 12:10 am Monday, December 14, 2020

When my company made the decision to switch to virtual telehealth back in March 2020, my first thought was “I am so glad I am off next week.”

I wouldn’t be in the office for the initial hiccups, it would only be for a few weeks, we’d be back to normal before long, it would be fine. Here we are in the first week of December – my clinic still nearly 100 percent Telehealth, COVID-19 cases skyrocketing in my area, and no end in sight.

Do I consider myself to be a front line worker? No. I don’t have to suit up in head-to-toe PPE to see my patients. I don’t have to differentiate between the common cold, allergies and COVID-19 while trying to decide who to quarantine.

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I don’t have to navigate a dozen medications treating multiple different organ systems. I’m not fine tuning ventilator settings. I don’t have to call the families of patients who have succumbed, sitting terrified at home waiting for that call because they’re separated from their loved ones in the last moments of their lives.

But I am very, very much immediately behind those front lines, facing my own fight in battling the emotional toll of this horrible pandemic in my Child and Adolescent Psychiatry patient population. My patients and their families are struggling, in a variety of different ways.

Overnight, kids were pulled from their normal lives and shut up in their homes. They lost their teachers, their friends, their sports, their clubs, their dance classes, their social support network outside their family in the blink of an eye. They were shoved into social isolation and had to finish their school year on their couches, with limited access to support and help. Many had unreliable Internet access, with no way to access work or contact their teachers. They weren’t able to see their friends or visit extended family or work with coaches and trainers. It was temporary, they were told. Just a little longer, and life can go back to normal.

Then summer came, and camps were canceled and vacations were put on indefinite hold. It still wasn’t deemed safe to play with their neighbors or go to the pool. Stay inside and stay safe, they were told. It’s just temporary, school will start back soon. Just keep going.

Then the academic year started — late in much of the country, and in a large percentage of the population, still either partially or entirely virtual. The young people still can’t sit with their friends and laugh and joke like kids are supposed to. They still can’t terrorize their teachers by passing notes and whispering behind textbooks. They’re forced to do hours of school work without the structure, routine and educational environment that teachers work so hard to cultivate. They still can’t tumble and cheer, run touchdowns, make foul shots. They can’t be kids.

And because of all this, they are hurting. My wait list for psychiatric intakes grows every day. Pediatricians and family care providers are being called upon to treat new onset depression and anxiety multiple times per day. Grades are dropping, and teachers are struggling to reach students who can’t sit in the desks in front of them. Parents are scrambling to find child care and help with assignments in subjects they haven’t studied in years. Behavioral issues are on the rise. Suicide attempts and completions are increasing in all age populations, including under 18.

Physical exercise is declining and screen time is increasing. Many kids across the country don’t have enough food to eat, or anyone at home to make sure they can complete the school work assigned. Some kids are not in safe environments, and are now subjected to constant neglect and abuse because they can’t get to school, which previously served as their safe space.

While we are closely surveilling our kids for runny noses, coughs, and fevers, we should also be monitoring for sadness, worry, and academic and behavioral issues. Sleep changes, poor appetites, irritability, aggression, and isolation should raise just as much concern as new onset loss of taste or smell. The emotional, developmental, academic, and social ramifications of this coronavirus epidemic are going to be felt even more strongly in the upcoming weeks, months, and years. My coworkers and I, as well as mental health professionals across the country, are as ready as we can be to help navigate these mental health difficulties, the consequences of the pandemic that haven’t been in the limelight. If you have concerns about the emotional well being of your child or loved one, PLEASE seek help.

Dr. Whitney Fulton, MD is a Child & Adolescent Psychiatrist with Valley Health, which has locations throughout the Tri-State.