A post-quarantine world will have its own challenges and conflicts for local families
For 13-year-old Nadia Kohles, the COVID-19 induced stay-at-home order had a silver lining.
“When I first heard that school was going to be out ... I was ecstatic,” Nadia recalled. “I’m going to have my friends over.”
Her mother, Alexandra, had different ideas: Nobody was going anywhere and nobody was coming near them.
“We had three weeks where we didn’t go anywhere,” Alexandra Kohles said. “We were completely quarantined. I wanted to make sure none of us had the virus or that we were not out and about at the peak of the virus.”
Kohles, a former doctor in her native Chile, kept Naida, son Ryan, 9 and husband Geoffrey in strict lockdown. She followed Washington state guidelines and followed developments in other countries.
“In the beginning, it was like a staycation,” Kohles said. During the day, the kids would study and attend their school, Tacoma’s St. Charles Borromeo Catholic School, online.
But the mood soon soured.
“I never had a ‘why are we doing this?’ moment, but there were several times during the quarantine I thought, ‘I hate this. I miss my friends. I miss going to school. I miss going outside,’” Nadia said.
Ryan would repeatedly call friends until they answered their phones.
“When they finally answered I forgot what I was going to say,” he said. “So, we just sat there in awkward silence until I remembered.”
From dream to nightmare
Alexandra Kohles is ready to ease her restrictions now that Pierce County has entered Phase 2. She’s balancing protection from COVID-19 with the impact social isolation is having on her family.
“What I’m thinking now is more the (detrimental) psychological effect on them and on us,” Kohles said.
For many families across Washington, the prolonged quarantine turned up the heat on financial and behavioral problems and hid long-simmering problems behind closed doors.
Like Nadia, many kids first thought they’d hit the jackpot when school closures were announced.
“The ones that didn’t want to be in school, suddenly this was their dream come true,” said Katie Cutshaw, a clinical supervisor for Capital Region ESD 113. Her staff treats kids for anxiety, depression, attention deficit hyperactivity disorder and other behavioral issues.
“I’m hearing from quite a few (students) that they’re missing their friends, that school engagement,” she said.
ESD 113 serves 73,000 students in five southwest Washington counties. Among other services, it provides mental health and substance abuse treatment to school-age children.
“For some of our kids, school is their safe place,” said Erin Wick, senior director of behavioral health and student support at ESD 113. “It provides structure, supportive adults ... even food.”
Schools can provide a connection and relationship with caring adults, Wick said.
Some kids are doing better in quarantine.
“They have their parents at home,” she said. “They have a lot of one-on-one attention.”
For those kids, Cutshaw worries those bonds could whither as parents return to work.
“I’m expecting to see more anxiety,” she said.
“We want kids to ask for help early and often if they need that or if they are feeling anxious, which is really critical right now because our kids are super anxious,” Wick said. “Our adults are feeling anxious.”
Wick said she expects to see significant increases in anxiety, depression and suicides in the next three to six months.
“As a system, how do we react to that?” Wick said. “The things that are occurring now are things that we’ve never dealt with before.”
Sara Bailey, a therapist with Olympia-based Community Youth Services, said she’s also seen the lack of social connections impact the youth she works with who are 14-24.
“It’s increased some of the depression in some of my youth because they are now only having to rely on social media and video games and that kind of stuff to connect with people, and it’s not always enough,” Bailey said.
Some kids, Cutshaw said, have disappeared from the system altogether.
Problems have gotten worse
Kids with mental health issues are already isolated, said Jackie Yee, a chemical dependency clinical supervisor for ESD 113. She treats mostly middle and high school age kids for alcohol, drug, tobacco and vaping use.
“It’s been a week-to-week thing, especially with our teenagers,” Yess said. “The first week it was like summer break came early ... then we started to see some depression and anxiety.”
A part of mental health treatment for kids involves building a community for them. That has been severely impacted by COVID-19, Yee said.
“We had about two weeks of kids coming in super emotional,” she said. “They missed their friends, their teachers. Lots of runaways.”
The pandemic has caused some kids and their adult family members to relapse, she said.
“Now, there’s drug use in the home,” Yee said. “Two to three weeks into the quarantine, folks started to get laid off. Stress around paying rent, food, even the phone bill, which affects telephone appointments with mental health folks.”
Rebuilding broken family relationships is another frequently encouraged leg of support in mental health treatment. While families have been spending more time together, it’s often in a highly stressed environment.
“Even in our really high-functioning families, there’s been disruption and more conflict within the home,” Yee said.
Bailey said she’s seen existing abuse conflicts get worse.
“Anytime there’s abuse in the home ... with the added stress of people potentially losing jobs and being home all the time and not being in school increases the potential violence and conflict,” Bailey said. “I’ve definitely heard that from some of my youth.”
Navigating unknown waters
Parents have no childhood experiences or wisdom from elders to share on dealing with pandemics and quarantines. The “back in my day” technique is nonexistent.
“It creates opportunities for us parents to model behavior,” Cutshaw said. “This is what I am going through. How do I mange my emotions? How do I take in information and use it to go forward?”
“If Mom and Dad are OK, then I’m OK,” Yee said. “I know my own kids and my treatment kids are looking at adults and asking, ‘How are they handling it?’”
Yee minimizes the amount of news her 10- and 14-year-old children watch on TV. Still, pandemic-related information reaches them, much of it scary and untrue.
Addressing concerns head-on is key.
“We have check-ins a couple of times a week with the kids,” Yee said. “How did this week go? How are you feeling? What are you missing? What can we do this weekend with our limited ability to do things?”
How do you merge your family’s safety level with another family’s?
Yee, who lives in Thurston County, recently gave permission for her son’s friend to play video games at Yee’s home.
She told her son that everything that was touched would need to be cleaned after the friend left.
“We still need to be taking these precautions, and it’s hard,” Yee said. “Our kids are so desperate to have anything that’s normal right now.”
Patience and empathy are what’s needed most when negotiating safety and explaining it to children, Cutshaw said.
“Some families make this choice, and this is what our family does. It doesn’t mean either is right or wrong,” she said. The process allows the parent to provide reasoning.
Allowing kids to make choices regarding safety can help, too, Yee said. Let them pick out their own masks, their own sanitizer.
Older youth, like the kind Bailey works with, have a variety of safety levels.
“I’ve seen completely varying degrees of that with young people in general,” Bailey said. “People wearing masks and staying away and other people saying, ‘Whatever, it doesn’t affect me because I’m young.’”
When negotiating social interactions, Bailey advises families to default to the one that’s more cautious. Discussions should be based on respect and trust.
“I would be respectful of other people’s wishes,” Bailey said. “If they have more concern about it, I would follow what they wanted. Even if I think they’re not at risk, I don’t want them to feel that way because of me or what my family chooses to do.”
It also helps if kids are educated in precautions and for parents to trust that they’ll follow family rules.
“I wouldn’t allow my kid to go (to a play date) if (the other family) weren’t going to be respecting of those boundaries,” Bailey said. “Because that’s a health and safety and potential life-threatening issue.”
Older youth who have left home are more likely than older adults to be under stress from loss of income. Stress can also come by being employed but as an essential worker where working from home isn’t an option, she said.
Taking care of adults
The pandemic has brought a sense of loss to many, said Tim Holmes, a mental health professional and president of MultiCare’s behavorial health network.
“All of us are experiencing our own personal losses around the pandemic ... they vary in intensity and impact,” Holmes said.
Loss can range from a canceled vacation to the death of a grandparent.
Normally, when faced with a crisis, we are told to seek out those people we trust, Holmes said.
“And we’re being told that’s dangerous now, in many ways,” he said.
A change in daily routines has become the norm for many during the pandemic. For some, all routines have gone out the window.
“Some people are using that as an excuse to create healthy routines,” Holmes said. “They are exercising every day or cooking healthy food.”
With many others, it’s leading to destructive behavior: overeating, drinking, use of drugs, not taking prescription drugs.
Compounding the problem, behavior in others that might have been discovered by friends, family or co-workers is now hidden, Holmes said.
“I think that we’re probably going to see waves of behavioral health needs in a variety of ways,” he said.
Some people are afraid to seek care. Others don’t know how, he said.
Like other health care providers, MultiCare has upped its use of telephonic and virtual care.
“It’s not for everybody, but it allows a much more convenient access to care and giving clients that choice has been really well received,” he said. “And clinicians love it.”
Many people are striving to keep as much normality as possible, he said. Sometimes, that can lead to conflict between individuals who view facts or precautions associated with the coronavirus differently.
That leads to differing behavior and potential conflict.
“Each of us has to take a step back and recognize those differences are not an affront to us, and that’s hard to do when you’re in a stressed or anxious mindset,” he said. “It’s a huge challenge.”
But the stakes feel high, he said.
“People feel really strong about their point of view,” Holmes said. “If you’re wrong, what are the consequences?”
Back in Gig Harbor
Nadia Kohles has been studying coronavirus-related assignments in school.
“That’s pretty cool, I guess, so we’re all aware of what’s happening right now,” she said. “Some people don’t watch the news or research, so it’s a way to let some of the students and families know why we need to be social distancing.”
Mom Alexandra is still concerned about being in closed spaces but will let her kids socialize outside.
“Some of my friends are willing to do it and some are not,” Kohles said.
She is empathetic to those who are more strict than she is.
“I think the public should not judge if families don’t want to socialize,” she said. “Nobody wants to put their family in danger.”
Ryan can’t wait to see his friends in person.
“Instead of trying to look at a computer screen and seeing their body and not just their head,” he said.
Nadia misses having social skills, she said. She gets nervous when strangers speak to her. She wants to get out of quarantine, but she’s not sure what she’s going to find.
“The world is going to be so much different,” she said.
Resources:
▪ Centers for Disease Control: cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html
▪ ESD 113: esd113.org/behavioral-health-resources/
▪ MultiCare: multicare.org/news/ways-to-cope-with-stress/
Pierce County Connected: gtcf.org/initiatives/pierce-county-connected/
This story was originally published June 13, 2020 at 7:00 AM.
