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This continues from Part 1 of this posting.
Planning for and fear of the future: The stress of uncertainty
One of the distressing features of the current crisis is the massive uncertainty about what is to come. In high school, almost all students (and teachers) have had to make an abrupt switch to online classes, many juniors would have been preparing for SAT/ACT testing, and many seniors are in the process of decision-making about college. But testing plans are not clear, and most universities and colleges are shuttered, so that campus visits are out. And no one knows when academic life will resume any kind of normality. Beyond educational and life planning upheavals, the fear that most everyone has about how bad this will get and how long it will last is very much on the minds of adolescents and their families. One thing we do know about stress—vastly greater than what we knew not that long ago (McEwen & Akil, 2020), with much credit going to the pioneering work of Bruce McEwen, whom we lost earlier this year—is that uncertainty, especially regarding important and potentially life-altering issues, is capable of triggering major stress reactions. The complicated connections among multiple kinds of uncertainty make it even more difficult.
Staying in the present moment as an aspect of mindfulness entails not sugarcoating the reality. It is what it is: we don’t know where it’s going or how long it will take to run its course. Pretending otherwise is almost certain to be obvious to adolescents. But this doesn’t mean just giving in to chaos. The best antidote to uncertainty is to gather and update whatever information is available, and to plan as much as possible given those constraints. Among the things teens can do: keep up with current online schoolwork (though not obsessively), because whenever schools return to normal operations, it will be important not to have the added stress of being behind; for seniors who have application decisions pending and/or decisions to make, most or all universities and colleges have regular updates on their websites, so checking in regularly reduces some uncertainty. Parents can remind students that this too will end, and that being mindful of their goals and sense of purpose is still important, even if it seems chaotic now.
Loss and grief for activities and rituals of school and college life
The loss of everyday interaction with peers, of the structure of academics and extracurricular activities that frame their time and commitments, and the likely disappearance of the rituals and rites of passage are quite reasonably going to spark strong emotions, including anger and grief. Parents can recall, for example, their own senior year experiences, with graduation planning, finishing up with your cohort and making bittersweet farewells, and going to special events like proms. Not being able to experience and enjoy those rituals is painful. For athletes, the sudden end of their team, teamwork, and competitions is yet another blow. It’s important for parents and other adults not to downplay the sense of loss and grief this new reality brings. Maintaining structured activities and strong social connections can mitigate these feelings, but they won’t make them disappear. It may help to let them know that these feelings fade over time, but don’t expect it to help much. Finding alternative ways to celebrate, and even rebooking post-school year events if possible, may provide additional mitigation, but at the end of the day, see above: it is what it is.
The evidence continues to grow that a major contributor to stress dysregulation arises from neglecting physical self-care. Physical activity is a sound stress reducer, as it burns off “fight or flight” stress hormones like cortisol. Doing so while adhering to self-isolation can be challenging but not impossible. Gyms are mostly closed for the duration, but walking, jogging, biking, hiking are all good options that maintain physical distance from others. Getting sufficient sleep on a (mostly) regular schedule is also a potent counterforce to stress dysregulation, and this is especially important for adolescents who need more sleep than adults, but rarely get it. Wild swings in timing do matter as well, even if the total sleep amount is adequate: high day-to-day variability in the timing of sleep impairs the ability to cope with stress, mostly independent of total sleep time. Stress eating is a major risk, especially when there are fewer distractions and activities to fill the day. It is biologically similar in some ways to social connections, in that high caloric intake is a cortisol counter-agent, but it is quite different in most other ways, including increased risk for diseases and disorders, like diabetes, obesity, and metabolic syndrome. “Comfort” foods and snacks don’t need to be banned, but relying on them to reduce stress has long-term risks, even if the short-term relief often seems worth it. This is even more true of substances, although this is a risk that may actually decrease during self-isolation and especially official lockdowns: their supply chain is likely to be disrupted. But parental awareness and monitoring of this possibility are still good ideas.
Finally, appealing to adolescents’ “better angels” may have a bigger impact than we imagine, given the often negative perceptions of adolescents as stormy, out-of-control, or “ticking time bombs.” Yes, they do engage in a lot of health risk behaviors (Demidenko et al., 2019) for a range of reasons—peer status, wanting the benefits of the risky behavior, and garden variety poor judgment—that current thinking attributes in part to hyper-activated incentive, arousal, and reward systems in the brain paired with slower developing prefrontal executive and judgment functions (Casey et al., 2011). But those same brains support and promote a great deal of social engagement in positive activities, like working against gun violence and climate change. Many adolescents are taking a lead in dealing with this crisis as well, warning their parents and family to take the requested or mandated precautions, keeping in touch with friends and acquaintances through social media, and staying informed about what is happening and what needs to be done. These manifestations of resilience are not uncommon, and need encouragement.
One parting note: don’t blame the victims, whether adolescents or adults. Appealing to the “better angels” is not an invitation to chastise less than ideal behavior. Adolescents will experience fear, sadness, loss, grief, and other difficult emotions, expressed in a range of ways. Telling them, or anyone, to “just get over it, be strong,” is unlikely to help them to cope with the major stress they are experiencing.
