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AHA News: For Kids, a Pandemic of Stress Could Have Long-Term Consequences

WEDNESDAY, May 27, 2020 (American Heart Association News) -- Chris Dier understands how trauma can follow you for a lifetime.

In 2005, he was entering his senior year of high school, looking forward to a year of making memories at Andrew Jackson High in Chalmette, Louisiana. Then, disaster struck. Twice.

First, a car crash killed three friends. Two weeks later, Hurricane Katrina hit.

He and his family got out in time. But the storm drowned his home in 13 feet of water, leaving his neighborhood a mess of toppled trees and abandoned cars, and severing him from the life he'd known.

"I remember feeling a deep sadness, and a deep sense of loss," he said. "Losing people in your community. Losing the community feeling. Losing your senior year. Losing connection with so many people."

Dier, now a teacher at Chalmette High School, is seeing that story play out among his students, whose lives have been turned upside-down by the coronavirus pandemic. It's the kind of trauma that could have long-term consequences, experts say, although there are steps parents can take to limit the potential for damage.

Natalie Slopen, an assistant professor in the department of epidemiology and biostatistics at the University of Maryland, College Park, said extensive research shows excessive or prolonged exposure to stress in childhood and adolescence is harmful to healthy childhood development. "And this has implications for lifelong learning, behavior and health."

Part of the link between childhood stresses and health problems is direct, she said. Stress hormones can lead to inflammation, which raises the risk of developing chronic diseases, such as heart disease.

Stress also causes problems indirectly. Children who experience high stress levels are at increased risk for being overweight, having disrupted sleep or smoking – all of which can lead to health problems.

Children who suffer adversity also are less likely to pursue education as far as people who did not, Slopen said. "And we know that level of education is strongly correlated with income in adulthood, and that income is a really strong predictor of later risk for cardiovascular disease as well."

The pandemic also is likely to increase the severity of food insecurity, household stress levels and parents' substance abuse – that researchers have linked to lifelong health issues for children, she said. She's particularly worried about children who are trapped in potentially violent households, in danger of abuse but with nowhere to escape. "It's terrifying, really."

Children from low-income families and families of color are at particular risk from pandemic-related trauma, said Slopen, who co-wrote a 2017 report from the American Heart Association about the cardiovascular consequences of a traumatic childhood.

"These children are more likely to have parents who have to work out of their home, so they may be more likely to be experiencing the financial consequences. And their parents may also be more likely to have underlying health conditions that make the illness of COVID-19 more severe and potentially deadly."

But Slopen said not every child who experiences trauma now will have problems down the road.

Robin Gurwitch, a psychologist and professor of psychiatry and behavioral sciences at Duke University Medical Center in Durham, North Carolina, agreed. The pandemic will affect individuals differently, she said.

One of the biggest predictors of how a child will do after a crisis, Gurwitch said, is how well the parents cope with their stress. If they appear overly distressed, without effective coping, there's a greater chance their children will have problems.

So, adults need to talk to children calmly, and with honesty.

"It's not that parents and caregivers can't be stressed or distressed or worried or scared or angry or any of those things," she said. "The question is, how do I cope with the feeling? Do I melt down and look at the world as a completely dangerous place? Or do I say, 'OK, here's the things that we're going to do to make sure we stay as safe and healthy as possible?'"

Whether their children are in kindergarten or college, parents need to reach out and talk about what is happening with COVID-19, including asking about their feelings. "If a child says, 'I'm really scared' or 'I'm really angry,' as an adult it's up to us to validate that."

Sticking to a routine can help children. And finding a way to help other people can be a powerful step in coping and resilience, she said. "It may be as simple as chalk art, so when people take a walk, they see a happy message, or sending a card or letter to essential workers."

For Dier, Hurricane Katrina's devastation lingers. "I still have nightmares of water coming in the house and stuff like that, even though I wasn't there."

But he's made a point of using his experience to help others. He's Louisiana's 2020 Teacher of the Year. And when he wrote an open letter to the class of 2020, telling them of his experiences, it went viral. That led to more media coverage than he can keep track of and invitations to speak virtually to teens across the world.

He encourages students to write in a journal to get their thoughts out, to find ways to connect with people they can confide in and to do things they love.

"I also tell them it gets better," he said. "They just have to really keep thinking about their life, and the long-term."

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