Navigating a Mental Health Crisis: How to Support Kids with Anxiety and Depression
No matter where you stand on Covid politics, we can all agree that the last 2 years have been challenging for everyone. The roller coaster of lockdowns, masks and mandates has led to isolation, fear, discrimination and even panic. While there is now a sense of things returning to normal, the last 2 years have left many suffering, unable to bounce back. Older kids lost out on graduations, proms, sports competitions and other once-in-a-lifetime experiences and all kids (and educators and parents) had to navigate online learning, in school cohorts, quarantines and frequent covid tests.
Young children hardly remember life before Covid and for the really little ones, coined Covid Babies, it's the only life they know.
Anxiety and Depression are on the rise.
Prepandemic, about 4% of children and youth between the ages of 1-17 years old, had fair or poor mental health as reported by their parents (1). In August 2021, a University of Calgary meta-analysis found that anxiety and depression had doubled in children and adolescents compared to prepandemic times (2). According to a research team at The Hospital for Sick Children, the loss of in-person learning had a significant impact on child and youth mental health (3). As Dr. Daphne Korczak puts it: "schools represent more than just academics for children and youth. For many, school and it's in-person interactions and activities form the cornerstones of their lives." (3).
It's clear: Covid impacted the mental health of many kids, youth and adults alike.
So where does that leave us?
While we cannot control Covid or predict the future where Covid is concerned, we can certainly address other potential causes and contributing factors.
As a Naturopathic Doctor, it is my job to assess all possible causes of anxiety and depression in youth and determine strategic recommendations to support them. Sometimes I am a patients first point of contact and other times I am an addition to an already established healthcare team. Often times, I am referring to or referred by clinical psychologists, psychiatrists or Medical Doctors, offering patients the best kind of integrative care.
Why Testing is so Important:
Sometimes anxiety and depression can be related to deficiencies in iron, B12 or Vitamin D. Anxiety can be related to drops in blood sugar and depression can be related to a slow functioning thyroid. Low cholesterol is also associated with anxiety and depression.
Other testing might include Organic Acid Testing, Food Sensitivity Testing or Hormone Testing as imbalances are commonly related to anxiety and depression in adolescents.
While not all testing is necessary for everyone, any tests that are completed should be done so strategically. I always want to prevent unnecessary testing, especially in little ones.
As Always, Food is the Foundation:
I've always been a big believer that you are what you eat, food equals mood and small changes make big differences. Diets low in critical nutrients are linked to mood disorders in children and while studies in kids are lacking, research does show that adults who consume a diet low in folate, magnesium, and zinc are more likely to be depressed (4, 5). Similarly, adults who consumed higher amounts of essential fatty acids such as fish, experienced lower rates of anxiety and depression (6).
As a parent, try to encourage a variety of different foods at mealtimes to maximize your childs nutrient intake. If they aren't getting the right nutrients from food, be sure to get them on appropriate supplements. Don't be fooled by misleading marketing! You get what you pay for so if you purchase cheap quality products you're going to see cheap quality outcomes. If you're interested in learning more about supplements for anxiety and depression, feel free to reach out for a complimentary consultation.
Become an expert in reading food labels, especially the ingredient list. If you can't read it, write it, say it, spell it or explain what it does in your body, your body doesn't recognize it either.
For instance, food dyes, preservatives and refined sugar can act as neurotoxins and are often linked to difficulty with focus and attention, irritability, restlessness and hyperactivity (7). Aspartame and preservatives such a sodium benzoate as well as some dyes such as tartrazine, have even been linked to depression (8). In fact, if you have Kraft macaroni and cheese in your pantries check to see if it contains Yellow 5 - otherwise known as tartrazine.
My recommendation? Experiment with removing these food ingredients from your child's diet for a minimum of 30 days and note changes. It might take you time to get to a place where you can do this challenge and I totally get it! Don't feel discouraged. Start with finding new, more wholesome alternatives for what your kids already like so that this process can be easy and exciting.
Rule out hypoglycaemia which can mimic anxiety or depression. Reactive hypoglycaemia is common in kids eating a Standard North American (SAD) diet (think chicken fingers, pasta and sandwiches) and occurs when insulin is secreted after a high carbohydrate meal, leading to low blood sugar in the hours following. Most parents report changes in their child's mood between 1.5 hours to 4 hours later! Balance your child's blood sugar levels by offering meals high in protein, fibre and fat such as yogurt (dairy or non) with nuts and berries, protein shakes or overnight oatmeal.
One last note about diet and mood disorders. Did you know that 90% of serotonin is produced in the digestive tract? This is significant because an impaired digestive system can predispose someone to anxiety or depression. Incorporate fermented foods such as organic yogurt, kefir or sauerkraut into your kids diet or supplement with a good quality probiotic. Be aware: not all probiotics are the same. Different strains have different benefits so be sure to connect if you want specific supplement recommendations.
Food Only Plays One Part. Don't Forget The Rest:
While food is the foundation of health and the most basic starting place for treating anxiety and depression, it is important to consider other fundamental contributing factors.
Is your child getting outside and getting natural Vitamin D exposure? If your child spends most of their time indoors, levels may be lacking and supplementation may be necessary. Since too much Vitamin D can be toxic, it's been to test before supplementing. FYI: Testing is not covered by OHIP.
Is your child getting regular physical activity, either at school, home or both? Exercise gets the blood flowering and endorphins pumping, naturally improving mood.
Is your child exposed to too much screen time? Understandably, screens are hard to avoid these days but Electromagnetic Frequencies can contribute to anxiety, depression, stress and reduced sleep quality (10). Consider the location of home smart devices, modems and smart stations. Limit daily screen time, especially close to bedtime. Turn computers and iPads off and have your teenagers turn their phones to air phones mode at bedtime or keep their cell out of their room altogether.
How much time is your child spending on social media? This is a question parents of older kids should be asking themselves if they have a family member struggling with anxiety or depression. Extensive research shows that the quantity and quality of social media use is associated with depression, including suicide, in adolescents (11). Kids on social media need to understand that filters are the modern day photoshop and that social media use poses its own set of dangers when used irresponsibly.
Does your child have support? Friends are wonderful but we know not all kids are fortunate to make friends easily. Sometimes a friend is not enough and professional support is needed. As a parent we hope our kids will talk to us about their thoughts, feelings and fears but sometimes an non-judgemental objective ear is really what they need. There are wonderful social workers, psychotherapists, psychologists and psychiatrists that can support your child if needed. Create a community and a support network for your child.
When is it Time to Consider Medications?
I see patients from all avenues and with all sorts of beliefs. Sometimes parents come to me looking for an alternative to medication and other times they are coming to me to offset side effects of the medication. Often times parents want to work integratively with their doctor to wean off medication.
Generally speaking, my belief is that it's always worth trying the basics first, in conjunction with some form of counselling or therapy. If medication is needed as it sometimes is in acute situations try to use that medication as a bandaid - a short term solution, while treating the underlying cause.
Covid has certainly left many people with anxiety and depression and we have to hope that the worst is behind us. While it may have been a trigger for many, it is not to blame for all. I am confident that becoming more mindful of diet and nutrition, incorporating strategic supplements and stepping away from the screen to be physically active outdoors, ideally with at least one friend, will make a world of difference. Sometimes botanical medicines or even homeopathics can work wonders.
If you have a child struggling with anxiety, depression or another mood disorder and want to know if I can help, please reach out. Visits are available online or in person, either out of my home office in Maple or out of Uptown Midwives and Family Wellness in North York. Visits are covered by extended health insurance so if you have benefits you can definitely take advantage of them. Click here to book a complimentary consultation today!
Dr. Shelly Ordon, N.D.