How are teens coping with changes brought on by COVID-19

Changes caused by the COVID-19 pandemic and social distancing have greatly impacted teens. They’re not in school or seeing friends in person, and many are struggling with the reality of missing milestones they had looked forward to celebrating, like graduation or prom.

It’s normal for teens to feel anxious during this period of their lives, and we want them to know they’re not alone. We checked in with our teen advisory council to see how this time has impacted them, how they’re coping with these changes, and their tips for other teens struggling with changes prompted by COVID-19. Despite the challenges of this uncertain time, they also shared good things that have come out of this period.

Read on for their experiences and advice, plus more tips from CHOC experts.

Layla, age 14

Layla
Layla, a CHOC Children’s teen adviser

I’ve had two performances, a school tradition and my spring musical postponed. My volleyball season is paused, and sadly, I do not think that we will be able to resume. The first week of cancellations and postponements was very rough, with more and more bad news piling on top of each other.

Strangely, as much as I miss my friends, I have not been contacting them as much as I thought I would. A huge part of our friendship was seeing each other every day at school and having many opportunities to joke around. Since being in quarantine, I find myself texting them about once a day.

Instead of talking with my friends a lot, I have been having more alone time. This has given plenty of time to think, which has come to be both good and bad. Sometimes when I am alone too long, I begin to feel negative and I put myself down. The most effective way of balancing this out with good is hanging out with my family or trying out new activities and putting my energy toward productive things.

There are good things that have come out of this time. One of my favorite things to do is to discover and listen to new music, and I have had a lot of time to do that recently. Another good thing is that I feel like I got a break.  Before, I was balancing school, theater, volleyball and other extracurriculars, and my life seemed to be moving incredibly fast. This time has given me a chance to reflect and take a breath.

My advice to others is that it’s important to remember that during this time, we are all sacrificing something so that our Earth can heal sooner.

Carina, age 17

Carina
Carina, a CHOC Children’s teen adviser

Some special events that have been canceled or postponed because of stay at home orders includes my junior year softball season and a concert. The softball season getting canceled was really disappointing considering my teammates and I have been practicing hard almost every day before we got the news. Currently, the softball season is over, but I see my teammates and my coaches every Monday through video calls. My concert getting postponed was devastating because it is an experience that you can’t recreate on a video screen. The energy, the music, and the emotion are all something that I was looking forward to, especially since junior year was getting stressful.

I’ve kept in touch with friends by having a group chat via text and group FaceTime with them almost every day. Most of my friends have been keeping themselves busy with schoolwork and video games. However, we know that if someone calls the group chat, they are lonely. That’s why most of us answer the call and talk about school or relationship drama. It is really effective, and we can add anyone to the call at any time. I also play video games with my friends and it helps me work on my problem-solving skills within a group while also joking around and having fun.

The stay at home orders aren’t difficult to follow, but being able to see my friends has taken a toll on my emotions. I have sometimes struggled with motivation to do my schoolwork or exercise but this time has given me a chance to reflect on what I want to do in my future in regard to college and beyond.

During this stressful time, I have noticed that I am more aggravated and have less of a patience with my brothers and family, but that talking to my friends over the phone helps me a lot.

The good thing about these stay at home orders is that I get to spend more time with my family and get to do some of my hobbies. This has given me more time to write in my journal, sew and draw with all my free time. I also have more time to focus on my homework and actually work through problems rather than find a quick solution and not understand the concept.

Lauren, age 15

lauren
Lauren, a CHOC Children’s teen adviser

My church had several events planned that were canceled or postponed. This has impacted me a lot because my faith is very important to me, and with mass gatherings being cancelled it has been quite a challenge to adjust to new routines. My family also had to cancel a few fun events like our kayaking trip and other bonding activities. Having these events cancelled has made me really sad because it prevents me from spending time with some of my family and closest friends.

To keep in touch with friends, I have been FaceTiming and texting them every day so we can chat and catch up. Working together on school assignments has also allowed me to collaborate with my friends.

The pandemic has its ups and downs regarding my emotions and mental health. While staying at home allows me to have more time for myself, it takes away a lot of the social aspects of my life. Staying home has its perks, such as how it has allowed me to dedicate more time to self-care, learn new hobbies, and relieve me of the pressure that comes with going to school with other students and teachers. I’ve also been able to catch up on all the sleep I missed out on during the school year. I have also taken more time to read the books I didn’t get the chance to finish, and to finish learning piano pieces. Distance learning has allowed me to work on schoolwork at my own pace rather than following a specific schedule at school.

I am closer to my family as a whole as a result of being quarantined since we are spending all of our time with each other. We have been going on family walks around the neighborhood and nearby trails.

Zoe, age 16

choc-childrens-teen-advisor-zoe
Zoe, a CHOC Children’s teen adviser

COVID-19 has caused a lot of cancellations. I was planning on spending a day at Disneyland with my friends on my birthday, but Disneyland has closed until further notice. I still find time to catch up with my friends, however. FaceTime and Zoom calls have been a good pastime and a great way to keep in touch.

In terms of my emotional state, it’s been difficult to stay positive when nothing is definitive. Everything is up in the air and there’s no answer to when things will return to normal. There are a few positives, however. I have a lot more time during the day due to the fact that all schooling is online. I get to watch more movies since I can’t go outside and it’s a lot easier to relax. I get to spend more time with my sister and parents which has certainly brought us closer.

Overall the coronavirus has made it hard for everyone in at least some way, but everyone is learning new ways to adapt and thrive in uncertainty.

Christian, age 17

christian
Christian, a CHOC Children’s teen adviser

I am currently a senior in high school and all my senior activities, including prom, graduation and grad night have been canceled. Our graduation ceremony will be virtual, and the day we get to pick up our diploma I must wear a mask and gloves and I am allowed 10 minutes to clean my locker out and leave the campus. My family had to cancel an upcoming vacation that was originally planned to celebrate my graduation and my parents’ 20th wedding anniversary. All these changes made me very upset. I felt robbed because I spent my entire life working very hard to get to this moment of graduation, yet I will not receive a celebration or commencement as others have received.

I am now feeling better and I am thankful that my family and I have been healthy through this pandemic. Also, knowing that I am not the only one dealing with this has helped. I am among many students in this country not able to walk across the stage on graduation and celebrate their achievements with the people they love. I feel this pandemic has brought many students together and knowing my generation, we will come up with a way to make up for our losses.

During this time, I have mostly kept in touch with my friends through texting and social media. I have also played video games with a few of them to pass the time, which has been fun. Although in the end, talking to them through social media or a video game is just not the same as physically being able to talk to them.

Since the start of the stay at home order, I have noticed my mental health change as a result. After a while of no major human contact, except for close family, it starts to get a little lonely. I have also noticed that sometimes I get the feeling of frustration from being indoors all day. Despite these feelings, I try my best to stay occupied so that these feelings do not occur.

While most of the effects of this pandemic have been negative, I have noticed some positives. One example is that I have been able to spend more time with my immediate family. Since the start of social distancing, we have been watching more movies, playing board games together and cooking. Before this pandemic we were all so busy and hardly spent time together. Now we do a lot of activities together and I am thankful for this time with my family.

Trevor, age 16

trevor
Trevor, a CHOC Children’s teen adviser

My volleyball season and my 16th birthday party were canceled due to COVID-19. It’s a shame the season had to end. We went undefeated last year and I was looking forward to repeating our success. My mom did the best she could to still celebrate my birthday under the circumstances. We got takeout from my favorite restaurant and she even had a cake shipped here from New York City.

I’ve kept in touch with my friends through social media and group chats, but I’ve started to feel claustrophobic. My room’s four walls seem closer than usual. I play video games, do homework, browse social media, and even eat some meals in my room for a change in routine.

A good thing that has come out of this time is that I’ve gotten even closer to my mom.

Sam, age 13

Sam
Sam, a CHOC Children’s teen adviser

Some birthdays, graduation and school festivals have been canceled. I have kept in touch with friends through FaceTime, Zoom, texting and phone calls. Once I found out we could do group FaceTimes, I was so excited to be able to talk to more than one of my friends at a time and actually see all their faces at once. Zoom and Google Meet have also been super helpful for soccer team meetings and school meetings.

I have noticed that I am becoming much less social since I have not seen my friends in more than one month. Though I have been talking to my friends on the phone, it is different from being able to interact and see them in person.

During this quarantine, I have much more down time to spend with my family. Since both my parents work in the hospital and work pretty much every day, I have had a ton of time to get to know my grandpa and learn more about him since he doesn’t live with us full-time. I have also learned to be more productive and active during the day because of this extra time from no school or soccer practice. I have taken this time to really take care of myself and family.

Tips for parents of teens struggling with stay-at-home orders

Many teens are complying with stay at home orders and social distancing during the COVID-19 pandemic. However, many of us have also heard stories about teens who were seen hanging out with friends in large groups, celebrating birthday parties in person, as well as being upset with parents who are trying to implement rules to keep their families safe. For those cases where teens are struggling to understand the seriousness of the pandemic, and observe social distancing, the question is, how do we promote increased teen understanding and compliance? Read more from a CHOC mental health therapist here.

How to help your teen cope with COVID-19 cancellations

To high school seniors, schools being closed doesn’t equal a vacation – to them, this is time they won’t get back with their friends. It’s normal for teens to feel anxious during this period of their lives, as they close one chapter and begin another. However, teens may feel especially anxious as they realize they may never walk through their high school hallways again, attend prom, perform in their final theater production, compete in their final season, or celebrate graduation.

If you’re a parent or guardian of a teen who is struggling with a loss of control and trying to cope with canceled celebrations, we have tips for talking about it and coping. Read more from a CHOC psychologist here.

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How to help your teen cope with COVID-19 cancellations

By Dr. Mery Taylor, pediatric psychologist at CHOC Children’s

To high school seniors, schools being closed doesn’t equal a vacation – to them, this is time they won’t get back with their friends.  It’s normal for teens to feel anxious during this period of their lives, as they close one chapter and begin another. However, teens may feel especially anxious as they realize they may never walk through their high school hallways again, attend prom, perform in their final theater production, compete in their final season, or celebrate graduation.

If you’re a parent or guardian of a teen who is struggling with a loss of control and trying to cope with cancelled celebrations, here’s tips for talking about it and coping.

Allow your teen to grieve

For most high school seniors, sometime in March 2020 they unknowingly experienced their last regular day of school with so many things left undone. I’m sure there were tears shed as this realization set in, along with confusion, anxiety and despair at the loss of their senior year.

During this time, it will be important to allow your student to cope and grieve in her own way. Some students will cope by throwing themselves into their academics, focusing on end of the year projects, and last-minute scholarship applications. Others may struggle through the typical stages of grief — denial, anger, depression, bargaining and acceptance. It is typical to jump back and forth between these stages.

As a parent, you may find yourself in a similar boat — accepting the new normal, only to be saddened the next day when you realize another disappointment due to COVID-19. This is normal. Many people feel like this when experiencing a loss of control over their circumstances.

Use dialectical behavioral therapy (DBT) skills to help you feel back in control

During this time of uncertainty, your teen may be struggling with a loss of control. Using skills associated with dialectical behavioral therapy (DBT), you and your teen can help to regain that lost sense of control.

  • Accept your emotions — What you are going through is not normal. What is normal is feeling emotional in these circumstances. Remember, you are the boss of your emotions. Name the emotion and put a label on it. Take a break and spend some time soothing yourself. The idea is to not let your emotions stop you from doing what you can.
  • STOP — This stands for stop, take a step back, observe and proceed Take a step back and observe your emotions. Let your emotions calm. Then observe the situation as you would if it were someone else facing it. What would you tell someone else to do?
  • Practice radical acceptance — Radical acceptance is the complete and total acceptance of reality. This means that you accept the reality in your mind, heart and body. You stop fighting against the reality and accept it.
  • Use your wise mind —Make decisions about the situation with your wise mind. Your emotion mind will urge you to give up, act impulsively, rage, or give up when faced with disappointment. Wait for your wise mind to be in charge. Your wise mind can take in new information, be flexible in considering alternatives, and be creative in thinking of solutions.

Marking this milestone

Taking the time to celebrate milestones is an important stepping stone in a person’s life, and an opportunity to observe achieving a goal or the fact that someone is entering a new stage in life. A high school graduation marks a time of academic success and transition to adulthood. Even though the current senior class’ year was cut short, it does not make their efforts any less significant.

Senior commencement ceremonies have always been just as much about the students’ past accomplishments as a view toward their future. Particularly, in these times, it will be important to highlight their strengths and virtues as they enter the adult world. Finally, marking this milestone is also an opportunity for the caregivers, teachers, family and friends, who have watched them grow and work hard for this moment, to share in the student’s triumphs and acknowledge their hard work.

The celebration

The celebration or milestone you and your student had originally envisioned may not look the same today, but it can be just as memorable. Take time to talk through what is important to you and your student and find creative ways to make it happen. Here are some ideas to get you started:

  • Mom wants pictures — While practicing social distancing, find a friend or hire a photographer to shoot pictures of your senior in a cap and gown in a lovely outdoor setting.
  • The student wants to dance — Use Zoom to meet up with friends and have a virtual prom.
  • Teachers want to see you in your cap and gown — Organize a drive-by parade around the school.
  • Dad wants to brag — Use FaceTime or Zoom to connect with family and friends. Think about putting a slide show together of your child through the years. Senior, don’t forget to wear your cap and gown.
  • Friends want to graduate together — Create a virtual meetup on Zoom, or practice safe-distancing in a park to ‘move the tassel’ from right to left and throw your caps in the air.
  • Siblings want to participate — Decorate the family car, driveway or front lawn with well-wishes.

Congratulations to the senior class of 2020! Best wishes for your new adventures.

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Cyberbullying and COVID-19

Cyberbullying has become an increasingly common and serious issue in recent years largely due to the easy access, and in some cases the anonymity, of digital devices. As children and teens spend more time online during the COVID-19 pandemic to complete virtual schoolwork and keep in touch with friends, cyberbullying may increase as well.

Parents, however, are also at home with their children more now than ever before. During this time, healthcare providers say, parents have the opportunity to be more mindful than ever about their child’s technology and social media use.

“Technology can be a wonderful, educational and fun resource, but it can have negative consequences s well, especially on children and teens,” says Dr. Christopher Min, a CHOC Children’s psychologist.

One of the best ways to protect your child from bullying is to talk openly about it, Dr. Min says.

“Remind your child that most bullies have low self-esteem, and they bully others to try and feel better about themselves,” Dr. Min says.

To start these conversations, ask open-ended questions, rather than firing off a specific list of questions. Try asking something like “Is there anything going on?” or “Is there anything I can help you with?”

Tips for parents

Every parent wants their child to feel comfortable and happy, and to stay safe. Dr. Min shares tips for parents of children using social media and technology:

  1. Monitor teens’ social media use. To what extent a parent should track social media activity depends on the child, Dr. Min says, but parents need to be aware how a child uses these tools. Monitoring can be accomplished through regular discussions or more formal means such as sharing log-in information, depending on the child’s responsibility level.
  2. Encourage teens to have virtual get-togethers with friends. The underlying reason for social media is to create a sense of connectedness, and this can be accomplished faster than meeting in person. Although in-person hangouts aren’t possible during current stay at home orders, teens should make an effort to maintain social relationships during this time. Encourage your child to video chat with friends, have a virtual game night, or host a virtual movie night with their friends.
  3. Remember that parents control access to social media. Min reminds parents that they pay for internet or cellphone access. Parents should exercise authority and reason with teens by stating clear consequences and rewards for social media use.
  4. Watch for signs of bullying. Pay close attention to signs from your child that may show something is wrong, such as acting withdrawn, sad or irritable, or changes in their sleep or appetite. Keep in mind however that sometimes kids will not display any signs at all so it’s important to keep an open dialogue with your child.
  5. Have a plan. Talk about what your child might do if he or she is bullied, including who to tell.
  6. Build your child’s self-esteem. The better your child feels about herself, the less effect a bully will have on her overall well-being.
  7. Tell others. Inform your child’s school about the bulling and talk with the bully’s parents about the behavior.

A reminder for teens

Remind your child to pause before they post. Teens ready to post something online should instead pause for five to 10 seconds to consider their actions, the post’s meaning and possible consequences.

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Teen advisers offer tips on avoiding peer pressure to vape

The dramatic rise in vaping among teens is alarming to pediatricians and parents alike. It’s common for teens’ first exposure to vaping to come as an effect of peer pressure, says Dr. Katherine Williamson, a CHOC Children’s pediatrician.

“The rate at which vaping has increased over the last several years see is really scary for me to see as a pediatrician,” Williamson says.

CHOC Children’s teen advisers, a group of teens active in their community, committed to academic success, and who support CHOC’s mission, offer their advice for teens struggling to deal with peer pressure to vape.

  • It’s just not worth it – “My freshman year of high school, I was offered the opportunity vape more than 10 times. In these situations, it’s your choice how to respond. Vaping is simply not worth it. Do not be guilted or tempted by those around you.” – Andei, age 16
  • Consider the long-term consequences – “You may not feel it at first, but as you vape, your lungs are being damaged. You could end up in the hospital as a result of vaping. Turn down the offer to vape and walk away from the situation.” – Sam, age 12
  • Offer a valid excuse – “My parents always told me that to get out of a peer pressure situation, I could tell a white lie and blame it on them. I could say something like, “My parents are super strict and will drug test me, so I can’t. Or, I remove myself from situations by saying I have to get to volleyball practice or have another commitment.” – Noah, age 17
  • Complications of addiction – “Teens endure tremendous social pressure, which makes it easier for teens to fall victim to vaping. Avoiding peer pressure to vape might not be an easy task, but it’s far easier than having to withdraw from addiction.” – Christian, age 17
  • Health consequences —
    • “Always think about the serious health consequences of vaping. It’s very addictive, causes breathing difficulties and increases your risk of cancer or even death.” – Lauren, age 15
    • “Although it is marketed as a safer alternative to cigarettes, they contain addictive chemicals. It’s a newer trend, and some teens may not be as educated on the dangers of vaping.” – Layla, age 14
    • “Vaping can change your life in an unhealthy way. Not only can you damage your lungs, but it can impact your life in others way, too. You could be punished by your school and parents, as well.” — Carina, age 15
    • “Although the side effects may
  • Re-evaluate your friend group – “Walk away from the situation and stop hanging out with friends who are pressuring you. That means they don’t care about you. Find new friends who do.” –Trevor, age 15
  • Social/school consequences – “Schools take vaping seriously. They can take away your ability to participate in activities, sports or dances.” – Jorian, age 15

Harmful effects of vaping

As more teens develop an addiction to vaping nicotine or CBD oil, Williamson has treated more and more teens with lung problems, agitation and anxiety.

Vaping hasn’t been around long enough for us to know its long-term effects on the body. But health experts are reporting serious lung damage in people who vape, including some deaths.

E-cigarettes also:

  • Irritate the lungs
  • May cause serious lung damage and even death
  • Can lead to smoking cigarettes and other forms of tobacco use

Some people use e-cigarettes to vape marijuana, THC oil and other dangerous chemicals. Besides irritating the lungs, these drugs also affect how someone thinks, acts and feels.

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Can HPV really lead to cervical cancer?

Human papilloma virus, or HPV, affects nearly all sexually active men and women at some point in their lives. Many people “clear” or fight off their infections without ever knowing that they had an infection at all. However, a percentage of people with the virus do not clear their infections and may develop genital warts, cervical cancer, or other types of cancer.

We spoke to Dr. Terez Yonan, an adolescent medicine specialist at CHOC Children’s, to get the facts on HPV and how it can indeed lead to cervical cancer.

terez-yonan-do
Dr. Terez Yonan, an adolescent medicine specialist at CHOC Children’s.

How common is HPV?

There are nearly 80 million people currently infected with HPV in the United States, according to the Centers for Disease Control, and nearly 14 million people, including teenagers, become infected with HPV each year.

How does HPV lead to cervical cancer?

The most common way to contract HPV is through sexual contact, from a direct transmission from one person’s genitals to the other. When transmitted vaginally, the HPV cells will integrate into cells of the vaginal wall and cervix. This changes the composition of the normal, healthy cells and you end up with dysplasia, also known as abnormal and pre-cancerous cells. This can worsen and turn into cervical cancer.

For people with a normal immune system, it could take years for HPV to turn into cervical cancer, but for someone who is immune-compromised, that process could take just a few months.

HPV does not always lead to cervical cancer. There are what we call high-grade infections and low-grade infections. Low-grade infections are easily cleared by the body on its own. It takes about two years for a healthy person to clear HPV. High-grade infections can last longer in the body and put you at risk for cervical cancer or genital warts. Although not considered dangerous, genital warts are unsightly and can cause irritation depending on where they are. If not treated, warts can grow into different types of cancer, including oral and anal and penile cancer.

What are the warning signs of cervical cancer?

Most of the time, people don’t know they have HPV because there are no warning signs. In some cases, genital warts may appear. Abnormal vaginal bleeding can be a sign of cervical cancer. If you notice abnormal bleeding, consult your primary care provider, gynecologist, or adolescent medicine specialist.

Can I get tested for HPV?

A Pap smear, also called a Pap test, is a pelvic exam designed to test for cervical cancer in women. An HPV test can be done using the same sample of cells collected during a Pap smear.

When should I get my first Pap smear?

A Pap smear is intended for healthy, sexually-active people. They are generally not recommended before 21 years of age. For people who are immunocompromised, Pap smears are recommended when you become sexually active regardless of age because of the increased risk for picking up infections , and for those infections to more quickly develop into cancer.

How often should I get a Pap smear?

Someone who is immunocompromised needs two Pap smears within the first year of becoming sexually active. If those are normal, the exam can be done annually. Healthy women in their 20s need a Pap smear every three years. Beginning at age 30, Pap smears can usually be done every five years.

Who can do my Pap smear?

You can get a Pap smear from your adolescent medicine specialist, family medicine provider, internal medicine provider, or gynecologist. Nurse practitioners and physician assistants  in each of these offices can perform the exam as well.

What does an abnormal Pap smear mean?

If your results are abnormal, you will undergo more frequent Pap smears for monitoring, until your results are in the normal range. The frequency of these Pap smears will be determined by your doctor, but it could range from every three months to every year. Since many people’s bodies clear HPV on their own, when the results are clear again, you will return to an every three- or five-year schedule for Pap smears, depending on your age.

Your doctor may suggest a colposcopy, another type of cervical cancer test. This gives them a better view of your cervix. If they identify cells that may be abnormal, they will perform a biopsy and remove a tiny sample of tissue from either the inside or outside of your cervix. If the biopsy confirms the presence of abnormal cells, your doctor will discuss specific treatment options.

How can I prevent cervical cancer?

Receiving the HPV vaccine is the only way to protect against cervical cancer. Each year in the U.S., 13,200 women are diagnosed with cervical cancer. This number has decreased since the introduction of the HPV vaccine.

What happens if I get cervical cancer?

If you are diagnosed with cervical cancer, you will be referred to a gynecologic oncologist—a doctor who specializes in cancers of the female reproductive system. Most cases require chemotherapy, and some require radiation as well. Surgery may be a treatment option.

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