A Wellstar psychologist talks about mental health as children and adolescents return to school

Dr. Janna Williams-Pitts in medical coatDr. Janna Williams-Pitts (photo courtesy of Wellstar Health Systems)

The return to school each year can be a stressful time for students and their families under the best of circumstances. With the disruptions brought about by the COVID pandemic, the new school year in the Cobb and Marietta school systems is likely to present special challenges to the mental health of students.

The Courier spoke with Dr. Janna Williams-Pitts, a psychologist with Wellstar Health System. She is a licensed clinical health psychologist and the lead for the Wellstar’s primary care behavioral health integration program.

She practices at the Kennesaw Medical Center and also supervises five behavioral health consultants who are assigned to different primary care clinics in the Wellstar system.

Dr. Williams-Pitts began the conversation by talking about how parents and other family members can recognize the signs of depression and anxiety among returning students.

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“Depression in childhood and adolescence can present primarily with irritability,” she said. “And that’s a little bit different than how it presents in adulthood.”

“So the first sign that your child or teenager may be experiencing depression is they seem a bit more grumpy than normal,” Williams-Pitts said.

She said that another sign of depression is less interest in doing things they typically enjoy.

“So if they typically really enjoy video games, or they typically enjoy riding their bike, they’re not doing that as much,” she said.

“Also negative self-talk. So if you notice your child saying, ‘I’m stupid, I can’t do this’. That type of negative self talk about themselves,” she said. “‘No one likes me.’ It’s really important that parents pay attention to that and lean into that, because that could be a sign of depression as well.”

She said that persistent worrying is a sign of anxiety.

“They may worry about their parents dying,” Williams-Pitts said. “They may worry about failing in regards to their schoolwork, even if they’re a straight A student, for example, or a B student.”

“Also physical symptoms: stomach aches, headaches … or just that they don’t feel well,” she said. “That could be a sign of anxiety as well.”

She then talked about the effects of the pandemic on student mental health.

She said that from a chronic stress management standpoint the way children and adolescents are facing stress is unique.

“And the stress can be associated with the school environment and the changes in the school environment, around virtual learning, hybrid models of learning, (and) being on campus,” she said.

“So they’re navigating all of these changes,” she said.

Dr. Williams-Pitts said there are also familial stressors, as parents navigate working from home, a hybrid model, and then going back to the office.

She said those are factors contributing to chronic stress.

“We know chronic stress can have an impact on both physical and mental health,” she said.

She said it’s important to work with children to manage their stress well, making sure the onset of mental health conditions or physical health conditions are recognized.

She stressed the importance of “making sure that the family has a structure … a bit of predictability around their their schedule through the day, and then also having regular eating schedules, and having a family kind of quiet time period before bedtime, and the household having a set bedtime.”

“And with this quiet down period … the house is quiet, the lights are dim, technology is off,” said Dr. Williams-Pitts. “And everyone kind of doing more quiet activities as they’re preparing for sleep can really help set the stage for good restorative sleep.”

“Also, movement is an excellent way for managing the stress response,” she said. “And we know it’s important for physical health as well.”

“Parents can help their children identify what type of movement they enjoy the most,” she said, “be it roller skating, skateboarding, hiking, rock climbing, whatever it might be.”

“I really encourage parents to be open minded and encouraging,” she said.

“I’m not saying parents need to get out on roller skates with their kids. But if you want to, go ahead … I’ve done it, it’s really fun. But really nurturing and encouraging your your kiddo to find their way to move that helps them great exercise and relieve their stress is important as well.”

“And also helping kids and adolescents identify what are those signs that … stress level is starting to increase? Is my heart pounding or racing? Do I notice feeling fatigued? Fatigue is a critical sign of chronic stress and that it’s starting to have an impact.”

She said parents should talk to children about stress response and normalizing it.

She said the conversation could be broached like, “I feel a little bit more tired than normal. When we get home, I’m going to take 15 minutes to myself to read a book to help recharge and restore myself.”

That could be something a family member could say to normalize prioritizing mental health and physical health, she said.

The Courier asked what parents can do to support children and adolescents in their academic recovery after the disruptive learning environment brought on by the pandemic.

She said that first, it has to be acknowledged that the situation has been difficult for everyone.

“This is difficult for a school, it’s difficult for the teachers, it’s difficult for administration because this is the first time at such a large scale,” she said.

“They’ve had to roll out everything without having a trial and error period,” she said. “So they have been learning: the teachers, the administrators, the school, they’ve been learning while they’re doing and trying to support students.”

“So parents can help by normalizing and saying, ‘Hey, everyone’s having a hard time with this, you’re not alone.'”

“And then also creating a learning space for their child in the household that is away from their bedroom,” Dr. Williams-Pitts said. “This is really important to help ensure that your child maintains healthy sleep habits. Reducing any activity in the bedroom outside asleep can be incredibly helpful for children and adolescents. And for adults, too.”

She said that parents could help the child or adolescent organize the work space.

“It really needs to be in a quiet area,” she said.

“So maybe having a midweek check-in where you evaluate the space, going over with your child, their folders, making sure that they have everything that they need, helping the child maintain organization, maybe a little bit more than you have in the past, just because they might be navigating, again, with the hybrid model, turning in things virtually. But then also they might have assignments that they need to bring in person,” she said.

“And that’s quite a bit for a child to navigate and a teenager to navigate,” she said.

She said that parents should stay in regular touch with teachers, also.

Then Dr. Williams-Pitts talked about a recent situation unique to teens: interruptions in life and college plans due to the pandemic.

“Something that I’ve noticed, specifically with teens who are preparing to go to college,” she said. “Their plans just completely changed.

“I had some teens that I was working with, where they were planning to go out of state for college, and then they ended up deciding to focus more locally and take courses at Kennesaw State University. It was really interesting to see these teens, in some ways, regress and get kind of stuck, because they had in mind a very specific plan,” Dr. Williams-Pitts said.

“And then it completely changed. And so I noticed some teens really struggling with finding and figuring out kind of ‘Who am I? What am I doing? What’s my purpose?’ Because in their minds: ‘I’m going off to Colorado, I’m gonna be in a different state, I’m gonna be focusing on this very specific program.'”

“And then with the pandemic, ‘Wait!, I’m doing a year at KSU. What does this mean? They don’t have my major. And will I transition and go back go to Colorado? Or will I just stay in state?'”

“So on the one hand, it’s an opportunity for increasing resilience and flexibility. But at the same time, it’s at a very vulnerable point and a crucial milestone and transitional point,” she said. “So it was really excellent to work with teenagers who are navigating this and encouraging them to utilize their social supports. And not only their peers, also their parents and their families, and also encouraging them to engage in self exploration, and ask themselves some questions about life: ‘What am I passionate about? What would a meaningful career look like? How do I want to spend my time on a day to day basis in the present moment?'”

“It was really an opportunity to do some interesting work with adolescents that they were going through this transition, but at the same time, I witnessed them really struggle with that,” she said.

The Courier asked Dr. Williams-Pitts if there are resources she’d suggest for navigating the stresses felt by teens and adolescents.

She said that the American Psychological Association has excellent resources at https://www.apa.org/.

She also recommended the website healthychildren.org created by the American Academy of Pediatrics.

“And if if a parent has concerns about their child experiencing a mental health condition or concerns, or their child has shared with them, that they’re having thoughts about not wanting to be here, they’re having suicidal ideations, I recommend that the parent take it seriously,” she said. “Because who knows, we don’t know how long the child or teen has been sitting on that and having that experience and struggling with it.”

“Take it seriously,” she said. “Don’t take it as a cry for attention.”

“And take your child to the pediatrician. Or you can take them to the ER for crisis evaluation.”

She said the pediatrician has local resources for child and adolescent psychologists and therapists. Dr. Williams-Pitts also suggested calling the number on the back of your insurance card to find out what health care providers are within the company’s network.

In closing, Dr. Williams-Pitts emphasized the importance of investing in your relationship with your children and adolescents.

“It’s critical, because then you have a baseline to work with. So you’re going to be more likely to be able to recognize if something’s wrong more quickly if you know your child,” she said. “And the way that you’re able to do that is by investing one-on-one time with them on a daily basis.”

She said that gets trickier during the student’s teen years.

“That sort of attitude helps you to have that strong foundational connection so that the child and teenager will feel more comfortable coming to you. And also says that you’re able to recognize if something just seems a little bit off,” Dr. Williams-Pitts said.

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