Photos: Sadiel Mederos
HAVANA TIMES – “When will the virus go away?” the little one asks. “Will we ever go back to school?” the middle child asks. “Are we going to die too?” the eldest one asks. This is how fear sounds in the voices of Lianet Rivero’s daughters. Uncertainty eats away inside their little heads. Where the only interest used to be how long they could play a game or whether mommy had bought enough candy for all of them, now there is only fear of a virus that threatens their lives.
Just like any other child, the emotions of Lia (9 years old), Lucia (6) and Lizt (3) have not gone unharmed during these long months of lockdown that have passed ever since COVID-19 was declared a pandemic, in March 2020. Nor have the emotions of their little one-and-a-half-year-old brother been spared.
Just like when the dynamics of human relationships change abruptly, this doctor has seen harmful behaviors in these four small children, which is normal in an abnormal situation. Thirty-nine-year-old Lianet realizes that “even if you don’t want them to be affected by everything that’s going on, it does and they are always worrying about what might happen tomorrow.”
At the beginning of the pandemic, this doctor that specializes in Medical Imaging and her husband (also a doctor) wanted their children to keep to their study timetables; but in the second lockdown, they couldn’t prevent their children from becoming demotivated in their studies. Their habits have changed over time and “they have become lazy”. The saddest thing is that Lizt doesn’t want to leave the house. “We try to take her for a walk outside, but she refuses because she’s afraid and doesn’t feel safe. The few times she does agree, she only goes if she’s with me,” her mother explains.
Just like adults have displayed clear signs of exhaustion in this second year of the pandemic, the negative impact of COVID-19 on the mental health of children and teenagers is becoming increasingly evident. The behavioral changes and moodswings they suffer as the result of a prolonged situation of adversity means that they are considered invisible victims. In Latin America and the Caribbean alone, a survey revealed that over a quarter of this age group has recently suffered from anxiety and 15% suffer from depression. In fact, before Coronavirus times, at least half of mental disorders appeared before 15 years of age.
In spite of almost every child having been isolated intermittently, restrictions on movement and closing down their key space for socialization, i.e. school, have interrupted their everyday routines and their networks of relationships. Last March, UNICEF reported that at least one in every seven children and young people across the world (332 million) have lived under compulsory or recommended lockdown measures for nine months during the pandemic.
With almost a decade of experience behind her treating children, psychologist Lourdes Santana says that mood swings are a lot more severe today than they were before the pandemic. “Their emotions and lability are a lot more explosive now; that is to say, they have sudden mood swings for no apparent reason,” she points out.
At her office at the Mental Health Center, in Plaza de la Revolucion, Havana, doctor Santana has received patients with attention deficit hyperactivity disorder, who refuse to study, indifference, anxiety (mainly caused by less physical activity) and changes in hygiene, food and sleep routines. She has noticed how the trend to focus on videogames, the Internet, social media and instant messaging, has gone hand-in-hand with access to inappropriate content for the chronological age of children, teenagers, and led to greater family isolation.
Santana also holds a Masters in Drug Use Prevention, having dealt with patients with existential crises and depression “that can lead to a threat, sign and even attempt of suicide. These acts are normally manipulative in nature and seek to get their parents’ attention. Routine changes, friendship changes, extreme isolation and great levels of negativity can be seen in teenagers.” According to the expert, the most alarming thing is that rebelliousness and signs of suicide are now appearing in younger and younger ages.
Preliminary statistics from a Cuban study, that surveyed some 9000 children and teenagers and approximately 6000 parents, confirm that the lockdown has changed eating and sleeping routines; regressive behaviors appear, as do emotional imbalances, anxiety, increase in technology use, concentration problems and irritability.
Meanwhile, an investigation undertaken in the country proves that more than 60% of minors displayed excessive family attachment and disturbed sleeping routines. Another study revealed voluntarism and rebellious and challenging behavior. The majority displayed signs of irritation, mood swings and crying. The analysis also warned about “the significant increase in child abuse via physical, emotional and sexual abuse.”
Add to this the fact that adults have had to take care of their little ones at the expense of losing their jobs or having to work from home; but even when there is a certain level of stability in the home, there are factors that exceed the family environment and affect them. This is the main reason why the socioeconomically disadvantaged or those living in overcrowded conditions are at greater risk.
On the one hand, social capital has been deteriorating and access to basic services is limited, which leads to people seeking out new means to put food on the table. On the other hand, the youngest ones in the house see how the adults fight for limited resources and deal with anguish, which creates fear of the virus or fear of losing a loved one. At the same time, children are now more exposed to abuse, negligence, violence and stress.
While shortages of food, medicine and personal hygiene items in the country might seem like an issue that only concerns adults, Lianet’s children are very familiar with them. She laments that her daughters “hear that there isn’t this or that. There isn’t any chocolate, there aren’t any eggs to make a dessert, there aren’t any crackers, there aren’t any snacks, there aren’t any and that’s that. They have even wanted to know if they will get lunch at school when they go back.”
“Yes, I go to the psychologist”
According to the World Health Organization, the pandemic has affected basic mental health services in 93% of countries worldwide, precisely at a time when they are most needed. So much so, that there are calls to heavily invest in extending these services.
Nevertheless, psychologist Lourdes Santana says that in Cuba “access to mental health services for children/young people hasn’t been cut, as they form part of a highly-vulnerable age group.” She stresses that there is an office at every polyclinic with qualified professionals to evaluate, diagnose and treat children and young people. These specialists consider that people should only go to these offices when it’s essential that the minor be examined and that they have a helpline and WhatsApp chat to help mothers or fathers who can’t go with their young children.
As well as the fact that not everyone who needs professional help goes out to look for it. Elaine, a housewife, knows how important advice from an expert is when it comes to dealing with stress over a long period of time. Following Lourdes’ example, this mother is treating the anxiety of her 16-year-old daughter. “We are facing a global pandemic and it’s particularly affecting teenagers because hygiene/sanitary measures aren’t always applied, and we have to guide them so they can keep safe. I have spoken a lot to my little girl about this to try and make her understand that she needs to look after herself and to respect recommendations.”
On the other hand, designer Yunet Amador defends that consulting with an expert will always help you get a fresh pair of eyes on the situation… rather than in an atypical situation for everyone. The young woman has seen her 7-year-old son anxious and even depressed, at one point. “He doesn’t want to hear about schoolwork. It’s somewhat disheartening. They don’t concentrate on a single activity for very long (they float from one to the other and lose their interest very easily) and she tells me how tired she is of so much lockdown.”
In an attempt to offset these effects, Yunet tries to keep her little boy distracted and not think about what’s happening. Sometimes, they go for a walk, keeping a safe distance from others at all times. Plus, she tries explaining to him what is happening in a language he can understand and she gives him a lot of love and affection and hope that this adversity “will end at some point”.
Elaine’s daughter says that young people like her have experienced so many emotions and have regularly felt depressed. “Because of the epidemiological situation in the country, some of us have lost interest in many things. We are adapting to lives in quarantine and we are mentally tired, exhausted, worn out.”
This girl confesses that she isn’t motivated by anything because “we are living in a vicious cycle at home” and that people her age suffer because they can’t see their friends, partner or family. “Sometimes, we feel so beat up by the situation that we distance ourselves from everything and isolate within ourselves. These are tough times when your Dife becomes never-ending monotony,” she says sadly.
Looking at things more positively, she believes that young people should contribute with efforts to stop the spread the virus. “We have to take this time as a spiritual retreat, to look within ourselves and seek out new motivation to help us to grow as people and to understand something different every day.”
If all of the family helps out…
Of course, guiding people under lockdown is anything but easy. Many of the indications that are recommended to deal with these disorders in normal conditions can’t be applied during the pandemic: socializing, going for a walk, running and doing physical activity to channel your energy. According to Lourdes, in exceptional circumstances like these, you have to insist on individual psychotherapy, using traditional natural medicines and going to get a referral for a child/young person psychiatrist when needed.
Experts on the subject agree that talking with children in a simple and honest way, listening to them, limiting their access to all kinds of screens and making them play and do physical exercise is vital for keeping their minds healthy. Without losing sight of the fact that the family is the main thing responsible for looking after and protecting minors, they need detailed guidelines when a problem arises.
In Lourdes’ words, games are an activity that allow young children to get to know their mood, their needs and worries, as well as a way to transmit information indirectly. Combining studies with play is a viable option and to reward progress depending on every family’s individual means, as well as getting younger ones in the house to help out with chores, depending on their age and how complex these tasks are.
Adults need to spend some time to make sure they don’t feel alone or neglected. There has to be lots of affection. “Even if parents are busy, they should always take a minute to give a kiss, a hug and say “I love you”. This reinforces their security, their self-esteem and helps to ease the weight of social distancing that they are being subjected to,” the expert adds, who has been focusing on solving dysfunctional problems “so that members of the family can work together and there is some consistency in education at home.”
In the case of teenagers, Lourdes suggests talking in an open way, answering their queries and explaining why there are restrictions to stop them from going to inexperienced friends to give them wrong advice.
Doctor Lianet, who holds a Masters in Bioethics, has set out to nourish her children’s interest in reading and for them to study something for an hour a day from Monday to Friday, “whether that’s Spanish or Maths”, and she has organized activities for them to celebrate as a family: birthdays or Mothers’ and Fathers’ Day. “We have sat at our front door and sung songs or inflated a swimming pool so they can swim. The few times we’ve been able to go out, all four of us have gone, aware of restrictions and taking great care. They need to feel like life goes on. Especially at home, but it goes on.”