Still, many kids are “suffering terribly, and suffering more so because of the pandemic,” Dr. Freeman added. For them, if their schools are opening this fall for in-person classes, leaving the house and going back to school “is going to be really hard, and that’s real.”
For teens with Covid-19 anxieties, being with friends who are more cavalier about risk is especially difficult, Dr. Duffy said. “I’m working with kids who are super conflicted. They don’t want to miss anything, they don’t want to seem weird, and yet they are very focused on fear of transmission. And there isn’t much space for them to express that.”
So how should parents address their kids’ fears and behaviors? How can they tell the difference between a reasonable response to a dangerous virus and something that might require treatment?
Look for disproportionate fear
It makes sense to be cautious, but with O.C.D., you’re disproportionately afraid, said Tara Peris, co-director of the Child O.C.D., Anxiety and Tic Disorders Program at the University of California, Los Angeles. Parents should look for behavior that falls outside their family’s norms and the guidelines set by the Centers for Disease Control and Prevention.
The C.D.C., for example, recommends washing hands for 20 seconds with soap and water after being in a public place. “If somebody moves into the realm of washing their hands 20 to 30 times a day, or if they’re spending 15 to 20 minutes when they do wash, or they can’t get out of the bathroom, then they’re clearly more worried than they need to be,” Dr. Peris said. “I’m interested in whether kids are following instructions around them or whether they’re washing to relieve distress, and whether that need is expanding over time or building and taking on a life of its own.”
If it’s affecting family life, friendships and a person’s ability to do schoolwork, those are red flags, Dr. Peris said.
Trust your instincts
One complicating factor, Dr. Duffy said, is that it’s difficult to assess whether a person’s basic functioning is disrupted when the pandemic itself is disruptive to basic functioning. We’re working with a modified baseline, he said.