The number of people living with mental health disorders amid the <a href="https://www.thenational.ae/world/mena/coronavirus-live-iran-death-toll-above-100-for-third-day-in-a-row-1.1021139">coronavirus crisis</a> has undoubtedly soared, but teenagers are particularly at risk, says one UAE psychologist. Tanya Dharamshi, clinical director and counselling psychologist at Dubai’s Priory Wellbeing Centre, says the clinic has seen an upsurge in teenagers visiting, as they have been diagnosed with issues such as anxiety, depression and obsessive compulsive disorder since schooling went virtual. “Without the normal routine and structure of school and college attendance, teenagers have been starved of some of the support and reassurance they are accustomed to as they grow in emotional maturity and approach adulthood,” Dharamshi explains. “Many teenagers have seen life as they know it completely turned upside down. Even with the gradual lifting of restrictions, their situation remains unchanged. They have had to contend with home learning, isolation from their friends, cancellation of ‘major’ events in their calendars such as the school prom, graduation ceremonies and launching themselves into the job market.” Teenagers may feel a monumental time in their lives has been snatched away from them, she adds. “Many teens may also be dealing with the illness directly if a family member has been affected, or if their families have lost income as a result of job cuts or salary reductions,” she says. “These circumstances can leave them feeling overwhelmed, damaging their self-confidence and motivation.” A recent UK survey revealed that more than 80 per cent of young people with a history of mental health problems say their condition has worsened since the pandemic started. More research needs to be done, however, in order to ascertain the true long-term effects of this situation on teenage mental health across the world. Here in the UAE, Dharamshi says the current lack of structure also has to the ability to pose challenges for those who haven’t dealt with mental illness before. “Some may be depressed, as well as anxious, and turned, or returned, to self-harming,” she says. “They need support to define and manoeuvre their thoughts, emotions and behavioural responses.” Masa Karleusa Valkanou, a psychologist and psychotherapist at Thrive Wellbeing Centre by Dr Sarah Rasmi, previously<a href="https://www.thenational.ae/lifestyle/family/how-will-the-pandemic-affect-children-s-mental-health-in-the-long-term-we-ask-uae-parents-and-experts-1.1009130"> told <em>The National</em></a> that teenagers are the most "endangered species" in this global crisis. “Psychological development dictates that a teenager is separating self from family and attaching more to a peer group,” she said. “In the situation of isolation, they lose the comfort of their peer group … Teenagers need love and support and someone to calm their anxiety and fears, but they can’t turn to parents, and can’t get it from friends, either. They can face serious feelings of loneliness and psychological isolation.” As a parent of teenagers, it’s important not to despair. Through regular, reassuring and open conversations among the family, Dharamshi says caregivers will be better able to support their children through the pandemic. “Desperately missing the ‘normality’ of their lives prior to Covid-19 and reflecting on what they have ‘lost’ – albeit temporarily – can only exacerbate feelings of anger and disappointment,” she says. “Many may take this out on their parents and other family members as they look for someone to apportion blame and vent their frustrations towards. Mood swings at this time can also be extremely common.” It’s imperative parents react accordingly in order to alleviate their child’s concerns. Dharamshi says there are a number of things parents can do to help, starting with reassuring them that change is a normal part of life. “Being able to embrace change and develop coping strategies is key and something to aspire to during this time, which can often save them from a lot of unhappiness and heartache in the future.” Nurturing their friendships with their peers is also a positive step forward. “They learn and develop their identity and beliefs as a result of mixing, socialising and chatting about key issues with their friends. They learn how to read behaviours and non-verbal cues, how to interact with their peers and teachers in a variety of situations.” As face-to-face time has been severely restricted, encouraging children to engage in video calls with friends and extended family is important. That being said, limiting their dependence on electronic devices is also crucial, particularly when it comes to social media and the barrage of news reports and statistics we all contend with on a daily basis. Most importantly, parents should lead by example. “Children, no matter their age, regard their parents and caregivers as role models and look to them for guidance and reassurance,” Dharamshi explains. “Calm, confident and reassuring adults will naturally help to encourage the same qualities in young people.” Remember, even the most ‘grown-up’, independent teenagers need a hug every so often, she adds. “Normalise and validate what they are feeling and share how this is impacting you as well, but look towards developing skills to help support each other; check-ins, daily hugs and rituals that you can develop to create a safe, secure space to feel and also to strengthen yourselves and each other.” And as difficult as it may be, try not to predict the future. “When we try, it can make us more anxious or result in us putting a negative spin on things, which only perpetuates our worry. Discuss with your teen how they can prepare themselves for their future, rather than worry about it.” Yasmine Dannawy, vice principal at Dubai's Hartland International School, says it is impossible for global mental health to have not been affected in some way by “enforced but necessary isolation”. However, this is something that she, and her colleagues, have been mindful of since day one. “Lack of socialisation has affected many of the students, as they comment about this regularly,” she says. “Some of the boys who are in a gaming culture still enjoy the interaction with their friends virtually, but all students still say they miss going to the movies together or hanging out on their bikes at the end of the school day.” While it’s difficult for teachers to monitor what happens outside school hours, the Hartland team has introduced a number of measures to mitigate the impact of the crisis on their students’ mental health. This includes twice-daily, face-to-face sessions with their tutor, availability of a full-time counsellor, weekly assemblies, charity drives that connect the community, and weekly activities that take place outside of lesson time, such as art, music, debate and Model United Nations. Regular house challenges and competitions are also still ongoing. “Our secondary students have the opportunity to engage in open discussions about this pandemic twice daily during their check-in with their form tutors,” Dannawy adds. “Each tutor from Years 7 to 10 has engaged the students in reflective exercises that have ranged from writing poetry to reflect their feelings, sharing stories from a selection of literature shared by our librarian, to creating fun challenges and videos that bring the whole class together.” The school counsellor also uploads a video on well-being each week, with tips on how to manage the stress of being cooped up indoors. “During the past few weeks, we have [also] been working on a Covid-19 time capsule.” For the most part, Dannawy has seen positive feedback on the new learning format from her students, and she believes they have all been “incredibly creative” during this trying time. “Their motivation to be online for 59 days so far at near 97 per cent attendance is a testament to the structure they say they like and the routine it sets for their day,” she says. “There has only been one or two examples of young people who have not responded as we might have hoped to the structure of distance learning, but even in these cases we have added additional support and a different framework to suit their needs.” Of course, policies regarding distance learning varies greatly from school to school, however. For instance, Arya Lalvani, 17, previously <a href="https://www.thenational.ae/lifestyle/family/how-will-the-pandemic-affect-children-s-mental-health-in-the-long-term-we-ask-uae-parents-and-experts-1.1009130">told <em>The National</em></a> that she was struggling with her homeschooling situation. "It's not been the best," the student of Dubai International Academy said in April. "At first I was super motivated, getting all my assignments done before they were due. Recently, my motivation is decreasing. I've been finding it harder to get in touch with friends; everyone is tired. It's hard keeping up with the workload." Dannawy, who also has a background in psychology and career counselling, offers this advice to parents: “Be patient; talk to your children; empower them to stay active; limit further screen time after school, but not at the expense of cutting off their connectivity to friends in a social setting. “Most of all, accept that this is challenging and different for them and expect a few tumbles along the way. Actively listen to their concerns and try to engage in an open and honest dialogue wherever possible.” The main thing to remember – no matter what circumstances you find yourselves in as a family – is that these are tough times for everyone, but all is not lost. “Children and young people can be extremely versatile and adaptable to change,” says Dharamshi. “What’s important is to help them recognise how we are all in this together and while it may not feel like it at the moment, there are huge positives that can result from this current situation. There is the potential, for example, for us all to become much stronger, accepting and kinder individuals as we emerge from this on the other side. “No matter their age or what they say, teenagers need lots of support – verbally and emotionally – not forgetting plenty of hugs as we all try to navigate these extraordinary times together.” If we do this right, we can actually turn a time of turmoil into an opportunity for growth – both for our children and us.