MHM Magazine

30 | MENTAL HEALTH MATTERS | 2022 | Issue 5 MHM with academics the more involved her parents became. At some point her parents were desperate and at times discouraged her to partake in social activities until her academics improved. Their rationale was that socialising would further distract Bev from completing her degree. The more irritable and restless Bev became the more difficult it was to focus on her work. Bev also experienced sleep disturbances and increased worry as she was aware that she was sabotaging her progress and at the same time felt so completely out of control. Bev resorted to spending more time on social media which in turn exacerbated her difficulties as she saw how her peers were excelling in their studies. Bev quietly started exploring her sexuality and religious standing but dare not share that with her family for fear of being dismissed for not focusing on her degree. When Bev felt brave enough to challenge some of her family’s ideologies, she was informed that there will be enough time after her studies to focus on other aspects of her life. As lockdown restrictions eased Bev implemented behavioural strategies that she felt would make her feel more in control of her life. Her parents were very sceptical of giving her more freedom to manage her life however Bev moved out the house and into a flatlet with her sister upon returning to campus. Here she was faced with a new set of challenges as she did not have the comfort of home and her parents’ guidance. Both Bev and her parents expected her to keep up the level of functioning pre-lockdown however she found it increasingly stressful to readjust to a sense of normality when she was isolated for almost two years. Bev reported feeling ashamed of her academic difficulties and therefore avoided seeking assistance when she returned to campus. Some of Bev’s difficulties included fear of peer rejection due to changes in her thinking processes during the lockdown period. Bev’s intense fear of sharing and exploring viewpoints which differ to that of her family intensified. The realisation that she could no longer relate to her social circle pre-lockdown left Bev feeling defeated and anxious about making new friends. Challenges From the above it is evident that Bev had challenges related to the limits set by her parents due to family fearfulness in response to Covid restrictions. Normal adolescent challenges that Bev could not explore were: • taking responsibility for self and others, • seeking employment, and • renegotiating rules at home. The inability to explore these challenges caused frustration leaving Bev feeling left behind. She was aware that her peers had more freedom and saw how they “moved on with life”. The challenges that Bev could not explore that were directly affected by Covid restrictions: • risk taking, • demanding rights, • seeking employment, • challenging environments, and • limitations hindering her from developing new relationships. How Bev’s anxiety presented Pre-lockdown Bev started to explore these healthy adolescent challenges however there was an abrupt halt as she needed to adapt to isolation without any transition. Post lockdown Bev had to work harder to fulfil adolescent needs. The lack of norms to assist the transition from Covid restrictions to post lockdown left Bev feeling irritable and intensified her frustration. Bev was also left feeling fearful as she believed that it was expected of her to adapt back to a sense of normality pre-Covid without any rules to assist her. Bev had difficulty focusing on her academics due to feeling overwhelmed by this pressure. In response Bev avoided her work and thereby prolonging her studies. During the lockdown Bev quietly explored her spiritual views and sexuality. She developed an intense fear of rejection by her primary support and peers due to changes in her thinking processes. There was also apprehension around disappointing her parents. Bev persistently ruminated about never finishing her studies. Treatment Bev’s treatment was three-fold involving; 1. behavioural intervention to minimise and better understand physiological distress, 2. psychotherapy to help Bev understand internal processes, accept neurological difficulties, and better navigate adolescent challenges, 3. parental counselling to help them best support Bev through understanding, - adolescence and the effect of Covid on their development, - set realistic expectations (Bev is not neurotypical even though she was raised to function as though she was). When considering Bev’s story, it seems as though lockdown restrictions have definitely exacerbated anxiety in adolescence. The interruption of “normal” adolescent development processes due to Covid restrictions has made it increasingly important to think systematically when working with adolescents even if that is not the therapist’s primary therapeutic modality. Involving parents assist them to understand the unique experience of the adolescent post lockdown. This should lower the adolescent’s anxiety leaving her feeling not only more supported but creates a safe space to explore her environment which aids identity formation separate from her family of origin. References available on request.

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