Don’t Minimize Children’s Anxiety about Pandemics, says Psychiatrist

By Gail Bergman and Indira Tarachandra

It takes longer for children than adults to get over traumatic experiences; fears must be addressed to avoid development of more serious conditions

Newmarket, Ontario – May 8, 2009 – The spread and severity of the Influenza A (H1N1) virus may fluctuate as the days go on, but for many children, the anxiety of contracting the mysterious flu remains constant. As a result, parents would be wise to educate and communicate with their kids to calm their fears and avoid the development of more serious conditions later on, says a Canadian psychiatrist.

“Children’s anxiety from crisis situations, such as a pandemic, can last one to two years, whereas the average adult may be affected for only a matter of months,” says Dr. Rasiah Paramsothy, a psychiatrist at Newmarket-based Southlake Regional Health Centre, explaining that this lag is due to children’s limited life’s experiences, level of understanding and maturity. “Even for children who are healthy, whose family and classmates are healthy, and who haven’t come into contact with anyone who has travelled to Mexico, the fear of contracting the H1N1 flu can be very real.”

Parents must be open with their children about the facts and encourage them to express their worries, says Dr. Paramsothy, adding that the next step is to empathize with them and accept their feelings. “Considering the constant flow of media reports, and the fact that H1N1 is a new stream of virus with many unknowns, it’s understandable for adults to feel anxious, let alone children,” he says.

Brigette Boaretto, a mother of three children aged 8, 6 and 4, knows first-hand about calming young fears about the H1N1 virus. Boaretto is Manager, Infection Prevention and Control at Southlake Regional Health Centre, who has been overseeing the surveillance of patients who have contracted the virus – a situation that has created anxiety in her eight-year-old daughter.

“In addition to having anxiety about me going to work, my youngest son’s friend went to Mexico and my daughter is concerned about him going to school,” Boaretto says. What has worked best to calm her daughter’s fears, says Boaretto, is explaining to her how their whole family can stay healthy by washing their hands often and coughing or sneezing into their sleeves – and encouraging others to do the same. “I gave all three kids a brand new bottle of hand sanitizer and they were all very excited about it. They carry it with them wherever they go and offer it to their friends.”

Dr. Paramsothy offers these additional suggestions to manage your child’s anxiety:

Share the facts: Allow your child to have full access to information. While parents should act as the sole information source for younger children, older children should supplement their parents’ education by reviewing public health pamphlets or visiting their websites. Keep in mind that it’s better for children to learn the facts at home rather than hearing half-truths or rumors from friends at school.

Talk it out: Probe, ask questions and encourage your kids to express their thoughts and fears so that you can better understand what’s going on in their minds. Be empathetic, but challenge automatic negative thoughts. It’s easy for kids to let their imaginations create a worst-case scenario, so do a reality check. Without getting emotional, ask: Is anyone sick around you? Are your friends sick? Have they or their parents been to Mexico recently? and so on.

Use art therapy: Encourage younger children or kids who are withdrawn to communicate using a paper and pencil. Ask them to draw how they feel when they are both healthy and sick. Parents can in turn use art to educate their children about the virus, how it is spread and what it’s all about.

Reassure: Keep things in perspective. With one exception, the cases identified in Canada have been mild, and those who have contracted the illness have recovered, largely at home with only bed rest and fluids. Discuss the symptoms of the H1N1 virus with your child, explaining that the illness is similar to a common flu but with a high fever.

Manage stress: If your child is still anxious in spite of your best efforts, try using relaxation techniques as a way to distract the child and regulate his or her emotions. Seek professional help if needed, and speak to your child’s teacher or guidance counselor who can carry over your efforts at school. Remember that children will observe adults’ behaviors and emotions for cues on how to manage their own feelings, so maintain a positive outlook at all times.

“If a child’s fears are not well-managed and persist over time, this may trigger obsessive-compulsive behaviour pertaining to germs and cleanliness, so it’s important for parents to take their children’s anxieties seriously and address their concerns early on,” Dr. Paramsothy says.

More information is available through your local public health office or by visiting

About Southlake Regional Health Centre

Based in Newmarket, Southlake Regional Health Centre is a full-service hospital with a specialized focus on cancer, cardiac, arthritis, pediatric and perinatal care, child and adolescent eating disorders, and child and adolescent mental health care. Serving more than one million residents of York Region and South Simcoe, Southlake is in the midst of transforming into a teaching and research centre.


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