Is it all in my head, or have children’s pain and mental health concerns gotten worse since the COVID-19 pandemic?
Did pediatric migraine get worse during COVID?
Among the hot topics surrounding recent events, one that some scientists, clinicians, and families have been asking is, have pain and mental health concerns among youth worsened as part of the COVID-19 pandemic?
This is a tricky question to investigate, but some researchers in Italy attempted to find some answers, and they published their results in the scientific journal Brain Sciences. To begin to answer this question, Checci and colleagues (2023) focused on pediatric migraine.
How this was investigated:
The team of researchers reviewed the records of over 400 adolescents coming into a neurology clinic between 2018 to 2022 who met criteria for a diagnosis of migraine. The adolescents had responded to questions about how often they got migraine attacks, and they had completed questionnaires about anxiety and depressive symptoms. Then, the researchers divided up the data into 3 groups depending on when the adolescents came into the clinic: (1) Pre-COVID, between 2018 through February 2022, (2) First Wave, characterized by nationwide lockdowns, between March 2020 through October 2020, and (3) Second Wave, characterized by the COVID pandemic persisting but lockdown restrictions easing, between November 2020 through January 2022.
What did they find?
The researchers found that in some ways, things did seem to worsen throughout the pandemic. The rates of adolescents with “high frequency” migraine increased in the Second Wave. Depression and anxiety also worsened since the onset of COVID-19, with rates of anxiety worsening particularly in the Second Wave. Those with “high frequency” migraine seemed to experience the highest rates of anxiety and depressive symptoms.
Interestingly, the authors found that the frequency of migraine attacks was typically the lowest in the summer months. However, anxiety and depressive symptoms did not show this pattern.
In conclusion, the researchers did find that in some ways, the COVID-19 pandemic seemed to make the experience of living with migraine worse for adolescents. High frequency migraine, anxiety, and depression seemed to worsen as we moved from 2020 through 2022.
The authors of the paper attributed these changes to stress related to the pandemic and school. Certainly, there was and is a lot of that to go around. It’s important to remember that so much changed very suddenly for so many families, and sometimes, those changes did not go away. Instead, sometimes, more changes kept coming.
Some factors may have included:
Direct exposure to the virus
Illness or death in the family
Changes in family health and financial stability,
School closure
Learning loss
Social and activity restrictions
Media reports
Increase in social media use
Changes in routine
Continued atmosphere of stress, uncertainty, changing rules and expectations.
Over many decades, we have grown to learn how psychological and social stress can be a contributing factor to migraine, and how migraine can also contribute to psychological and social stress.
It’s important to remember that what the researchers found may not apply to American teenagers. This study was conducted in Italy, and there are many differences in culture, COVID-19 policy, and healthcare utilization. The researchers also only studied teenagers, and those with a diagnosis of migraine, so the results may not apply to younger children, nor children with other headache and pain conditions.
How Parents Can Help Teens with Migraine:
If you are a parent of a child with migraine, what can you do to reverse or mitigate this trend? While we may not have control over everything, there is a lot that we can do.
We can create an atmosphere of safety and stability for children and teenagers, by focusing on family routines and values.
We can encourage children and teens to develop resilience and flexibility.
We can support open communication when they are feeling pain or emotional distress.
We can remember that while some things improve with certain seasons, not everything will.
We can remind them that they are definitely not on their own, and that their family and medical and psychological professionals are available to help.
If your child, teen, or young adult is struggling with migraine, headache, or other pain, and you are concerned about their stress, anxiety, or mood, Pediatric Pain and Behavioral Health PLLC is here to help. Please reach out by calling (734) 221-0874 or clicking the Get Started button at the top of your screen.