Children whose lives were disrupted from the COVID-19 pandemic are beginning to feel a strain on their mental health, new research suggests.

In a study published recently in JAMA Network Open, 1,784 children in second through sixth grades in Hubei province, where the coronavirus emerged, were surveyed to assess their mental health due to coronavirus shutdowns.

The study found approximately 1 in 5 – 20% – reported symptoms of depression after their schools had been closed for a month. Results were similar for anxiety symptoms, suggesting serious infectious diseases might influence the mental health of children.

According to the Anxiety and Depression Association of America, between 2% and 3% of children ages 6 to 12 suffered from depression before the pandemic.

Hope Nichols, a family therapist who practices in Philadelphia, said she wasn’t surprised by the increasing numbers of children showing symptoms of depression or anxiety.

“This is a disruption,” Nichols said. “It’s a big change in the system. And lots of people – young people, old people – can be triggered with anxiety or depression due to a sudden change.”

Researchers have cautioned that parents and school officials should expect to see worsened mental health in children – and adults – from the pandemic due to social isolation, economic recession and a public health crisis.

School closures, in particular, meant some students lost access to mental health services. An analysis of data from the 2012-2015 National Survey on Drug Use and Health found slightly more than one-third of adolescents who accessed mental health services only did so in educational settings.

That’s why it’s important for parents to make kids feel like they can talk about their emotions safely at home, said Michael Consuelos, senior medical adviser for NeuroFlow, a behavioral health platform.

“This is not an individual trauma, it’s a community one,” he said. “Kids feel that, too. It’s likely that there will be some post-traumatic effects because it is a prolonged disruption in their daily lives, and there is no end date on this. It’s important for parents to be open to their kids’ feelings without judgment and when it’s over to continuously be there.”

Nina Cummings, a psychologist based in the Philadelphia suburb of Narberth who specializes in adolescents and young adults, said when a child is struggling emotionally, they might behave differently.

Children might be angry one minute, clingy the next or more prone to crying. Their sleep and appetites might be affected, as well, and they may have difficulty concentrating when doing schoolwork.

“Kids and teenagers are incredibly disrupted right now,” Cummings said. “When you take away the structure of the school day, they feel really lost and may feel a tremendous amount of anxiety and depression.”

Parents need to find a way to navigate those painful feelings together with their child. Explaining to them they have the right to be upset, but that it’s unproductive to make those around them miserable, could start conversations about the emotions COVID-19 is triggering, Cummings said.

Nichols said for very young children, the abrupt schedule changes may have been confusing and upsetting. That’s why parents should look out for signs of persistent sadness, hopelessness, loneliness and helplessness in their children that look different from “everyday blues,” she said.

“The language you use is important,” Nichols said. “If it’s a young child, talking about how you are feeling might help them name how they’re feeling since they don’t have the language to tell you that they’re feeling depressed or anxious. Then you can go about telling them how we deal with this feeling.”

Consuelos, a former pediatrician, said asking how a child is feeling and listening to them can be crucial to identifying any depressive or anxiety symptoms before they progress into a clinical diagnosis. He also said making sure kids have routines in their life can help lend some structure in a time filled with uncertainty.

Cummings agreed, saying having regular eating times and bedtimes might help create an environment in which kids can thrive.

“There’s a huge sense of grief right now,” Consuelos said. “Kids may be reflecting some of the stress from their parents.

“If they’re more irritable, it’s possible that their parents are also more irritable. And kids are hearing death and illness being talked about in a way that isn’t normal in conversations on the news.”