Kids in Crisis: Pandemic taking terrible toll on mental health of young people in Hamilton

In the quiet of pandemic isolation, 14-year-old Stella Markettos heard the voices grow louder.

To me, it's almost like having two people inside of your head, and you have rational and irrational thoughts," she said. Being deep in an eating disorder is almost like being a hostage ... being in your body, but you're not in control."

Stella, a Grade 8 student from Ancaster, was diagnosed with anorexia in June 2019 after losing 25 pounds in four months. Her eating disorder started after a nutrition unit at school, which prompted her and a few friends to embark on a healthy eating and exercise journey.

With help from family, she restored her weight. But a few months later, in March 2020, the pandemic hit and it began to drop again.

After a second straight summer spent consuming calories and cutting back on exercise - even bike riding - there was another period of normalcy, and then, another relapse. In the last two months, in the midst of COVID's third wave, Stella was admitted to hospital four times.

Everyone has so much more time to think," she said. There's nothing really else to do."

Over the past year, the pandemic's toll on mental health has gradually come into focus.

In March, Hamilton's McMaster Children's Hospital reported an unprecedented" spike in eating disorders among school-aged children and youth. Between September and December 2020, the program received nearly twice the number of new referrals as it did in the same period the previous year - 117, up from 67 in 2019.

Kids with eating disorders ... have no motive to get better," Stella said. There's no events with food that would make the eating disorder uncomfortable ... so you're constantly obeying the rules of the eating disorder in the comfort of your home."

The hole left by the absence of peers - classrooms in Ontario have been shuttered for roughly six months, intermittently, since the pandemic began - is filled by Instagram and TikTok, which set body image expectations that are impossible to meet, she said.

We don't go to school and see all these the kids that are, like, your average kid, so we're constantly comparing ourselves to unrealistic standards," Stella said.

Stoney Creek mother Sally Medeiros said her son, Junior, a Grade 6 student at Billy Green Elementary School, has gained about 60 pounds since last April.

He's just constantly eating, constantly eating, constantly eating," she said. He never gets full, and it's scaring me."

Medeiros said in one night, her son has eaten a family-sized pack of Bear Paws. At 11 years old, he weighs 140 pounds.

The family is speaking out because they know many kids are struggling with mental health. Junior said he hopes his story will raise awareness and help others.

Junior, who was diagnosed with ADHD when he was younger, has always struggled with his mental health and needs extra help with in school - help he's not getting while his class is virtual.

One morning he honestly broke my heart into pieces, he's like, I don't know how to feel anymore ... I don't feel like I'm alive anymore.'"

It's the emergency room ... my daughter's there'

As part of its multipart Kids in Crisis series, The Spectator is examining the toll the pandemic is taking on the physical and mental health of young people in Hamilton.

Eating disorders are just one issue.

In the four-month period from October to January, youth admitted to McMaster Children's Hospital with substance use disorders - the majority related to alcohol and cannabis - doubled compared to 2019. Meanwhile, youth admitted to hospital with psychosis - a break from reality," as described by a MacKids medical director - also doubled.

Most of them are between the ages of 15 and 17.

That's the period where children are separating from their parents, they're individuating ... they tend to be much more peer-based in terms of their references," said Dr. Olabode Akintan, director of the in-patient program and mental-health emergency services at the hospital, and also an assistant professor in McMaster University's psychiatry department. Anxiety disorders tend to start to present."

He said substance abuse disorder may be just part of a diagnosis. Depression and anxiety disorder often go hand in hand with substance abuse.

Sometimes they're here because they're suicidal," he said. We've had kids who ingest a lot of alcohol and then make a suicide attempt because they're disinhibited when they've been drinking."

The hospital also reported in March a sharp increase in youth requiring significant medical intervention following a suicide attempt. In the same October to January period, there were 26 youth admissions for medical intervention and stabilization following a suicide attempt - more than three times the seven recorded in the same span a year earlier.

One night at work, right around the time that report was made public, a Norfolk County mother got an unexpected call.

It's the emergency room saying that my daughter's there," said the woman, who The Spectator agreed not to name in order to protect her daughter's identity. The 15-year-old high school student had poured bleach into a juice glass and consumed it. She immediately felt sick, her mother said, and called 911.

That was one of the most awful phone calls I've ever gotten in my life. To think that she was struggling that much and that she couldn't come to me or her father," she added.

As the only child living at her family's rural home, this teen has spent much of the pandemic isolated from her peers. When her school is closed to in-person learning, she just kind of wilts," her mother said.

When she'd come home from school, she'd have stories about what she did all day," her mother said. When she doesn't leave, she's like a different person."

The Spectator spoke with a number of families who shared similar stories.

The pandemic's troubling' effect

While not all kids are ending up in the hospital, studies show many - and in some cases, most - are struggling with mental health.

This year I have basically been looking at a screen every day, all day, and I have found it really hard, but I have nothing else to do," student Chloe Kronas, 14, typed. It's difficult to get motivated, it's very hard to concentrate during class, it's easy to isolate yourself and the lack of real social interaction for so long puts a toll on mental health."

Chloe is a student at Glendale Secondary School in Stoney Creek. Her Grade 9 English class allowed The Spectator to sit in on one of its daily Teams meetings - that's the way most students comment or ask questions in class these days - where they shared the ways in which the pandemic has created stress, anxiety and loneliness.

We had to make friends online, never sat in the cafeteria before, social distanced and have never seen what people actually look like," classmate Ryleigh Gross, 15, wrote of the first year of high school.

A February survey from Toronto's SickKids children's hospital reinforces the pandemic's troubling" effect on kids. It found 70 per cent of school-aged children reported worsened mental health, which includes depression, anxiety, irritability, attention span, hyperactivity, and obsessions/compulsions.

Since the beginning of 2021, we have seen a huge increase in mental health presentations for children and youth to the emergency department," said Dr. Paulo Pires, psychologist and clinical director of the child and youth mental health outpatient program at Hamilton Health Sciences' Ron Joyce Children's Health Centre.

Pires said the number of youth seeking mental health care ebbed in the first few months of the pandemic as families were told to stay home, and returned to typical volumes last summer, when school was out and the sun shone.

Then, in the fall, the numbers began to climb.

I think there's a delayed effect," he said. I can't help but wonder if it kind of hit the adults first."

Pires said the impact on kids may feel less obvious" - they are relatively low risk for COVID and most don't have jobs to lose. But school closures and a series of lockdowns and stay-at-home orders over the last year have created room for enduring feelings of isolation, anxiety and fear - outcomes that are harder to quantify.

They've had to struggle, as we all have, with changing circumstances, like, am I going to school, am I not going to school? Am I in-person, am I virtual?" he said. It's been an ongoing stressor that we've had to endure without a very clear end in sight."

A survey conducted in May 2020 by McMaster University's Offord Centre for Child Studies reinforces that it's not just children, but entire families that are affected. At that time, just a few months into the pandemic, it found 40 per cent of Ontario parents had observed a deterioration in their children's behaviour or mood, and 60 per cent met the criteria for depression themselves.

We knew that obviously families at that time ... were likely struggling with everything," said research lead Dr. Andrea Gonzalez, a professor in the university's psychiatry department. We just weren't expecting those really, really high numbers."

A follow-up study launched early this month will seek to better understand the pandemic's impact on families with children a year later. Gonzalez said she anticipates the number of parents that indicate deteriorating mental health in their children - and themselves - will only increase.

I think the length of the pandemic has probably only exacerbated that," she said.

How young people are coping

By now, we understand some of the reasons kids and teens are suffering: isolation, lack of routine, fear of the virus or falling behind in school, and tension at home, to name a few. But many youth - and their parents - are wondering what they can do about it.

Pires said there are sometimes signs that indicate a child is struggling with their mental health.

Changes in eating, sleeping, and behaviours which last for many days or weeks may be a sign," he said in a release. Changes in behaviour can include expressions of distress, disconnecting from loved ones, or acting out behaviours."

Experts at MacKids recommend establishing a routine, exercising - unless a child has been advised otherwise by a healthcare professional - getting regular sleep, staying connected with friends and family, and picking up a new skill or hobby, among others.

I try to cope by expressing how I feel through artwork whenever I'm feeling really down," wrote Chloe, the Glendale student. I have started a journal to write out how I feel and to rant about all of the struggles that this year has brought."

Her classmate Ryleigh, meanwhile, said she has substituted her usual outlet - dance, her Glendale major - with FaceTiming friends and going for walks. And Stella, the Ancaster teen struggling with anorexia, has begun to write poetry with her grandfather, a published poet.

I can see when my poetry sort of gets darker and, like, I can tell very much how I'm doing based on the trends in my poetry," she said. It's sort of an outlet to express emotion, but you don't have to tell anyone. It's not talking to a therapist, it's just putting it down, it gets thoughts out of your head, even if it's just onto paper."

Kate McCullough is a Hamilton-based reporter covering education at The Spectator. Reach her via email: kmccullough@thespec.com

In Stella's words

Stella Markettos, 14, has begun to write poetry with her grandfather as a way to cope with her eating disorder and the stresses of the pandemic. Here is one of her poems:

My mom always said,

Don't recover for me. Do it for yourself. Eat for you."

She said this as if it were easy.

Mom, she's gone, there is no me, I lost her, a long time ago.

She left once inside MY head was no longer MY thoughts, once my body was no longer a beautiful thing",

Once my heart almost forgot how to beat.

I can't find her now.

Every set back, every relapse, I can't even start with her.

She's gone.

I can no longer search through every ounce of feeling in my body to find her.

No matter how deep down.

She's gone.

I used to write about the birds.

I can no longer see them through the clouds.

I can no longer find the beauty in the sharp irritating chirps that force me to open my eyes.

That part of me isn't there anymore, she's gone.

Coffee doesn't work anymore.

I've spent too many years feeding myself fake happiness,

Fake smiles, and laughter.

Broken.

Falling hurts the most.

Rock bottom.