After a summer of postponed vacations, closed pools and limited summer camps, all a byproduct of COVID-19, parents are concerned about the wellbeing of their children. “My kids have heightened anxiety now and they’re awkward when they do see people,” said a Bethesda mother of three.

“He’s so bored and misses his friends,” said a McLean mother about her 12-year-old son. “My husband and I work, so he’s spent a lot of time alone this summer.”

Mother and child psychologist Amanda Dounis, adds, “My 12-year-old son emphasizes how terrible it’s been,” and “He claims many of his friends are depressed.”

As a new school year begins under a cloud of uncertainty that could prolong the disconnection from peers, child psychologists and psychiatrists are expressing concern about the current, and possibly long-term, effect these restrictions will have on children, particularly teens and tweens. Some are wondering if the benefits of social connection are important to balance against degrees of safety measures for COVID-19.

“For middle and high school students, socialization teaches them lessons as important as math or English,” said psychiatrist Dr. Carole Lieberman M.D. “During these years at school, they learn how to face the challenges of making new friends, becoming popular, trying on social values, [and] developing leadership skills. Social isolation, however, robs them of these opportunities and sets them back on their psychosocial phases of development.”

The mental health damage can be overlooked, says child & adolescent psychiatrist Dr. Marilou Jimenez, M.D. chair of the Addiction and Mental Health Center at MedStar Montgomery Medical Center. “The potential impact that prolonged social isolation will have on these kids is profound,” she said. “We're seeing that Generation Z is uniquely impacted by this pandemic. COVID-19 has caused prolonged social isolation, missing important milestones, an increase in social media usage and screen time, and prevalence of extreme stress among adolescents.”

Those with preexisting mental health conditions like anxiety and depression can be affected most significantly, says Jimenez. “It can wreak havoc on their mental state,” she said. “Social distancing can greatly impact and exacerbate mental health issues. We have seen, and are going to continue to see, a dramatic rise in depression and anxiety among these kids that will carry over long after enforced isolation and the pandemic are over.”

Attending classes in person could offer a layer of protection for students who might be experiencing mental health concerns, particularly for those who have limited family support. “When children are in school, detection occurs because educators and other adults may be the first to notice, said psychiatrist Dr. Gail Saltz M.D., associate professor of psychiatry at the NY Presbyterian Hospital Weill-Cornell School.

However, not every child misses attending school. “There are some kids who find it less stressful because they don’t have to deal with bullying or peer pressure,” said Saltz.

While Zoom and other social media platforms have filled some of the social voids, this form of communication cannot replace the benefit of in-person contact. “From the first few days of life we begin to bond based on social cues, and it is very difficult to read tones on a screen,” said Darby Fox, Child & Adolescent Family Therapist who sees patients in Fairfax, Great Falls and Arlington. “Social media is very staged and relies on external cues. To build a solid sense of self we need to teach our adolescents to develop their internal strength. This cannot be done if they are constantly worried about external judgment and acceptance.”

Not only are electronics and social media unable to replace in-person contact, they can be detrimental, says Lieberman. “Texts are known for easily being misinterpreted,” she said. “Social media is where kids get bullied or become jealous of other kids who can make their life seem fantastic when they can make it up with photo-shopped pictures and tall tales.”

Pandemic safety precautions like the cancellation of sports can also stunt a child’s emotional growth, says Darby. “The physical benefits are undisputed, but mental toll of missing sports is underestimated,” she said. “Kids count on the sports [not only] for exercise, but for socialization, discipline and even college recruitment. Many of these kids’ entire sense of identity is built around who they are as athletes, so there’s a great sense of loss for them.”

The time void left by a lack of options for sports or other activities can lead to precarious behaviors, warns Jimenez. “Kids are left with a lot of extra time on their hands and some may turn to more unproductive means or unhealthy habits to fill those gaps,” she said.

Balancing the physical health risks of COVID-19 with the cost of mental health perils is an important part of mitigating damage, advises Darby. “Parents need to still insist their kids have live social interactions,” she said. “The restrictions have relaxed enough that most people are able to connect with others while following appropriate protocols. There is no substitute for asking a date out live or meeting their parents.”

Taking precautions like checking the temperature of each child before small gatherings can help allay COVID-19 concerns, suggests Lieberman. “Parents can organize pods of kids to watch classes on Zoom together and do homework after the classes are over,” she said. “Kids are more able to become engaged when they are with other kids, in a small class of their own making. You can hold these pods outside, weather permitting, and have them wear masks.”

Spending time outdoors on sunny days has proven to be therapeutic for Dounis and her son. “We eat breakfast there and absorb Vitamin D from the sunlight, she said. “My son also became the master barbeque chef. We wheel the grill to the front and connect loud music and let him cook.”