The Lonely Pandemic Girl

The cutting off of girls' social lives is a really big deal. I am seeing many mental health issues, depression, self-esteem issues, and boredom, malaise, and more. This is happening with many of my patients who have been more strictly quarantined. The lack of sports or other structured activities has left many girls disconnected, bored, apathetic, and many are gaining weight.

One of my patients, “Julie,” stated the quarantine made her very lonely and depressed at times. She is depressed with weight gain which impacted her body image and self-esteem. She told me the problem is that she feels disconnected, “It's not a real connection on the phone.” She went on to say that she missed her friends, and while a call “gets the tone of voice,” it does not feel real and “seemed like simple-minded conversation.” It is hard staring at the screen instead of being with a person. Julie elaborated that when she had a problem, she “would not reach out to a friend, teacher, or guidance counselor. I just did not feel that people could help me.”

She shared that being alone in her room was just so boring. “I pick myself apart in the mirror, constantly trying to change my body and appearance. I dyed my hair four times as I had no other distractions, but was never satisfied.”

A recent study from the Rox Institute for research studied a total of 1,273 girls from fifth through 12th grade, who attended 88 different schools. The report showed that girls are really suffering during COVID. Seventy-nine percent say they feel more lonely and isolated, compared to before COVID (33%). And 1 in 4 girls report feeling depressed for four or more days per week. I have heard girls tell me they are so down, tired of being alone with their parents working, and their only source of joy is social media.

One-third of girls say they spend six hours a day on social media. Half of the girls use four hours or more glued to their devices with little break. This has become their outlet with lack of opportunities for socialization.

Social media has never been a great way to build teen’s self-esteem. It causes them to constantly compare themselves to others. They are also living virtually rather than making important social connections. One of the unfortunate outcomes of this is that social media can lead to cyber bullying if not really carefully monitored by parents.

This is a great time to make sure all of their technology is parentally controlled. There should be discussions all the time about what they are seeing online. Parents should go through their girls’ social media accounts to discuss everything from clothing choices to comments made by others. The goal is not to cast judgement or to punish but to create an ongoing dialogue about what is appropriate and what is not. It is also a great way to connect, show interest, and gain insight into their worlds and values. This is a great way to keep an open discussion.

Girls are now more stressed. Thirty-seven percent report their stress level is going up and half are saying they are “thinking differently about their future since COVID happened (52%).” These stress levels are translating into more panic attacks and more need for prescription medication in my office. I had girls who were stabilized before relapse and are now requiring a return to medication since COVID started.

The ROX study states:

“in general, girls, more than boys, tend to define themselves in relation to others. Their relationships are significant sources of support. Being disconnected from some of their most primary sources of stability and encouragement can be detrimental to their mental health. With nearly 80% of girls reporting more isolation since COVID-19 began, it is important that schools ensure they are adequately attending to the potential mental health threats that can accompany unsupported virtual learning. Without the interaction of their peers and teachers, these girls are at risk for significant mental health problems.”

I also would like to consider the lack of human-to-human contact. This cuts off non-verbal communication and the impact of pheromones (odor) on an interaction. This is very important in animals. While not totally understood, it is thought to be important in humans as well. In one study, Pheromones and their effect on women's mood and sexuality, the authors state:

“Pheromones may be present in all bodily secretions but most attention has been geared toward axillary sweat which contains the odorous 16-androstenes. One of these steroidal compounds, androstadienone, is present at much higher concentrations in male sweat and can be detected by women, albeit with wide variation in sensitivity. Upper-lip application of a pharmacological dose of androstadienone women results in improved mood and heightened focus—particularly to capture emotional information.”

It is not hard to imagine the devastating impact on lack of in-person interaction on girls who are hardwired to be social.

As a doctor, we are always looking at the risks and benefits for any treatment or medication we prescribe. You must consider the risks to benefit from social isolation versus allowing your daughter to socialize. You also need to look at the risk factors within the family unit, such as:

• Are there older people (greater than 55) in the home?
• Are there pre-existing conditions, such as cancer, lung diseases, or diabetes in the family?
• What is the percentage of positive COVID tests within your community? If it is above 6 percent, then your community is at real risk for spread of the virus.

Julie tells me “I am so lonely, I can't take it, my parents are so unfair.” It's not simply that Julie does not understand the risks associated with social interactions but she is also jealous of her other friends who have been allowed to interact more.

For Julie's parents and others, it is really important to take a comprehensive look at the risks versus benefits ratio for their family. What I recommend when making decisions for your family is this:

• If the risks as described above are low, then the risks of mental health (in this case: concerns of quarantining your kid) tip the balance in the favor of being less restrictive.
• As the risk factor of catching or suffering from COVID increases, then it favors a more restrictive approach with your child. In this case, I might suggest building up a virtual support system with guidance counselors at school or finding a therapist online.

I think we have yet to understand the consequences of this pandemic on mental health; and we should do everything in our power to mitigate that as parents, educators, and mental health providers. The lonely girl is an unprecedented problem that we have never seen like this before. Girls are hardwired to be social from birth and this is meant to be done in person, so let’s not let the lonely girl become the second wave of the pandemic.