TORONTO -- A year ago, many Canadians were washing down any package that came to the door. Now we’re tearing with abandon into that Amazon box before the masked delivery driver has even left the front porch.

But for some, a year’s worth of timed handwashing and pushing crosswalk buttons with our elbows has caused significant stress that won’t be so easy to cast aside when the world turns back to normal. This is particularly true for children who are prone to anxiety.

“Certainly (the pandemic) is causing significant distress in kids,” says Dr. Sandra Mendlowitz, a psychologist and co-founder of Reframe Psychology Clinic in Toronto, which focuses on anxiety disorders, depression and obsessive-compulsive disorder (OCD) in children. “Part of being a child is to have lots of social interactions and learn from that, so I think that it's kind of like they're in basically a living prison.”

To be clear, digesting a certain amount of coronavirus worry in the current environment is a good thing. We do want children to follow distancing protocols and wash their hands more thoroughly than normal. The problem is that for some people, a healthy fear can often transform into an unhealthy anxiety or obsession.

“If you have a predisposition to anxiety, this will affect you more than if you don’t,” says Mendlowitz.

According to Anxiety Canada, upwards of 20 per cent of children and adults suffer from anxiety at some point in their lives, and studies show the pandemic has intensified mental health issues among Canadians. 

A survey taken in February by Mental Health Research Canada found that 25 per cent of respondents self-reported anxiety and 17 per cent reported depression, which are the highest levels in a series of ongoing polls conducted during the pandemic by the non-profit.

As Mendlowitz points out, OCD and generalized anxiety are closely related. “OCD is about having intrusive distressing thoughts and specific sort of repetitive patterns of behavior that you get locked into. Generalized anxiety is also about worry, but it's about real-life problems,” she said.

For people with a predisposition to anxiety or OCD, the circumstances of the pandemic can serve to bring out their symptoms, such as for an OCD sufferer with a germ issue who responds with excessive handwashing. Mendlowitz says it’s not uncommon for some of her patients to complain that their parents are not being careful enough in their pandemic precautions.

“The kids who have germ issues will think that their fears have been verified, that like, ‘see you do have to wash your hands!’ and I'm like 'Well, there's a big difference between following guidelines of 20 seconds versus your version, which is 20 minutes,'” says Mendlowitz.

“I certainly work with kids who don't have the typical sort of OCD germ issues. But nonetheless they will all say that their symptoms have been exacerbated by the pandemic, and for various reasons,” she added.

Fortunately, children are resilient, and it’s very likely the majority of them will have little trouble re-embracing typical childhood behaviours when the pandemic winds down. But some may require some help readjusting to a world of unmasked conversation and proper handshakes. A good approach for parents is to lead by example, says Mendlowitz.

“I think an important point is that kids are a great barometer for what’s going on in the house,” she says. “So we want parents to bring some semblance of rationality to the worry.”

Tamar Chansky, a psychologist and author of several books about anxiety and OCD, says it’s important for parents to listen to their children’s fears and not dismiss them.

“Tell your child it’s OK to feel afraid. It’s OK to have worry thoughts. It actually makes sense given how hard and scary things have been. Now let’s work on fact checking the worry to make sure that your thoughts are telling you the truth so you can be safe, not scared,” she said.

Of course, readjusting to life after the pandemic requires an ‘after’ to the pandemic. While vaccination efforts are sure to eventually reduce infections and hospitalizations from current levels, some doctors worry there could be recurring seasonal flare-ups of the disease on a much smaller scale.

That type of situation could be problematic for some people whose anxiety has been triggered by pandemic-related pressures, says Roger McIntyre, a professor of psychiatry and pharmacology at the University of Toronto.

“I think the driving force behind this and the great unknown is the degree to which COVID-19 is going to be part of our national conversation nine months from now or a year from now,” he said. “I think the longer this thing stays in our conversation, the longer you're going to see some people who are susceptible to this continue to be fixated on it."