Child Development & COVID-19: Q&A with Dr. Manpreet Singh, Pediatric Psychiatry
Have you wondered about the impact of COVID-19 restrictions on your children's development, or just more broadly, how to instill resilience in kids? As a mother, I constantly think about my children's development, how to build their resilience, and how their development is being impacted by the restrictions of this past year. I first met with Dr. Manpreet Singh, an Associate Professor of Psychiatry and Behavioral Sciences (child and adolescent psychiatry and child development) practicing at Stanford Health Care, last summer. Over the year, our conversations have spanned her sister's inspirational story of resilience, our worries about COVID-19 and the impact of virtual schooling on our children, social injustices, and the importance of cultivating hope, compassion, and kindness. Read on to learn more about Dr. Singh's story and her guidance for parents as an experienced mother, pediatric specialist, and caregiver.
To start off, can you tell us a bit about yourself?
[Dr. Singh] Hello! I’m someone who is on a lifelong journey trying to cultivate self-compassion in order to be true to my name, Manpreet. Man = means mind/heart/soul/essential self, and Preet = means love, so Manpreet means love of your essential self.
I was the eldest of 3 kids, born in India and emigrated to Canada when I was 3. I am a child, adolescent, and adult psychiatrist, with a focused interest in developing novel ways to diagnose and treat children, adolescents, and young adults who suffer from serious mood problems, and to support youth to live their best. In addition to mood disorders, my scientific interests are focused in understanding what makes us resilient, and how we can harness our own biology to lead fulfilling and enriched lives.
I have 3 children, 10, 9, and 6 years of age, who keep me honest and on my toes.
What was your inspiration for pursuing the field of child and adolescent psychiatry and child development?
[Dr. Singh] My sister, Kirat, was born a few months after we moved to Canada, and she had a number of medical issues, born prematurely with Down Syndrome and complex heart problems. She inspired me to pursue a career in medicine, aimed to help kids like her, who experienced chronic health conditions. In medical school, I nurtured my interests in chronic illnesses, development, and was immediately fascinated by brain based health conditions, like schizophrenia, bipolar disorder, and depression. I learned that with neuroscience tools, there were new and exciting ways to understand the brain and how it adapts to stress and genetic influences. As a daughter of an academic, I got the research itch and took some extra care to learn some fundamentals on how to do research while doing my residency training in Pediatrics, Psychiatry, and Child and Adolescent Psychiatry. My interest in mood disorders developed after working under the mentorship of a female scientist who has been instrumental in establishing evidence-based treatments for youth suffering from serious mood disorders. After my sister, my mentor became a new inspiration to me, and I wanted to be just like her.
Your sister sounds like a warrior herself! What does resilience mean to you, and based on your experiences, what has your sister’s story taught you?
[Dr. Singh] My sister is indeed a warrior. Her story has taught me to have humility in the practice of medicine, because not every problem has a simple solution, and some of the most complicated problems in maintaining our health and wellbeing require thoughtful and creative solutions. She has also taught me that our patients need hope even if we don’t have all the answers. We all take our health for granted until it is compromised, and when we are most vulnerable, we rely on social support, which is critical to our healing. So is paying attention to the basics: like brushing our teeth and combing our hair. In fact, the health of our caregivers is just as important as our health. When my sister got sick, I told my parents to take care of themselves, take care of each other, and then care of Kirat. Healing is a team effort, and with collaboration, healing from serious illness can not only save lives, it can provide important insights moving forward.
We all take our health for granted until it is compromised, and when we are most vulnerable, we rely on social support, which is critical to our healing.
Shifting gears, let’s talk a bit about this past year and the variety of personal and social hardships children have faced. Many families have worried about their children being in virtual school because of COVID-19. As a mother and a pediatric specialist, what concerns do you have about the impact of quarantine and remote learning on child development?
[Dr. Singh] Human beings are inherently social animals, and our social interactions make us resilient. Social distancing, though unintended, has had some negative consequences, particularly for youth, who undergo much social development, especially during adolescence. With CDC reports of rising depression and suicide particularly among adolescent girls, the effects of social isolation are being realized in what many have forecasted would be a mental health pandemic to follow the COVID-19 pandemic. As a mother, I saw that the initial novelty of the pandemic and the technology learning curve were likely distractions from what would ensue after long stretches of virtual learning, but by the Fall of 2020, the deleterious effect of pandemic-related dysregulated sleep and routines, social isolation, and shifting nutritional demands became apparent in most kids, and especially in kids who already had or were predisposed to mental health issues.
What have you learned from your research about how parents can help their children build resilience and cope? How can parents best support their children as schools and communities begin to open up once again?
[Dr. Singh] What our preliminary research has found is that even healthy and otherwise non-stressed adolescents had increased symptoms of depression and anxiety. Coping by talking with friends and prioritizing sleep seemed to have a protective effect against anxiety for healthy teens. Parents can support their children by encouraging routines that include structured learning and fun, and time in nature. Stress can spread like a virus, so parents can also support their children by modeling self-care to more effectively manage their own stress. I suspect that the scientific evidence for these latter strategies will only grow over time, and as we all become more facile with managing our lives under unpredictable circumstances.
Stress can spread like a virus...
Is there light at the end of the tunnel? How do we imagine a hopeful outlook amidst shifting landscapes of COVID restrictions?
[Dr. Singh] Yes, I think there is a light at the end of the tunnel with previous restrictions being eased, and our communities getting back to some pre-pandemic typical functions. Funny enough, just as we were beginning to see the light, our son developed some cold symptoms. We all got tested (my husband and I vaccinated at this point), and were negative for COVID but positive for rhinovirus: the virus that causes the common cold. This took us by surprise after a year of being infection free and reminded us that our bodies are still susceptible, and that our social contract is to protect the most immunocompromised among us, for whom even a common cold, could be life-threatening. My sister, curiously enough, nearly died from rhinovirus just before the pandemic. Her story was prescient for the theme of the year: cooperation as a social responsibility, cultivating kindness, being self- and socially aware have all been necessary for our individual and collective resilience through the pandemic. Even though we are still in a pandemic, it has taught us how to be kinder to ourselves, to each other, and to earth.
Cooperation as a social responsibility, cultivating kindness, being self- and socially aware have all been necessary for our individual and collective resilience through the pandemic.
Tell us about your work relating to cultivating kindness and hope. What was the inspiration for this and what does it look like?
[Dr. Singh] My goals in introspecting about the importance of social connections was stimulated by the increase in conflictual interactions among family and society during an incredibly stressful time in history. I wanted to stimulate others to introspect about the nature and quality of their interactions and to encourage sustained efforts to enhance kindness through presence and participation, and to read more about ways to seek impossibly difficult conversations to illustrate how live-saving such transformative dialogues can be. It was Kirat and my work in understanding the sociobiological substrates of resilience across species that stimulated this effort.
In the process of having difficult conversations that seemed to be more about trust rather than truth, I wondered how we build expertise, and why we love being right, any why we hardly have time to interact with one another respecting intersectionalities, nuances, and complexities that breed misunderstanding without ever giving ourselves the benefit of the doubt, grace, or compassion. Compassion, I realized, wasn’t just something we needed to give each other, we also needed to give it to ourselves.
Compassion, I realized, wasn’t just something we needed to give each other, we also needed to give it to ourselves.
Let’s talk about cooperation. What do you mean when you talk about “saving the world through cooperation?”
[Dr. Singh] There’s always a long line of critics, and our brains are like Velcro for negative experiences, but like Teflon for positive ones. Neuropsychologist Rich Hanson suggests that to counteract negativity bias, we need self awareness, reframing our language towards changing behaviors (candor), and thinking about alternative explanations for why things have occurred to rebalance the scales by flooding ourselves with positive experiences while actively removing negative ones. This mindset shift can lead to more cooperation, as we move from self-care to collective care. Anthony Biglan’s The Nurture Effects talks about creating nurturing environments that may solve many problems in our society, to mitigate coercion while enhancing cooperation.
What are next steps for you? Scientifically or otherwise?
[Dr. Singh] I have deep interests in rolling up my sleeves and helping to create scientifically-informed solutions to the most pressing mental health challenges we face today. I think understanding how we are resilient and how we can nurture our resilience is like a black swan: which is an unpredictable event that is beyond what is normally expected of a situation and has the potential for significant impact. Black swan events are characterized by their extreme rarity, impact, and the widespread insistence that they were obvious in hindsight. What if the solutions that we seek were right under our nose or within us?
What parting words or advice would you want our readers to consider?
[Dr. Singh] Sometimes we do things to feel seen or to help others be seen. Ultimately, you can only save yourself. Once you've done that, an orientation toward nurturance becomes easy because it is essential for our survival.
Ultimately, you can only save yourself. Once you've done that, an orientation toward nurturance becomes easy because it is essential for our survival.
Manpreet K. Singh, MD MS is an Associate Professor of Psychiatry and Behavioral Sciences (child and adolescent psychiatry and child development) practicing at Stanford Hospitals & Clinics and Lucile Packard Children's Hospital. She leads a multidisciplinary team that aims to test and innovate novel diagnostic and treatment approaches in youth with a spectrum of mood disorders along a developmental continuum. Her research focuses on investigating the origins and pathways for developing mood disorders during childhood, as well as methods to protect and preserve function before and after the onset of early mood problems. Dr. Singh’s research team in the Pediatric Emotion And Resilience Lab conducts research examining the neural, cognitive, and genetic underpinnings of pediatric mood disorders. She has extensive experience with multi-level investigations involving children and families, as well as clinical, neuroimaging, and dimensionally-based behavioral research assessments. She completed her NIMH career development award that characterizes emotion regulation in healthy offspring of parents with bipolar disorder, and has been leading three independent NIMH funded studies examining the mechanisms of mood and other psychiatric disorders and their treatments among youth. She is extensively involved in collaborations aimed to investigate methods of treating problems associated with and leading up to mood disorders in youth. Specifically, she is examining the benefits of family focused psychotherapy, mindfulness meditation, and medications in youth with or at risk for mood disorders to reduce mood symptoms and family stress. She has also been reviewing the neural effects of medication and psychotherapy in youth. These areas of research aspire to impact our understanding of the core mechanisms and early interventions for pediatric onset mood disorders.
Like what you read? Get notified of new stories by entering your email information at Silver Linings Stories.
Mother. Warrior. Storyteller.
Parul is an inspirational speaker and executive advisor championing resilience and mental wellbeing. Combining her learnings as a business executive, patient, and caregiver, with her research into the science of resilience, Parul works with organizations to engage, educate, and empower their members to better navigate personal and professional uncertainty and challenges. She has reached thousands of people through her cancer blog that's been read in ~85 countries, films on survivorship and mindset, TV and radio segments, podcast interviews, and public speaking engagements for organizations such as the World Economic Forum and Stanford Health Care, and global employers like Bain & Company and Oracle. Previously, Parul served a 15+ year career in executive leadership roles spanning strategy, marketing, and operations in management consulting and technology start-ups. Parul holds degrees from MIT and the Harvard Business School, and resides in California with her husband and two daughters.
Follow Parul on: