These are not easy times.
We have spent the last few months in lockdown because of the coronavirus. Isolated from family and friends, we worry about infected love ones, or worse, experience the illness ourselves. Perhaps some have died along with over 127,000 of our fellow Americans, especially in communities of color and older populations.
In addition, massive BLM protests are sweeping the country due to the murder of George Floyd.
It’s not hard to predict that you may be experiencing anxiety, anger, worry, sadness, and depression. If you have had mental health issues in the past or presently are struggling with them, you may be seeing an intensification or reactivation of these issues.
Nearly all of us are suffering from grief and loss, whether it be of a loved one, separation from our family, our own vulnerability, our way of life, a job that pays the rent, being an essential worker on the front lines, or fears about an uncertain future.
Exacerbating our anxiety is the somber apprehension of the safety of reopening, going out to eat, taking a swim or workout, attending birthday parties, or just hanging out at the local watering hole.
These stresses and worries are taking a huge toll.
In this post, I will cover the signs of worsening mental health, how to gauge your mental health status, and list many resources available that can help all of us stay mentally healthy.
If you want to get right to the practical mental health recommendations, just scroll down to the Gauging Your Mental Health Status section below.
How Badly Is Our Mental Health Being Affected?
Rise in Drug Use
According to the Wall Street Journal –
“Prescriptions for anti-anxiety medications, such as Klonopin and Ativan, rose 10.2% in the U.S. to 9.7 million in March 2020 from 8.8 million in March 2019, according to the latest data from health-research firm IQVIA. Prescriptions for antidepressants, including Prozac and Lexapro, rose 9.2% to 29.7 million from 27.2 million in the same period. The information doesn’t include data on whether dosages have increased along with prescriptions.”
Coinciding with the increase in the use of antidepressants and anti-anxiety medications has been the recent report of shortages of some dosages of Zoloft. Zoloft is used to treat both anxiety and depression, as well as post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD).
Forbes quotes Dr. Samantha Meltzer-Brody, Professor and Chair at the UNC Department of Psychiatry and the Director of the UNC Center for Women’s Mood Disorders who said in response to the shortage:
“a shortage of a medication that treats anxiety and depression is very concerning and comes at a particularly bad time due to the general population facing an enormous amount of stress around an unprecedented global pandemic and confronting the horrors of endemic racism that are always present but have been particularly glaring and heartbreaking in recent events.”
Luckily, not all dosages of Zoloft are in short supply. It’s important for people using Zoloft to speak with their provider and evaluate what might be the best way to proceed.
A recent Household Pulse Survey performed jointly by the National Center for Health Statistics (NCHS) and the Census Bureau to gauge the changes in mental health of Americans during the coronavirus made some disturbing discoveries.
Starting on April 23, the Census Bureau sent 1.3 million surveys to American households every week for four weeks with 6.6% responding. The most current responses are for May 21 to May 26th. This is before the death of George Floyd.
The survey found some alarming indicators of mental health due to covid-19 –
· A third of Americans are exhibiting signs of clinical depression and anxiety.
· 24 percent showed clinical symptoms of major depressive disorder.
· 30 percent showed clinical symptoms of generalized anxiety disorder.
· The percentage of people reporting such symptoms was double that found in 2014.
These findings reflect the state of American mental health after suffering through three months of isolation, fear, unemployment, and perpetual uncertainty.
The worst rates of anxiety and depression were found among young people, women, and the poor.
It seems paradoxical that the rates of depression and anxiety are highest among the young when the older adult population is more susceptible to the worst virus outcomes.
In line with established ideas about the social determinants of health, such as socioeconomic status, accessible health care, housing, food insecurity, etc., the Pulse Survey found that 60% of those making over $150,000 indicated that they did not worry at all during the past week. Those numbers were inverted for those making less than $25,000 a year. Only 32% of those in the lower income bracket said they did not worry uncontrollably and 23% said they worried uncontrollably every day.
A person’s mental health is not determined by purely psychological factors. Just as physical health has many social preconditions, mental health is also dependent on economic conditions, poverty or wealth, genetics, biological predispositions, past experiences, traumas, or the lack of them, education levels, employment status, racism, food access, social status, and living conditions or homelessness.
To improve our mental health in the long run, these issues must be addressed on a societal level through effective policies, funding, and availability of resources that provide vulnerable individuals and populations with needed care.
Shockingly, nearly none of the trillions of dollars appropriated by Congress to deal with covid-19 was allocated to mental health programs and clinics. Considering the poor state of mental health resources prior to the pandemic, virtually nothing is being done to adequately address the rising tide of mental illness and despair.
During this crisis it’s essential to evaluate your mental health. Doing so can keep you on keel, avert more serious conditions, and assist you in seeking proper interventions when needed.
Mental health has many components. When evaluating your own status, it may be helpful to think about certain feelings and behaviors. Here are some of the things you can look to that can help when evaluating your mental health.
· Are you experiencing positive emotions such as joy, happiness, and satisfaction?
· Do you feel an overall calmness and an ability to manage stress?
· Do you feel energetic and optimistic about your life?
· Is there a sense of purpose to your life?
· Are you capable of positive and loving relationships?
· When stress hits, are you resilient and able to cope satisfactorily?
· Do you have positive feelings about yourself?
During particularly stressful times such as these, the CDC lists several things that you may start to experience that will give a clue to the extent that stress is unduly affecting you.
Stress reactions during an infectious disease outbreak can include:
Fear and worry about your own health and the health of your loved ones
Changes in sleep or eating patterns
Difficulty sleeping or concentrating
Worsening of chronic health problems
Worsening of mental health conditions
Increased use of alcohol, tobacco, or other drugs.
Try this mental health screening test from Mental Health America to gauge your mental health status in multiple areas.
What Can I Do Stay Mentally Healthy?
On the individual level, there are things each of us can do to maintain and improve our mental health even amid a pandemic and social unrest.
The National Ability Center has a simple yet effective approach that was developed by the CDC called Be Kind to Your Mind and offers tips on staying mentally healthy:
· Pause, breathe, and notice how you feel.
· Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting.
· Take care of your body:
o Take deep breaths, stretch, or meditate.
Make time to unwind. Try to do some other activities you enjoy.
Connect with others. Talk with people you trust about your concerns and how you are feeling.
Psychiatrist Simon Rosenbaum and psychologist Jill Newby list 10 actions we can all take that are beneficial to maintaining our mental health during crises:
· helping others (see section below)
· finding a type of exercise or physical activity you enjoy (like yoga)
· connecting with others, building and maintaining positive relationships
· learning strategies to manage stress
· having realistic expectations (no one is happy and positive all the time)
· learning ways to relax (such as meditation)
· counteracting negative or overcritical thinking
· doing things you enjoy and that give you a sense of accomplishment.
I would add a few things to the list that may be equally helpful:
· Expressing your feelings – don’t hesitate to express your feelings to friends and loved ones willing to listen. Start a diary. If you need professional help, use the resources listed below to find the necessary help.
· Getting creative – creativity is often a great way to release stress and find ways to deal with difficult situations. Here are ten ways to be creative during the pandemic.
· Getting out in nature – connecting with nature is a sure way of reducing stress and lifting your mood.
Cognitive-Behavior Therapy has proven to be a very effective mode of talk therapy that may reduce the need for medications, or, at least, act as an adjunct to them.
If you choose to see a psychiatrist, you may be prescribed medication to reduce anxiety. When necessary, medications can be helpful and an important part of treating depression, anxiety, and other temporary or chronic conditions.
However, Beth Salcedo, a psychiatrist in Washington, D.C., and the past president of the Anxiety and Depression Association of America, recommends taking additional steps to address anxiety, including “exercising, eating well, avoiding alcohol and making sure we surround ourselves with our social support as much as possible.”
Here is a short but helpful video with some good suggestions on dealing with mental health issues.
Mental Health Apps
In the past few years, there has been an explosion of online apps that can be very helpful, especially if you can't afford therapy and are facing emotional challenges. These apps can help you deal with anxiety, depression, PTSD, addiction, bipolar disorder, worry, and more. PsyCom has listed the 25 best mental health apps for a wide variety of issues.
Keep in mind that most mental health apps don't have much peer-reviewed research to back them up but do play an important role in keeping people connected outside of therapy and offer the anonymity so many people need to feel comfortable sharing their struggles.
PsyCom itself is a great resource to learn about mental health issues.
Helping Loved Ones
Helping others is another important part of maintaining emotional balance and social connection. Here’s how:
· Touch base with family, friends, and loved ones on a consistent basis.
· Use social media to keep tabs on how they are doing.
· Text and video chat.
· When necessary keep tabs on medications.
· Purchase food and essential products.
Caveat: Being a caretaker during this time can be very stressful. It is important to not be overwhelmed. The National Center for Caregiving has lots of information and resources for those of us caregiving during the pandemic. The site Helpyouthru has invaluable general information on caregiver support.
What if I Need More Help?
If the above suggestions are not sufficiently helpful, if you are overwhelmed emotionally, suffering from domestic violence, alcohol and substance abuse, feel suicidal, are a health care professional or essential worker, a teen needing support, or a member of the gay, lesbian, and transgender community, I’ve reprinted a comprehensive help list published by CNN.
Get informed: The Centers for Disease Control is offering a list of resources and guides for managing stress, anxiety and how to cope through the Covid-19 pandemic.
Get support: Free 24/7 crisis support is available by texting The Crisis Text Line at 741741. Online volunteers are also needed to help others as crisis counselors. Substance Abuse and Mental Health Services Administration Disaster Distress Helpline provides 24/7, 365-day-a-year crisis counseling and support to people experiencing emotional distress related to disasters. Call 1-800-985-5990 or text TalkWithUs to 66746 to connect with a trained crisis counselor.
Counseling for health care professionals and essential workers: For The Frontlines is offering free 24/7 crisis counseling and support for health care workers dealing with anxiety, stress, fear, isolation or other difficult emotions experienced during the coronavirus response. Additionally, FrontLineHelp.org is also providing unlimited free sessions with experienced, professional coaches who can provide emotional support until July 31, 2020.
Get addiction support: American Addiction Centers is hosting free virtual support meetings. They will be based on traditional 12-step meetings, hosted by a person in recovery, and topics or meeting types will vary based on the group’s preference.
Tempest is also offering free virtual support meetings to help people maintain or continue their path to sobriety while socially isolating. They have also launched a Covid-19 scholarship for their Recovery at Home program.
Get help with domestic violence: The National Domestic Violence Hotline has posted a “Staying Safe During Covid-19” guide for survivors and their families. Trained counselors are also available by phone 24 hours a day at 1-800-799-SAFE (7233) and by chat at www.thehotline.org.
Know you’re not alone: The National Suicide Prevention Lifeline can be reached at 1-800-273-TALK (8255). They have also compiled this guide for Emotional Wellbeing During the Covid-19 Outbreak. Additional resources can be found on American Foundation for Suicide Prevention’s website and at SpeakingOfSuicide.com/resources.
Support for teens: Boys Town provides counselors for youth-specific online chat at this link. The TrevorLifeline offers a suicide prevention counseling service for LGBTQ teens, call 1-866-488-7386 or text START to 678678.
Support for LGBTQ community: The Lesbian, Gay, Bisexual and Transgender (LGBT) National Help Center is providing confidential peer-to-peer support for youth, adults and seniors.
Find international resources: For support outside of the US, a worldwide directory of resources and international hotlines is provided by the International Association for Suicide Prevention. You can also turn to Befrienders Worldwide.
Final Thoughts
Social isolation and uncertainty can directly affect our mental health. When we are alone and living with uncertainty the chances of being overly anxious and depressed increase significantly. The massive isolation we are experiencing is unprecedented. Being cut off from others can lead to intense feelings of anxiety, hopelessness, anger, and deep frustrations. Ultimately, it can lead to clinical depression, social anxiety disorder and even suicidal thoughts.
It is of the utmost importance that you take your mental health seriously. The suggested actions and resources listed above can help address your emotional state and lead to improved mental and physical functioning as we all shoulder the uncertainties of the pandemic and on-going social and political unrest.
Click this link to access my Survivor’s Guide To Reducing Stress During The Coronavirus Pandemic.
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Reminder: please continue to social distance, wear masks, and wash your hands regularly. We are not even out of the first wave of the virus.
I wish everyone safety and health in these demanding times.
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The information contained in this post is not meant to diagnose or treat any disease or to replace the advice of medical and health professionals. Information contained in links are the sole opinions of the owners of the websites referenced.