Psychological Health During the Lockdown

During these last chaotic six months, health has been at the forefront of everyone’s minds—maintaining health, protecting health, improving health, and saving health. For many of us, COVID-19 has completely taken over our priorities and we now are watching and monitoring our bodies with greater scrutiny than ever before. But there is an area of our health that we are not paying as close attention to but that is just as crucial to our well being during these difficult times—our mental health. Luckily with so many services turning to the internet now, we can all find ways to manage and maintain our mental well being during these difficult times. No matter how dark or depressed your brain may be feeling, you are not without hope or help. You are not alone. Whether or not you are one of the populations we discuss in this article, we have outlined steps below that will hopefully help anyone in need recognize and address any mental issues this virus and its impact has given way to.  

Mental health is a tricky idea to get a hold on even during the best of days.

It’s not an illness we can usually ‘see’. It’s also often complicated, needing a professional to pull back the layers and to correctly diagnose the issues at hand. And even with therapy and treatment, something like depression can come in waves, meaning maintenance skills are just as important as initial diagnosis. But mental health during the time of coronavirus is even more complicated. A lot of people who would never have identified themselves as depressed or anxious are now finding themselves experiencing the symptoms of depression and anxiety. Some of you reading right now might still not identify yourself as depressed or anxious. You still get out of bed. You still do the errands and chores you need to do. You’re still eating and sleeping. A depressed person couldn’t do all those things, right?

Or alternatively, perhaps you’re telling yourself that you’ve just been feeling a little tired lately. It’s been harder getting regular sleep. Or maybe your appetite has been fluctuating, eating a lot less or a lot more. Maybe old interests and hobbies have lost some of their sparkle. You might be brushing off these signs as just a little extra stress from the chaos of the pandemic. But with no certain end in sight for this virus in the near future, it is imperative we reassess these signs our bodies are making to make sure we are truly taking care of ourselves from the inside out. 

There is no ‘right’ way to be depressed. A depressed doctor can treat patients all day. An anxious mom can find herself paralyzed in bed, unable to even sit up. Neither are more or less depressed or anxious than the other. The brain is truly incredible at how it can sublimate and distract ourselves from our own feelings. And right now, many of us are also running on adrenaline. With things changing constantly, most of us are racing to keep up. It’s hard to let our feelings settle when we’re always on the move. 

But it’s more important now than ever for us to get in touch with how we’re feeling and recognizing what kind of help we might need. With many of us still experiencing quarantine or lockdown, experts are worried about the challenges and difficulties people might face having to quarantine in isolation or the loneliness one might feel social distancing from everyone in public. In the long term, experts are worried this kind of mental stress will leave lasting physical damages to our health, leading to shorter lives and unhealthier bodies. But in the short term, researchers are worried that huge populations in desperate need of mental care and attention might lead to dangerous spikes in suicides and suicide attempts which is why taking proper care and control of our mental health is so crucial right now. 

One of the biggest and probably most surprising groups experts worry about are the millennials. Why the millennials of all generations? While millennials are not the high risk targets of COVID, they were already the high risk population for depression and suicide. Pre-COVID, a 30% increase in depression and anxiety had been reported between millennials and Gen X-ers at the same age. Millennials also report higher suicide numbers and the numbers have only gone up in recent years. Now, in a COVID-19 world, almost a third of millennials are unemployed. And of that group, many have lost jobs to companies that will not return once the pandemic is over. Any millennial students in school have now had their schooling disrupted with many colleges quickly scrambling to figure out the game plan for fall. 

This is all new and yet old hat for millennials.

The 2008 economic crash left many millennials, fresh out of college, completely unemployable and without options. Many graduates found themselves taking up barista jobs just to make ends meet till their prospects hopefully improved while others decided to wait out the recession in schools, returning for higher degrees. The insecurity, instability, and stress of the millennial reality were what many reports pointed to as exacerbating factors in worsening millennial mental health. Now another economic crash looms in the future. And what stability many millennials have found for themselves after 2008 seem to be on shaky untenable grounds. And while this may seem to be a mental battle, it can lead to a physical one as well. Research has shown that there is a physical impact of living and working through an economic depression. A recent study of the recession of the early 1980s shows that people who entered the labor market at the time suffered increased mortality, starting in their late 30s, due to causes that included lung cancer, liver disease, and drug abuse. The current mental trauma people are experiencing right now can affect their health for the decades to come. 

Another affected population experts are worried about are the healthcare providers themselves. Doctors and nurses are all facing a new frontier of a global pandemic. The shortages, the extra long hours, and for some nations, the politicizing of the crisis leave many busy, exhausted doctors having to campaign for aid on top of the work they are already doing. Many countries, short staffed, were graduating nurses and doctors prematurely and throwing them into the fray as quickly as possible. Just as any other frontline worker in a crisis, the stress can be overwhelming. Many healthcare providers are reporting symptoms of PTSD. Nurses in the UK have started demanding that therapy be provided by their hospitals as a way to help them cope with the sheer amount of stress and trauma they have dealt with on a daily basis for six months. They are not only seeing patients grow sick and die, feeling helpless as they try their best to save them; they are also seeing their colleagues get sick and die. As frontline workers, they are making themselves the most vulnerable and open to infection. 

For some, the stress and trauma and lack of support and aid can become too much. Dr. Lorna M. Breen, a top E.R. doctor from New York was working nonstop to treat COVID-19 patients. She ended up eventually catching the virus herself but after recovering, threw herself back into work. But shortly after returning to work, she committed suicide, leaving her family and her hospital devastated. Having no prior history of mental illness, her family is only left with guesses but they feel that the trauma of dealing with the onslaught of death and sickness that COVID brought her is a likely cause of her unfortunate suicide. Without providing proper support and counseling to our healthcare providers, we risk losing a whole generation of nurses and doctors to burn out. 

Therapists are also finding themselves overwhelmed.

Therapists are trained to counsel and advise during multiple types of crises but the current situation have left therapists with another type of crisis to solve—providing help in a socially distant but effective manner. Teletherapy or online therapy has been growing in popularity but it still hasn’t overtaken traditional therapy by any means. And many therapists found themselves totally unfamiliar with how to navigate this new online world. And while one could argue that this is not such a huge hurdle for providers to overcome, it may not work the other way around. 

There are many lower income neighborhoods where reliable access to the internet is not possible. A personal computer is still a luxury to many families across the nation. Teletherapy also works best when it is used specifically for talk therapy. But there are a lot of people in need of rehab centers and one-on-one counseling. And in these cases, a therapist needs to be regularly present. It is a difficult maze for many therapists to navigate right now. 

The elderly have been the center of attention since the outbreak of the virus because of their higher mortality risk to the virus. But they are also at high risk of mental health trauma due to the pandemic. Nursing centers, assisted living facilities, and hospices went into extreme lockdown across the nation once the threat became clear. Even in pre-pandemic times, senior citizens were at higher risks of depression, anxiety, and just plain loneliness. Now with many senior citizen care centers barring any visitors, they are at even greater risk of succumbing to isolation and depression. With the elderly, any additional stress can only weaken their already fragile physiological defense systems.  Unfortunately this mental health crisis in our elderly population is only worsened by the fact that there is a workforce shortage in health care providers specializing in geriatric psychiatry and medicine. Preliminary research has shown that there has already been an increase in depression, anxiety, and PTSD found in elderly populations. While their physical health is of paramount concern during this pandemic, we cannot forget their mental health as well. 

One of the fastest growing populations in need of mental healthcare are the COVID-19 survivors themselves. The virus is so new and every day we are learning new information about the symptoms, the presentations, the after effects. Doctors are learning new information and new protocol on a nearly hourly basis, which means they can sometimes offer contradictory information or seem unhelpful. And that leaves many survivors to fend for themselves after recovery. 

Many survivors experience trauma right from the beginning of their illness. Survivors who caught the virus early in the pandemic have reported doctors dismissing their symptoms as colds or pneumonia, leaving many to feel angry and betrayed. An especially vulnerable population are people of color, specifically women of color. Women of color have historically been reported as being ignored and dismissed more often than their white counterparts by medical professionals. Many women of color have had to demand and fight for a test to prove they were sick with COVID. 

The stress and fear of experiencing a new, dangerous virus is of course traumatizing. But then surviving it can also introduce a whole new host of anxieties and worries. COVID-19 is so new that doctors are not sure what the long lasting effects of the virus will be on survivors. And the reported recovery process has run the gamut of mild lingering shortness of breath to brain fog, severe difficulty breathing, chest pains, even strokes. Survivors are left to be their own experiment, figuring out their own post-virus symptoms. Early studies have already shown that virus patients have reported higher percentages of anxiety, depression, and PTSD. And with the number of growing cases, the number of COVID-19 survivors will only rise, meaning there will be a growing population of people in need of serious mental healthcare. 

When everything feels so overwhelming, it can be easy for us to slump into a “so what” attitude. But we shouldn’t let ourselves be defeated. There are small, concrete steps we can take to help ourselves and these vulnerable populations from putting their mental health at serious risk. 

• The first step we can all take is the most tried and true—talk to a friend. Reach out. Human connection is powerful and during this time when many of us are stuck at home, isolated, it is even more so. Talk with a friend about how you are feeling. Even if your friend cannot solve your problems, it’s a good feeling to know we are not alone. Many of us are in the same, bleak place and sometimes sharing that burden, knowing we are in the fight together can be galvanizing. You are not alone. If it feels too difficult to talk, sometimes it is just as helpful to listen. Call someone. If you have an elderly family member in your life, call them. Ask after them. If you can, educate them on how to use the video chat function on their phone or computer. Simple connections like that can make a huge difference for both the listener and the speaker. And for the elderly, it is not an exaggeration to say that regular phone or video calls can be life saving. 
• Next, find a therapist who provides tele- or online therapy. A lot of providers now offer this service but there are also apps or services such as talkspace or Open Path that can help you find a remote therapist for you. Professional counsel can’t make the virus go away but they can help you learn coping mechanisms for anxiety and depression. They can provide a safe space for you to express your worries. And services like Open Path are catered to those who are in lower income brackets, so that mental health care is accessible to as many people as possible, which is crucial during these difficult times. 

There are also therapists who specialize in counseling healthcare workers. They provide special counsel in dealing with the trauma of being a frontline worker and can offer flexible hours to accommodate shift schedules. With online therapy, you truly can receive care anywhere. Healthcare providers must not forget to care for themselves as well as their patients. 

If you are a COVID survivor, all of the above steps are important to take but also look into online support groups. Body Politic was one of the earliest groups to form and has members all across the world. But there are many other support groups forming, all with different focuses or missions. Some groups focus on stigmatized or marginal groups, such as POC or AIDS positive or queer-focused groups. You can easily connect and find a local or international group online through Facebook or you can even contact the hospital you were treated at to see if they are affiliated with any local survivor support groups. 

Support groups can be an immense resource in collecting and providing information on new symptoms from post-viral survivors as they wait for medical science to catch up with them. It can be enough for many survivors to just feel validated and seen for having a symptom that their doctors haven’t yet recognized as a post-COVID effect. And support groups can offer this. It can also give patients, especially patients of color, a place to discuss even the early difficulties of the virus, such as the fight to get tested and treated. They can find the support that they might not have experienced in the medical system. Support groups are also a great way to hear from medical authorities. Many medical researchers are looking to support groups to better understand the virus and its impact. In international groups, survivors can share what their nation’s medical experts have said about the virus, creating a global information network. Until more is understood about the virus, a support group can be the best place for a survivor to truly learn and discuss their post-viral life. 

Lastly, for everyone and anyone, it is important to remember to be kind to yourself. This is an extraordinarily stressful period so it is more than fair to give yourself the space to be angry or sad or scared. But don’t let yourself drown in it. You are not alone. Reach out and there is help for you. If there is one thing this pandemic seems to have solidified in so many is the knowledge that we need each other to survive.

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