Pandemic stressors affect mental health
- Published: April 30, 2020
A global pandemic.
The words alone are frightening, the fodder of horror films and dystopian novels.
It’s no surprise, then, that the current medical crisis of COVID-19, while physical in nature, affects our mental health, whether we contract the virus or not.
Experts say it’s normal to feel fear, anxiety and stress when facing the unknown, especially when the multiple specters of illness, job loss and death are added to the mix.
“The ‘unknown unknown’ — not knowing what you don’t even know” is what the National Alliance on Mental Illness, or NAMI, calls the kind of circumstances we’re all facing now.
And along with the pandemic, the accompanying closures of schools and businesses and the governmental orders to stay home, come the disappointment of canceled activities and plans, the disruption of regular routines and the desultory effects of long-term separation from friends and loved ones.
Mental health officials cite depression, anxiety, insomnia, irritability and issues with appetite as possible responses when faced with such situations.
“A pandemic is a crisis, so there’s lots of thoughts, feelings and behaviors” that arise,” Greta Mayer, the CEO of the Mental Health Recovery Board of Clark, Greene & Madison Counties, said in a recent telephone interview.
“We’re going through something we haven’t gone through before,” she said. “It can feel very unsettling.”
Sadness, agitation, even numbness are all normal responses to crisis, Mayer said.
Locally based counselor Bruce Heckman echoed Mayer.
“Of course you feel depressed,” Heckman said in a recent phone interview. “These are hard times.” Issues begin to pile up and can feel overwhelming, he said.
But, he added, as with any life crisis, there are strategies for crisis management.
When you feel powerless, figuring out something you can do, and acting on that, whether it’s as simple as taking a shower and getting dressed, is helpful, Heckman said.
It doesn’t have to be complicated, he pointed out. “Go for the low-hanging fruit.”
Identifying the things that support one’s personal resilience is another strategy, Heckman added. “What are some of the things that have worked for you in the past?” is a good first question to ask.
Listening to or making music, creating art, coloring, writing, cooking, crafts, physical activities of all sorts, playing with a pet, meditation and/or prayer, a phone call with a loved one, reaching out for professional help — all are among the ways experts suggest for coping with difficult times.
The Centers for Disease Control notes that children as well as people who have experienced past trauma, especially if it involved illness and loss, are particularly vulnerable when facing a crisis.
Locally based clinical psychologist Esther Battle said the effects of loss can be profound.
“Children and adults who have suffered the unexpected loss of a loved one — it’s shaken up their ability to tolerate [new difficult circumstances],” Battle said in a recent phone interview. “It’s shaken up their worldview. Their sense of control is disrupted, of life being predictable, of their expectations being met.”
And the effects can be long-lasting.
“The symptoms of those circumstances tend to persist over time,” Battle said.
Similar responses can occur after other losses as well, experts agree, including lost connections to work, school, church and friends, all of which are happening now with businesses and schools being closed and stay-at-home orders in place.
Such experiences can leave people feeling rudderless. And experts agree that establishing a new routine is vital.
“One of the prime interventions that I recommend for families who are struggling with loss, is try to establish some kind of routine and predictability in their lives,” Battle said. “Gradually start to develop a new normal. … People learning new patterns and new habits will restore some sense of security,” she said.
Establishing a routine is especially important for children, said John Gudgel, the counselor at Mills Lawn elementary school and past principal at Yellow Springs High School.
“Maintaining a daily routine and regimen is important in terms of following through on academics, physical outlets — playtime — and eating habits [and] helps to eliminate fears or anxiety,” Gudgel wrote in an email in response to a News inquiry.
Heckman also agrees with the importance of setting a routine, noting that establishing new patterns and habits also opens the possibility of positive life changes that extend beyond the current crisis, knowledge of which is empowering as well.
Complicating the current crisis is the statewide order to stay home as much as possible, along with the prescription to maintain physical distance from others if you must go out. Such distancing and the isolation of staying home can exacerbate mental health issues, Battle said.
Battle added that she doesn’t care for the frequently used terminology of “social distancing,” preferring the phrase “physical distancing,” to stress the healthful purpose for the action.
We are social beings, Battle said. “Social interactions sustain people when they’re anxious.” And loneliness is a real concern as normal methods of engagement are canceled. Battle suggests finding alternative ways to support social interactions that maintain physical distance, such as phone calls, email, video calling and letters.
Heckman noted that isolation also can bring up existential questions about life and one’s place in the world.
As a counselor, he said some of the questions he might explore with a client dwelling on existential issues include, “What meaning are you making of this? What’s your responsibility in this world? What are your beliefs that are going to be helpful to you? On whom can you lean?”
A focus on children
In practice for over 40 years, Battle has focused on working with children, teens and families.
“Parents and how they are able to adapt to the crisis is going to be the most powerful model and intervention that’s either going to help or produce anxiety,” she said. “Children will pick up and mimic how the parent is dealing with it.”
“Children look for guidance from trusted adults and therefore it is important in discussing COVID-19 with children that we are calm, honest, reassuring and good listeners,” the counselor and educator wrote.
One general strategy for helping children, Battle said, “when they’re having to face a major change in their life, especially a negative change, is attempting to connect for them the new experience with ones that are familiar. So the old familiar things can provide an anchor.”
Possible questions might be: Remember when school was closed for snow days and what we did? Remember how you learned to cough into your elbow when you had a cold? Remember how we washed our hands every time we came inside so as not to pass germs to your baby brother? Such questions remind children that they know some things to do and they can be successful at them.
“It normalizes what’s going on, and they can feel expert,” Battle said.
According to Gudgel, “Stressing the importance of hygiene and hand washing is important and gives young people a sense of empowerment in terms of ‘doing their part’ in reducing this virus.”
Tell children that they are loved and cherished and the current actions being taken are to protect and keep them safe, Battle added.
Battle also noted that it’s helpful to remember that a child’s sense of time is different than an adult’s. A week can feel like an eternity to a child, and the stretching out of time can increase their feelings of anxiety and possible anger as the crisis continues.
Adults can help children by acknowledging the child’s feelings and the difficulty of the situation, and also by recognizing the child’s successes in managing their hardships, Battle said.
“Being patient and showing empathy is of paramount importance,” Gudgel wrote.
While some mental health agencies elsewhere in the country are reporting increased numbers of people seeking help related to COVID-19 issues, local officials say they have as yet seen no such increase.
Yellow Springs Police Chief Brian Carlson said this week that the number of mental health-related calls they receive is on par with the same time last year.
According to Erica Picklesimon, the executive director of the area chapter of the National Alliance of Mental Illness, or NAMI, the local group “is not seeing an increase in a need for services,” but current clientele is seeking support.
“The feedback we are receiving so far varies on a wide range of emotions like boredom, loneliness, anxiety and depression,” Picklesimon wrote in an email. “Many are grieving their everyday routine, and miss seeing their peers, as routine and inclusion are what many individuals thrive on.”
On a hopeful note, she added, “We are also hearing from some that they have taken this time to focus on enhancing their mental wellness and implementing new things into their lives like painting, yoga, meditation, making phone calls. Individuals are navigating our ‘new normal’ as best as any of us can.”
Although the area group’s three drop-in centers are closed in response to the COVID-19 crisis, support groups continue to meet online, and “we are providing a lot of phone support,” according to Picklesimon.
The Mental Health and Recovery Board’s Mayer said that while her agency hasn’t yet seen an increase in the number of people seeking help, she anticipates the numbers will rise as the crisis continues.
“We believe this is the calm before the storm,” Mayer said, adding that menta; hea;th care providers are available and ready to respond.
“We want people to call for help,” Mayer said.
A variety of resources are available for adults and children feeling the stress of the current pandemic.
If you are in immediate danger of hurting yourself or others, or someone is hurting you, call 911.
If you just need some extra support, the following resources may help.
Online resources include:
- The CDC’s web pages on COVID-19 include a page on Daily Life & Coping: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html
- The national Substance Abuse and Mental Health Services agency has several resources online:
- “Talking With Children: Tips for Caregivers, Parents, and Teachers During Infectious Disease Outbreaks,” at https://store.samhsa.gov/product/Talking-With-Children-Tips-for-Caregivers-Parents-andTeachers-During-Infectious-Disease-Outbreaks/SMA14-4886
- and “Coping With Stress During Infectious Disease Outbreaks, “ at https://store.samhsa.gov/product/Copingwith-Stress-During-Infectious-Disease-Outbreaks/sma14-4885
- NAMI, has produced a 15-page booklet titled “COVID-19 Resource and Information Guide,” available online at https://www.nami.org/getattachment/About-NAMI/NAMI-News/2020/NAMI-Updates-on-the-Coronavirus/COVID-19-Updated-Guide-1.pdf
- The National Council for Behavioral Health has “Resources and Tools for Addressing Coronavirus (COVID-19) online at https://www.thenationalcouncil.org/covid19/
- The Ohio Department of Mental Health & Addiction Services also has a variety of resources on its website, mha.ohio.gov.
Some national phone numbers include:
- The Disaster Distress Helpline: 1-800-985-5990.
- The National Alliance of Mental Health Helpline: 1-800-950-6264.
- The National Domestic Violence Hotline: 1-800-700-7233 and TTY 1-800-787-3224.
- The National Suicide Prevention Lifeline: 1-800-273-8255, or dial 988.
An Ohio statewide crisis text line: Text 4hope to 741741.
On April 22 Ohio launched a “COVID Careline,” a toll-free and confidential line. The number to call is 1-800-720-9616. It will be available for Ohioans from 8:00 a.m. to 8:00 p.m. Calls made outside of that time frame will be routed to the National Suicide Prevention Lifeline.
Some local numbers include:
- The Mental Health & Recovery Board of Clark, Greene & Madison Counties: general number, 937-322-0648; crisis line, 937-376-8701
- NAMI Clark, Greene & Madison Counties: 937-322-5600.
- TCN Behavioral Services, Inc., in Fairborn: 937-376-8700
- The Family Violence Prevention Center in Beavercreek: general number and crisis line, 937-426-2334.
Mental health tips
Stay connected: Reach out to friends and family via Skype, Facetime, text, email.
Talk feelings: Share with loved ones if you are comfortable. Experts also suggest reaching out to a spiritual advisor, a mental health professional or a trained volunteer through a crisis line.
Relax: Take time for yourself; try practicing breathing techniques.
Pace yourself: Balance stressful activities with fun.
Stay positive: Try keeping a journal about the good things that you have going on.
Limit media exposure, but stay informed.
Supporting your child
Reassure them that they are safe; share ways you deal with stress.
Keep a structure.
Talk and answer questions: Share facts that your child can understand; don’t go overboard with details.
Be a role model: Practice good coping skills that children will mimic.
Limit media exposure.