It’s been a year since I wrote The Invisible Impact of an Invisible Threat soon after the official declaration by the World Health Organization that COVID-19 had achieved global pandemic status.
Much has happened in those 12 months (!). And 2021 has already given us a glimpse of the rollercoaster ride it will be.
Even as we move forward and see glimmers of post-pandemic life, there are reminders everywhere of COVID-19’s impact. The invisible virus exposed visible chasms in society, far deeper than many might have ever imagined. There’s no doubt, there are long-lasting wounds, some of which first took root hundreds of years ago. However, blessings are also interwoven through the layers of loss, grief, anger, and despair, one of which is the further destigmatization of mental health conditions given the literally global and simultaneous experience of emotional distress. And not a minute too soon.
COVID-19 impact on mental health
The invisible is invisible no longer.
Uncertainty has been universal. Nobody has been spared the impact, although the negative repercussions have been experienced much more by some than others.
Overall, depression tripled in adults. Those at greater risk include women, those with lower income, less than $5000 in savings, of Asian ancestry, unmarried status, and exposure to more stressors.
Recent research found 52% of those who experienced a COVID-19 infection were suffering from depression. It was seen more frequently in young males who had suffered from severe COVID-19 symptoms.
Anxiety rates greater than 30% have been noted in adults, and children have also been seriously affected.
Coping with COVID-19
With the loss of “normal” and, for many, a greater blurring of the lines between home and work, some people significantly increased their alcohol consumption. In-store sales increased 54 percent, and online sales jumped even more – 262 percent.
Why? A study of a select population by the Bloomberg School of Public Health found 60 percent of people increased drinking to ease stress and boredom. Plus, there was greater availability.
It wasn’t just a few drinks. Thirty-one percent binge drank, and 7 percent engaged in extreme binge drinking.
The compounding effect of despair from depression and/or anxiety can be seen in the greater likelihood of increased alcohol use if suffering from these conditions.
Although alcohol may help provide relief in the moment and in the short-term, it can exacerbate depression in the longer term, leading to the potential development of a vicious cycle.
This self-medicating habit may cause more harm than good and doesn’t address the underlying issues driving the increased consumption.
It’s also not easy being a hero during a pandemic. A recent Yale study indicated 25% of healthcare workers were suffering from PTSD.
Other COVID-19 impacts
COVID-19 has changed lives in many other ways related to emotional distress.
- Domestic violence has risen. The incidence has been as present for same-sex couples as for heterosexual pairs. Within these groups there are a variety of factors such as race/ethnicity, immigrant status, cognitive disability, and gender identity which can increase the likelihood of life circumstances which raise the risk.
- Loneliness has increased, has been exacerbated, and is greater among women, children through young adults, and the elderly.
- Those with substance use disorder (SUD) are at greater risk of COVID-19 infection and its severe complications.
- The impact of racism on mental health and well-being is well-documented. And the recent murder of 8 people in Georgia, which occurred in Asian-owned businesses and 75% of whose victims were Asian, was a catastrophic reminder of the degree to which hate can vanquish lives.
It was just the latest tragic example of the type of events which can result in extreme fear and anxiety in communities of color.
The recent one-year anniversary of Breonna Taylor’s death in Louisville and preparations for the start of the trial of the police officer charged with the death of George Floyd in Minnesota has triggered for many African Americans the trauma which can be deeply embedded from an ancestral history of innumerable atrocities and death.
Then there is the distress of grief and mourning. There is a universality to the feelings of what has been termed “disenfranchised grief.” That’s a situation in which individuals suffer losses that would be considered lower in the grief “hierarchy.” Therefore, they may say to themselves “I can’t complain about my grief, because people have it worse,” as stated by a patient of a licensed clinical social worker in Pennsylvania.
And it is not yet clear how many of us will suffer from “complicated grief (CG).” That occurs after a loss related to a death and in which “people get stuck indefinitely in grieving, preventing them from processing the death and moving on with life. CG is a chronic, impairing form of grief, distinctive from depression and post-traumatic stress disorder and other conditions that may follow the death of a loved one.”
Amidst the dark storm that was COVID-19, ironically, there have also been “blessings”. When one scans the current reality, there are indeed some rays of light and discovery that can offer hope and guidance to increase our ability to strengthen our resilience.
For example, values for many people have been tested and clarified. The importance of family, friends, and human connection has been deeply reinforced.
The positive impact extends beyond family. Mother Nature has provided a glimpse of the power we have to save the planet, IF we choose to do so.
Within society, eyes have been opened to the 414-year history of (1) hate and systemic racism, (2) the vast, internecine, tentacled infrastructure built to sustain its subjugation, oppression, and injustice, and (3) the soul-crushing destruction of the physical health and well-being and even death it has wrought in the lives of its myriad victims.
And there are more blessings:
- There is greater recognition of the importance of the emotional health of healthcare workers and the impact their distress can have on the rest of us.
- More people, including healthcare workers, have been open and willing to seek help from mental health professionals. And digital offerings like the two below have expanded the options available for supporting emotional well-being and mental health conditions:
2. Supportiv which supports its services as “precision peer support” to achieve “mental wellness.”
- Nascent, preexisting technology platforms have been leveraged to help increase access. The level of behavioral health virtual care engagement remains high. Both patients and practitioners report a high level of satisfaction with this form of interaction and its outcomes.
The challenge? Eradicating the well-documented inequity experienced by large segments of the population in both rural and urban areas as well as Indigenous lands due to lack of access to broadband and/or the challenges of digital literacy and/or the economic wherewithal to afford the devices needed to enable a virtual visit as well as the cost of the visit itself.
The surge in telehealth provides the opportunity to optimize the access and quality of care of this increasingly popular model of care, to avoid “digital redlining,” and potentially increasing disparities overall in those historically marginalized segments (e.g., communities of color, low socioeconomic status) of the population.
- There is greater knowledge about those more likely to suffer emotional distress as well as factors and actions which can help prevent and/or mitigate the mental health repercussions of the pandemic (as well as better prepare for the inevitable traumas which arise in the future):
1. Risk factors for elevated anxiety in young adults include behavioral inhibition (described as “a childhood temperament characterized by high levels of cautious, fearful, and avoidant responses to unfamiliar people, objects, and situations”)
2. In addition to those factors already mentioned, the risks of anxiety and depression are greater in those with:
– higher COVID-19 infection risk (suspected/confirmed cases, living in hard-hit areas, having pre-existing physical or mental conditions)
– longer media exposure
3. Helping others can serve as a balm for our souls and improve our spirits, by providing a greater feeling of purpose as well as a sense of contribution that can translate into an experience of having some degree of control in our lives, which reduces stress.
4. Reaffirmation of the positive impact of techniques and coping skills which are within our power to leverage such as gratitude, kindness, mindfulness, guided imagery, and managing the anger which arises from injustice as well as the stress of grief and loss.
Moving forward: post-pandemic
We now have 3 vaccines that provide the chance to get a handle on the virus in ways that were not possible last year and which will bring more “normalcy” to our lives.
However, I do not believe we will ever go all the way back to the way things used to be. The COVID-19 impact is too far-reaching. And in many respects for many people, that in and of itself is a reason for hope.
As I said last year, and bears repeating:
“Mother Nature, by way of COVID-19, seems to have given us a second chance and the opportunity to create a ‘new normal.’ And that new normal has the mega-potential for designing a humane and caring world guided by the lessons the coronavirus has taught us – I value your life and protect you, and you value my life and protect me in order for each of us to survive.”
Our ultimate global response to COVID-19 has the power over time to drive positive, transformative change if we have the courage and resolve to move forward into a different future……a future we have the opportunity to craft so all of us, as well as the planet, have a chance to thrive.
Remember you are not alone. Check out these emotional and mental health resources:
- The NAMI Helpline is a free, nationwide peer-support service.
- SAMHSA’s National Helpline is a free, confidential treatment referral and information services. It’s available 24/7 in English and Spanish.
- HelpGuide provides actionable articles and resources to help you get started on the path to improved mental well-being.
- Crisis Text Line provides 24/7 crisis counseling for depression.
- The National Suicide Hotline provides 24/7 support for those in crisis and contemplating suicide.
- Mental Health Resources for the Black Community
- AAPI Mental Health Resources
- 9 Mental Health Resources for the LatinX Community