SANSUM CLINIC BLOG

What have we learned about covid-19’s impact on mental health?

The pandemic has had a huge impact on mental health. People who had no prior mental health history have been affected by COVID-19. For people with pre-existing mental health conditions, the pandemic exacerbated their underlying

vulnerabilities as it relates to mental health.

The latest research released by the Centers for Disease Control and Prevention last summer, a cross-sectional survey, showed about 40% of U.S. adults were struggling with mental health or substance abuse issues. About 30% of U.S. adults suffered anxiety disorders, double from the prior year’s totals. 26% were experiencing trauma or stress-related symptoms. 11% of U.S. adults had considered suicide. All that was substantially higher than what was predicted, and what was shown a year prior in 2019.

What are some of the most common psychological reactions or symptoms linked to mental health from the pandemic?

It’s anxiety and depression for sure. These conditions are already quite common, roughly 20% of the population has an anxiety or depression disorder. We entered into this pandemic with a population of people already worried about the state of affairs in the country. You throw in COVID-19 and anxiety has increased substantially. People were afraid to leave their homes, had fears about the virus, fears over social interactions, fears about the vaccines, and so on.

If our mental health was stressed during this pandemic, what has happened to our physical health? are they linked?

We know there is a correlation between how you feel physically and how you feel mentally. Many people lost their outlets during the pandemic. Their gym closed, physical activity with others fell by the wayside and people became more sedentary. We are seeing the ramifications of people bored at home, eating more and not exercising. We know that exercise has an important role to play in terms of addressing anxiety and depression.

Are there certain groups who have been impacted disproportionately by covid-19?

Absolutely. The data supports this. We know that minorities were hit harder in terms of the impact. African-Americans and Hispanics had much higher rates of mental health issues. These populations already had less access to mental health resources, leaving them more vulnerable at the start of the pandemic. Data from the CDC shows that the 18 to 29 year old group was the age demographic hit the worst in terms of an increased percentage of mental health concerns and suicides. The reasons behind that are not entirely clear. One theory is that this group may have less support, could be more prone to isolation, or could have less-developed coping skills.

In terms of gender, women were more greatly impacted than men, suggesting that women were tasked with managing households, online school for their children, while also managing their own careers.

What happens with mental health as we transition from emergency mode to going back to normal?

For some people, the pandemic was a trauma event, losing loved ones or perhaps becoming ill from COVID-19, and we don’t quite know what that will unveil down the road. For other folks, the reintegration is part of the challenge; re-entering with your normal connections, your community, your job, and your school in a safe way.

How can we know if our increased stress, anxiety and depression is temporary due to the circumstances, or if this is something that we should be paying more attention to?

For some people, changes in mental health are very situational, with external factors like social isolation, loss of a job, financial insecurity and housing insecurity. Childcare and work have been very big issues. Mothers in particular have had a tough time navigating the responsibilities of their jobs, home, and kids learning remotely. For some, when these issues were partially or fully resolved, their mental health improved, but we also know there is a percentage of the population vulnerable to depression and anxiety, no matter what the circumstances. These are incredibly common conditions and those people are still recovering, still dealing with the ramifications of a worsening of their condition.

Getting an expert opinion or evaluation from a professional to determine what is going on is always a good idea, whether that is a doctor or a therapist. I always ask, if we remove the stressor, are you better? If you remove the stress, the person should rebound. Was it just a stressful job or were you truly biologically depressed? For those who have a biologic vulnerability to depression and you bring in a major stressor like the pandemic, it can create a host of problems.

Is there a way to protect our mental health as we all ride this out?

Routine certainly helps. Those with structure tend to do better. I advise my patients to focus on their own individual lives and factors they have control over. Where do you have room to manage your life? How do you start and end your day? That might involve reaching out to other people, helping someone, or checking on your neighbor. What helps the hopelessness or burnout is doing things that bring meaning and purpose to your life, having a connection to something. We just have to search for it.

Are there silver linings from covid-19 and the pandemic from a mental health standpoint?

One real saving grace for psychiatric care and mental health care has been telemedicine. A physical exam is not always needed to be able to provide adequate mental health care to patients, and the data supports that we can do this well over video. It has increased accessibility for many, and it may even be more comfortable for some people. Many new virtual, online therapy service organizations were created during the pandemic, bringing services to areas with few mental health providers.

In addition, Congress passed a number of bills with funding for mental health programs and services to address what’s occurred during the pandemic. Nationally and globally, mental health disparities and challenges have been brought to light. There is still a stigma around mental health, but we are talking about it more. We need a continued reminder that mental health is important.

Photo caption: Scott Dewhirst, MD