A Toll on Mental Health

COVID-related isolation is causing an uptick in depression, especially among seniors

It’s well known that being alone and being cooped up can lead to depression. And months of home-bound isolation related to the COVIDinspired health order is taking its expected toll, especially on seniors who have greater risks from the virus and less opportunity to combat the effects of depression. Shortly after Gov. Michelle Lujan Grisham issued the shutdown orders in March, Presbyterian Hospital significantly expanded its beds in its psychiatric ward for both adults and youth, said Dr. Shannon Stromberg, Presbyterian Healthcare Services medical director for behavioral health program. And those beds have been full since, he said. “We are, as a program at Presbyterian and as a state and in the country in general, seeing a rise in depression and anxiety across the board in all age groups,” Stromberg said. “We’re seeing a rise in substance abuse. We’re seeing new levels of patients coming to the emergency room every single month since COVID began. And we’re also seeing an increase in requests for services in outpatient setting. And our hospital beds have been full since the pandemic started.” In fact, 35% to 40% of emergency room visits are directly related to behavioral health issues, he said. It is a grim picture that is being seen by hospital systems across Albuquerque. “There are more people reaching out and for some of them the depression is worsening,” said Dr. Kanchan Kohli, a geriatric psychiatrist and psychiatry professor in the University of New Mexico psychiatry department. “With people being more isolated at this time, we’re continuing to see a steady stream of people. It’s definitely an issue we’re seeing for many people and definitely the elderly, as well.” Combating these issues is not easy and takes some time and dedication from family members or friends, she said. “Some people have started doing more Facetime calls,” Kohli said. “People who are not as tech savvy with younger family members are setting up Facetime calls or Skyping. Some programs are now doing online mindful meditation or online yoga classes.” It is important to keep the older generation in sight, she said. “You have to give patients some opportunity to still engage,” Kohli said. “That’s beneficial to them but do it in safety of their home.” And that’s difficult because like everybody else, seniors like to be out and about. “We are social creatures and we like to be around people, having some around all the time is great,” Stromberg said. “People like to go out and exercise and go to gym and go to movies. All the things that we like to do are gone right now.” Finding something else to fill that void is an important first step, he said. “If we’re losing our ability to go out and eat or exercise or distract ourselves, what do we replace that with,” Stromberg asked. “The first thing I would say is go back to the point where there was not any depression or anxiety, have a daily schedule. A pattern of activities can keep somebody healthy, medically, physically and spiritually.” Additionally, making an extra effort to take care of your body helps the mind, as well, he said. “Our patients and even our employees have to take care of ourselves, eating well, exercising if possible, getting plenty of sleep and avoiding alcohol and drugs,” Stromberg said. “Just the basic stuff of taking care of your body and your mind and not losing sight of this just because we’re cooped up.” Spending the extra time doing something enjoyable around the house is a good way to avoid brooding, Kohli said, and family can help with that, as well. “Something else which is really important when with a family member is figure out people’s hobbies, what they liked to do when they were in their 30s or 40s,” she said. “Maybe it was something they had to give up because they didn’t have the time. Now that they have the time to engage and maybe starting to reengage in hobbies. Knitting, pottery, picking up an instrument after many years because people have more time to do that.” Again, physical activity is an important factor, she said. “Maintaining activity can be a struggle for people,” Kohli said. “We’re lucky, we have nice, open areas where we can maintain that physical distance. Go for a walk in the apartment complex where there’s not really any other people or take a short stroll or hike.” That’s something Stromberg stressed, as well. “I would recommend everybody exercise, it’s absolutely key,” he said. “It changes your mind, body and soul. It’s important to continue to be able to do whatever you can.” Family and friends should be aware of warning signs somebody may be slipping into depression. “A change in sleeping patterns, so if they’re not sleeping as well,” Kohli said. “Or finding themselves a little bit more withdrawn and not really wanting to engage with family or noticing some inability or frustration. These are early signs that may be a change in their mood and maybe something they want to check out with primary care physician or psychiatrist where they are mood-wise and what can be helpful.”