Depression, anxiety rise amid pandemic
The COVID-19 pandemic has brought with it an epidemic of anxiety, depression and other mental health issues.
Not everyone is equally vulnerable, and some are finding strength in their ability to be resilient, a term mental health professionals use for being able to cope under trying circumstances.
“Mental health is health, and mind and body are connected, so the mental health impact of this pandemic is highlighting what was already a mental health crisis in this country,” said Lisa Winjum, executive director of the National Alliance on Mental Illness’ Connecticut office.
“We average about 45 calls and emails a month,” Winjum said, though there were only 43 in the first three months of 2020. “I’m surprised our number was so low in the first quarter,” she said. But since April 1, they have received 157 calls or emails, almost twice 2019’s monthly average.
“We’re increasingly seeing more calls from people who are in crisis,” including people having thoughts of suicide, she said. “Our calls are becoming more frequent and more complex.”
NAMI Connecticut, based in West Hartford, offers 29 online support groups for all ages, for individuals and for families of those suffering mental illness and groups serving veterans. The agency also refers callers to local crisisintervention groups. “We’re led by the voice of lived experience,” Winjum said.
No one is immune. People who are isolated in their homes can grow depressed. Losing a job increases anxiety over finances and brings fears of homelessness. Not being able to mourn deaths of loved ones adds to the grief. And having children at home, who either need to be homeschooled or watched while parents are working at home, adds to the stress.
“Isolation isn’t really a good thing for anyone. We’re social animals, but particularly people prone to depression and people in recovery, we want people to connect with other people, not disconnect,” said Dr. Randall Dwenger, chief medical officer of Mountainside recovery center, which has locations in Canaan, Wilton and New York state.
“When people isolate they can certainly increase their substance use and look for other things to cope,” Dwenger said. “I think that one of the other things that people are dealing with when they start feeling like they have some depressive symptoms, they’re not calling to get treatment. Even if they’re suicidal, they’re not going to go to the hospital. … There’s a lot of suffering in silence. They think other people’s problems are more important.”
People addicted to alcohol or other drugs may increase their use while isolating, Dwenger said, but if they try to stop on their own, “withdrawal from alcohol can be dangerous; it can be deadly. You can have seizures. You can have DTs, delirium tremens. You may find yourself in an ICU bed if you try to stop on your own.”
Dr. Craig Allen, vice president of addiction services for Hartford HealthCare, said “deaths of despair” also are on the rise, based on a study he recently read.
“There will be 75,000 more deaths because of the environment caused by COVID-19,” he said. “We’ve thought all along that this type of situation would drive substance abuse, and even people who are in recovery are relapsing because they’re not getting the support they need.”
Gerardo Sorkin, a licensed clinical social worker with an office in New Haven, said since the pandemic began, he and his clients have gotten used to therapy via the internet.
“I would say that it has certain advantages and disadvantages,” he said of telehealth. “It’s easier for the therapist. … It seems that it facilitates the opening of the conflicts and the emotions. They’re more open and they do that faster.”
But Sorkin, who also is licensed in New York state, said isolation is “creating a big problem … The effects of this already will take many months and years to process. I don’t think there is any ‘back to normal,’ at least the normal we are used to.”
He said his work includes helping people who may be stuck in anxiety or depression to stop ruminating and to take action to care for themselves. “It’s understandable, because now you have the sense of the end of the world, the feeling of catastrophe. There is so much uncertainty that we feel.”
Those who care for COVID patients in the hospitals’ intensive care units also are vulnerable, and the stress is increased if a staff member has been transferred from another section of the hospital to care for the surge in COVID admissions. The death toll has made it all the more difficult.
“It’s a tough time for people working in those settings at so many levels. The patients, some of them, are extremely ill,” said Dr. John Krystal, chief of psychiatry at Yale New Haven Hospital. Many are on ventilators and some never come off the breathing machines. “Dealing with that day in and day out can be very draining. I think the health care workers have this unique kind of stress, the stress of taking care of patients in this uncertain time.”
Because of the demands of the job, a buddy system was created “where people would look out for each other,” Krystal said. A peer support system was created within units of the hospital and an internal website offers educational materials and resources that are offered to the medical community.
Also, mental health professionals conduct rounds in the medical units to check on staff and a leadership-support
program for those who suddenly were overseeing COVID care teams.
“The hospital had to rapidly convert units” to ICUs, Krystal said. “The medical school and the hospital work together to provide leadership support to those new teams.”
On a wider, community level, “stress and resilience town halls” have been held to share coping techniques and there is a daily online meeting for whoever wants to drop in, Krystal said.
“One of the challenges that we see is that some of the people who need the support are either not inclined to get that support or they may not even have a sense of themselves as someone in need of support,” he said.
A stress self-assessment questionnaire has been distributed to the clinical staff. “The reality is that many people are so busy and so preoccupied with their work that they haven’t paid attention to their stress level,” Krystal said. “We’ve made it very easy to go right from completing the questionnaire to signing up for one of the support programs.”
There is no underestimating the need for health care workers to seek help.
“Many of us are aware about a sad story of a doctor in New York who was reported to be a remarkable doctor but ended up taking her life,” Krystal said. The doctor, who was 49, had recovered from COVID-19 herself.
Krystal said medical workers need a “culture change” among people who see asking for help as a sign of weakness. “It doesn’t work so well as a long-term coping strategy,” he said.
“When people really pull together and support each other and get the help that they need … there can be positive consequences of working together through this crisis,” Krystal said. “It’s very meaningful to care for people who have the most serious kinds of illness. So if we do this right as a health care community … we’ll come out of this better and stronger and more
resilient and we’ll have learned a lot.”
Similar steps were undertaken at Silver Hill Hospital in New Canaan , using the same buddy system as in Yale New Haven’s hospitals, said Dr. Andrew Gerber, president and medical director. “With the help of a local donor, we launched something called a COVID resilience campaign,” he said. “We started building up pretty quickly a service that would be available for people in the ICUs,” as well as for New Canaan police and firefighters and staff at the Waveny LifeCare Network nursing home.
“We offered them the practical support that they could use,” Gerber said. “In the moment you want to help, you want to get to work.” He said a nurse goes to the workplaces, “shoulder to shoulder with them and listening more than anything to how they’re doing.”
The nurse offers “concrete information about making sure that they’re checking in with social contacts,” Gerber said. “If things started to slip in the wrong direction, they could reach out.”
Fairfield County was the first and hardest hit by the coronavirus, with more than 15,000 cases and 1,246 deaths as of Friday. Fortunately, there have only been two cases of COVID at Silver Hill, which has 400 staff members and 100 inpatient and residential beds, plus 100 outpatients, all of whom were treated remotely from the beginning of the pandemic.
“I think every indicator points in the direction that we are facing a mental health crisis that is only slightly behind the COVID crisis,” Gerber said.
When the virus hit in March, “initially we saw a drop-off and that’s because people were understandably scared,” Gerber said. “Anybody who could put off mental health treatment was doing so. … We are now seeing a resurgence.”
The National Suicide Prevention Lifeline is 800-273-8255.