Our country declared all-out war on COVID 19 earlier this year, with extreme measures aimed at containing the spread of the virus, and managing its effects on our nationwide healthcare system. But what about “flattening the curve” of the psychological consequences of COVID? Somehow, the anti-COVID discussion hasn’t included “mental health,” a critical aspect in any discussion of healthcare.
Life Change Psychotherapy co-founder, Tricia McKenna, Ph.D., has some insight into how the pandemic has—and will—affect emotional health for months to come, and how we can address the needs.
Mental health hasn’t been factored into any mandates, orders or strategies for managing the virus lockdown. Why the blank spot? Stigma?
“When things have to do with the body, like physical disease or the virus, people completely forget that the mind is part of the body. And the heart Is the seat of the emotions. There’s been a huge mind-body split here.
“The government probably thinks if they are addressing the physical aspects of fighting the virus, the mental-emotional aspect is secondary.
“Sometimes people will tell me they are experiencing a physical problem, but they think they don’t have anything going on with their mind. I remind them the mind and body are connected. And they are always surprised.
“When your brain and your heart are sick, it’s going to manifest itself in the body.
What have been the biggest mental health concerns during the lockdown?
“Uncertainty causes anxiety. Loneliness can cause depression. I also think it has made difficult relationships more difficult…and this isn’t necessarily a negative thought, but I think it’s caused people to pause and do some serious reflection about where they’re headed and how they want to change.
“I’ve talked with clients who are now considering divorce, retirement, career change. It’s been an about face for a lot of people.”
What about people who already struggle with emotional issues?
“Anybody who has had any previous mental health problems is going to have an intensified reaction during this quarantine. People with PTSD are going to suffer more during this time, and those who are grieving alone are going to be in even more distress. Paranoia—which is usually just extreme anxiety—can also ramp up in some people because of the uncertainty.
“For people with OCD, this is a horrible experience! And anyone who is a germophobe can barely get in the door with the groceries—or barely get out the door to get them.”
What signs or symptoms are likely to show up in people who are suffering from COVID stress or lockdown-induced depression?
“Sleep problems, appetite changes, lethargy, increased irritability, drug and alcohol abuse. Nightmares possibly. Being argumentative…Just feeling kind of bleak about the future, difficulty making decisions, concentration problems.”
How might our emotional conditions change as communities begin opening up and people go back to work?
“Relationship stress is going to start to max out. Different members of a couple might have different plans on how to re-enter and different anxieties about what feels safe. That is also going to spill over into conversations around the dinner table, as to how kids or teens might be allowed to re-enter or how much to relax with neighbors.
“You have to be okay with wherever anybody is—and not try to convince them to change their plan. It’s not going to be helpful. People are going to have to dip their toe into this at their own pace and not be pressured into changes one way or another.
“I think it’s going to be hard for people to not be judgmental towards others as to what their choices are.”
How has the grief/loss process been affected by the lockdown? Will it be harder for people to work through losing someone?
“I think their grief gets frozen. It’s so important in the grief process to have these rituals that we have grown accustomed to in our society, such as funerals, gatherings, memorials. To have that taken away means that people are going to need to come up with their own rituals that may be very different than the customary ones.”
Any specific suggestions?
“You might all sit down and share a favorite meal of the person who died. You could have a family memorial service in your own home. With your ‘pod.’ You could write a letter to the deceased, and share that. Create a little altar.
“People need to “recognize that it might take longer to recover from their grief. There’ll be lots of extra tears!”
Establishing routines, staying busy, got us through the main lockdown and addressed basic COVID-caused mental stress, but don’t those suggestions seem tame for those whose level of distress has escalated?
“I’m not sure that they are so banal. I think it still is about getting back to the basics of what people can do moment by moment to make themselves feel better. Putting routine into your day can get to be an art form.
“I would be telling people who are that distressed the same thing whether they are in a quarantine or not. Therapy is also a good answer here.
“Now if someone is suicidal, they need something else. I would tell them to call a hotline. I want people to know there’s help and they ought to NOT resist getting help.”
Is helping patients deal with COVID mental/emotional stress more challenging?
“Yes, it’s testing my toolbox. I’m really really trying to focus on meeting people where they are. I am trying to not get too far ahead of them and not let them get too far ahead of themselves. When you get too far ahead, conjecture breeds anxiety.
“When I see people begin to get anxious, I pull them back to looking at the ‘now.’ What do you need to do today?”
What resources should the healthcare community or government try to make available?
“Form groups for medical health professionals. After all, they are the heroes here. We also need to destigmatize the need to reach out for help. You don’t need to be extreme on the mental health continuum to talk about it and get support from family and friends, regardless of how maximal or minimal you think it is.
“Doctors and psychologists ought to be working even more closely. Doctors need to be cognizant of people coming in with emotional problems that are overdue attention or that their emotional problems have turned into physical ones. They will have to keep an eagle eye out here for emotional components that need attention.”