This article was originally published on HuffPost US.
Nothing particularly out of the ordinary happened on the day I completely broke. Well, aside from going into month seven of a terrifying global pandemic.
It was October. As a wellbeing editor, I had been covering Covid-19 and following every single update daily. When I wasn’t brainstorming stories about transmission and how to protect ourselves, I was meticulously tracking vaccine developments and death rates.
Outside of work, I was also thinking of these facts and how they applied to every facet of my life. I became my loved ones’ trusted source on the coronavirus, meaning questions about it dominated most of our conversations. I was having nightmares about being in public without a mask and waking up with headaches that made it difficult to see straight.
I kept telling myself I was lucky and that my fears were overblown, even though my body was telling me differently. No one I knew had died. I wasn’t working in an ER like some of my close friends. What right did I have to break down?
“What you’re dealing with is trauma,” my therapist said kindly during our session that day, noting that I had been traumatised to some degree for more than 200 days straight ― and it was likely going to continue. She was right; I’m still working through it as I write this, and probably will be for months to come.
So many of us have been grappling with changes to our mental health over the last year. People who have lived with mental health conditions their whole lives are finding that they’re changing in ways they weren’t expecting. Others who didn’t feel their emotional well-being was at risk are finding themselves seeking therapy, perhaps for the first time.
Mental health professionals are scrambling to keep up with the demand for their expertise. The mental toll of this health crisis cannot be underestimated. It also manifests in different ways. While I may be dealing with trauma, someone else is navigating other hard issues ― perhaps even more than one.
Here are some of the most common mental health problems therapists are seeing because of the pandemic:
Depression has always been a common mental health issue, but “what is different is the intensity and the number of people who present these symptoms,” said Alfiee Breland-Noble, a psychologist based in Washington DC and founder of the mental health nonprofit, the AAKOMA Project.
“It’s exacerbated by the isolation, the loneliness, the lack of activities that normally keep people functioning well,” she said. “Once the isolation hit us – after probably the first three or four months when we began to realise this wasn’t going away anytime soon – that’s when the floodgates really started to open.”
We all experience anxiety to some degree in normal life, but the pandemic has exacerbated it beyond many people’s control. Some may be hyperaware of their own body, tracking every symptom wondering if it’s Covid-19. Many may be worrying over their financial situations. Others might be struggling with all of the uncertainty the pandemic has introduced. The circumstances of the last year have thrust us into a heightened state of chronic stress, said Jessica Gold, an assistant professor of psychiatry at Washington University in St Louis.
“In something like a pandemic, where we are basically in a constant state of uncertainty, we are always surveying our environment for threats and also always running from them,” she said. “There is only so long you can run a marathon without your body giving way, and especially with a constantly-shifting finish line, like we have during the pandemic.”
“There is only so long you can run a marathon without your body giving way, and especially with a constantly-shifting finish line, like we have during the pandemic.”
Millions have died from Covid-19, leaving millions more in mourning. That alone is devastating. We’re also grieving the loss of certainty and structure, said Sheva Rajaee, a psychotherapist and director of the Center for Anxiety and OCD.
“While the pandemic itself might end, it’s important to consider the economic, social and cultural fallout of what this past year has meant for our mental health and what it will mean moving forward. Job loss affects our mental health in significant ways, as does political and cultural instability,” Rajaee said.
“Dealing with grief and loss, whether that be the loss of a loved one to Covid-19 or the loss of our expectations for what our lives might have been if the pandemic had not occurred, will need to be addressed and processed.”
Trauma comes in many shapes ― you don’t have to physically witness a horrific event to feel the mental health effects from it. Watching cases rise, losing your job, being exposed to the virus and so much more all can contribute to trauma.
“We don’t talk enough about how this pandemic has been basically one big traumatic event, with a lot of little traumas within it. ... There are a lot of people suffering because of that right now,” Gold said.And, of course, those who work the front lines or have personal experience with Covid-19 are dealing with trauma in a big way.
“I see health care workers and they struggle from what they have had to see in their jobs day to day ― that much death, that much suffering and not being able to help,” Gold said. “Others I see are struggling from watching their loved ones die of Covid-19 over an iPad because they were unable to visit them.”
Panic and agoraphobia
We’ve been told daily how dangerous it is to be around other people and strongly urged to isolate ourselves from others. In some instances, that has contributed to a real aversion to being in crowded places. Rajaee said she’s been seeing more cases of agoraphobia ― which is the fear and avoidance of public and crowded locations ― in her clinic because of the pandemic.
“Mundane occurrences like going to the grocery store or seeing a friend in the park have become life or death questions, moral battlegrounds where we must make choices that seem to carry very real consequences,” she said. “We’ve spent the last year teaching our brains that the world and other people are not safe.”
“We’ve spent the last year teaching our brains that the world and other people are not safe.”
“Things like substance use have increased because people often turn to quick, pleasurable coping skills to deal with the range of emotions and with working from home, access to the kitchen is easy,” Gold said.
A recent report from the American Psychological Association found that people increased their substance use over the last year as a way to cope with the stress of the pandemic. Overdoses have also increased.
The same pleasure derived from substance use can also contribute to binge-eating behaviours, Gold said. “On the flip side, restricting food intake has also increased because when then the world feels out of control, sometimes people turn to coping mechanisms to regain control, and that is the one thing you can control: food and what you put into your body.”
Compounded mental health issues
Unfortunately, in many cases, people are dealing with varying degrees of multiple mental health problems. After all, we’ve all been exposed to loss, anxiety, uncertainty, isolation and more.
“The pandemic causes a lot of mental health problems because it is a sea of compounding stressors,” Gold said. “Often we say one stressor doesn’t usually trigger someone to ‘be depressed’ but it could be the thing that ― together with the rest of your family history, past history and physical symptoms ― pushes you over the mental health edge into depression or anxiety at the time. This pandemic is like a boiler cooker for that.”
What to keep in mind if your mental health is suffering because of the pandemic:
“I would say to anyone struggling right now that I want you to know that ― even if we cannot physically be together ― I see you, I hear you and I value you,” Breland-Noble said. “I feel like people need to hear that message, they need to know they are not alone.”
She recommended finding one safe person in your life to confide in. That could be a therapist, but it doesn’t necessarily have to be. Just someone to lean on who you trust, whether it’s a friend, family member, co-worker or someone from an online support group.
And speaking of the internet, “make sure that what you’re reading and consuming and watching is good for your mental health,” Breland-Noble said.
“Curate your news. Of course you want to be informed, but there’s a way to do it while taking care of yourself. That may mean you gotta understand when you need to watch a story unfolding live or when you need to read it later.”
Finally, know that what you’re experiencing is a normal reaction to a completely abnormal situation. And while there’s no one-size-fits all treatment plan, there are professional resources and experts available to help you find what works best for you. If your mental health struggles are drastically affecting your daily life, please seek help. It’s so, so worth it.
I know the trauma I’ve endured isn’t going to magically evaporate the second we go back to normal (if we ever do). One day we’ll shed our face masks, but what we endured will linger. However, with the right help and coping strategies, it won’t always feel so heavy.
Useful websites and helplines
Mind, open Monday to Friday, 9am-6pm on 0300 123 3393.
Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill).