Over the last several months as the COVID-19 virus has spread, many people have experienced fear, stress and worry.

There have been significant changes to people’s lives, including isolation and the lack of physical contact, unemployment, and the fear of getting the disease. Parents and caregivers are also dealing with issues of their own, including being cooped up with children and home-schooling. Additionally, people with substance abuse issues are often relapsing.

According to a Kaiser Family Foundation poll, almost half of Americans say the pandemic is harming their mental health. Additionally, a federal emergency hotline for people in emotional distress registered a more than 1,000% increase in April compared with the same time last year.

“The whole COVID situation is a collective trauma that we’re all in right now,” Indiana University therapist Lindsay Potts wrote in an article for IU Health.

Isolation’s impact

Perhaps the biggest challenge people have had to adapt to throughout the COVID-19 pandemic is isolation.

Dr. Clair McCarthy of Boston Children’s Hospital and an assistant professor of pediatrics at Harvard Medical School said the total change in many people’s daily lives has wreaked havoc on mental health.

“Every trip out of the house became treacherous,” she said. “For those who can’t work from home, work either became dangerous or it disappeared, taking income with it. Supplies became precarious. Interactions with anyone outside our home became almost entirely virtual or nonexistent.

“There is no way that we can live this without anxiety and sadness — and no way that our children can live it without anxiety and sadness. We all need to do our best, sure, but it’s important that we acknowledge that we are feeling strange and bad, that our kids are too, and this can’t help but affect how we all behave. We have to take care of ourselves in a different way, being proactive about our mental health.”

The manager of Howard Regional Behavioral Health Services in Kokomo, Matthew Matteson, said the process of isolation changed how mental health had to be provided, with virtual settings taking the place of face-to-face and group therapy.

Matteson said his organization has seen an increase in addiction relapses, suicidal thoughts and depression related to isolation.

Addictions

According to market research firm Nielson, online alcohol sales are up by 243% since the start of the pandemic.

That number raises concerns among mental health professionals that addicts are particularly affected by isolation because it is a community that relies on connection and interacting with each other.

Kevin Sprinkle, of Restore Ministries in Kokomo, said extra money from unemployment and the stimulus checks coupled with idle time and lack of meetings helped to contribute to the rise of substance abuse during the pandemic.

“When you take away accountability and connection that comes with treatment programs and legal supervision, you’re going to see an increase in relapse, and all relapse really is, is a loss of connection,” Matteson said. “COVID-19 did very, very well at creating disconnection between everything.”

To help combat relapse and overdoses during the period of isolation, Sprinkle created virtual “sobriety lounges.” These online meetings are facilitated by Sprinkle and those in recovery who felt called to take on a leadership role. Sprinkle said it gives those in recovery the opportunity to share experiences, feelings, and to be together and get support.

“The first step of a 12-step program is getting out of denial … and so when you attend a meeting in any way shape or form, you are saying, ‘I need something,’” he said. “That’s a crucial part of a meeting because then you are admitting you are unable to do this on you own and your own ways haven’t been working.”

Graham Roe is one of the sobriety lounge leaders who took up the role while he was in recovery, and saw firsthand how it could be ruined by the current circumstances after the overdose death of a good friend.

“He came home to visit his family. I think he decided to go and do drugs one more time and he died. There’s a lot of different stories like that,” he said. “We’d been through active addiction together … and by God’s grace we were doing recovery together, and to lose him really opened my eyes to how serious this COVID thing was and how fragile recovery really is.”

Roe said it’s hard to have something so important like being part of a group and the connections taken away, when those connections are what keep recovery going strong.

“I can’t understate the effect that it’s had on addicts just because it’s just such the opposite of what needs to be done in recovery,” he said. “When you deal with addiction … the numbers aren’t the greatest. You don’t have a 100% success rate or anything, but to see the successes and just to see people want to get better and strive to get better — then they get better, turn around and want to help people get better.

“It’s life full-circle and to me that’s the most awesome part about the leadership role in recovery. [It’s] seeing the guys and girls that struggled, that you weren’t sure were going to make it — and then all the sudden they’ve turned it all around and they’re helping other people to get where they’re at.”

Effects on young

A drastic change in routine or daily life can be jarring in any situation, but when they were told schools would be closed, classes would move online and their social lives were put on hold, kids were placed in a situation unlike any they had ever experienced.

Howard Regional Behavioral Health Services Director of Operations Tiffany Seekri oversees programs for young people. She said one of the key focuses when addressing children’s mental health during the crisis has been making sure the parents are involved.

“When you’re dealing with children and adolescents, their brains aren’t as developed as adults’ are, so we tend to idealize childhood as carefree, but youth alone does not offer any type of shield against emotional hurt and trauma — especially not a pandemic,” she said. “For most of us as adults, we haven’t faced a pandemic before so we’re facing it for the first time.

“So, we had to work with parents to encourage them to not join in the chaos of what was going on in the world, but to share their calm.”

Seekri said some signs of mental health issues in children include excessive worry, irritation, crying in younger children, regression, unhealthy eating and sleeping patterns, poor school performance — especially when school shifted to online — and attention and concentration.

Parents and caregivers should be honest with their children about the pandemic, said Seekri. Sharing what is going on in the world in an age-appropriate manner, teaching kids to help themselves by helping others and maintaining as much of a daily routine as possible are all ways to promote mental well-being for kids during the pandemic.

“Be the example, be the role model. How you respond to this is most likely how your children will respond to this …,” she said, adding to not to be afraid to say, “I don’t know.”

The loss of school also came with the loss of proms, sporting events and caused many schools to delay or even cancel their graduation ceremonies. Those missed milestones were a huge loss to many high school seniors who believed this would be the best part of their high school experience.

“It’s hard to know that you might not get your right-of-passage moment,” said Emma Key, a senior at Western High School in Howard County. “Everyone remembers their high school graduation or their senior prom or their last time out on the field. Those sorts of memories are what we’re really missing to cherish.”

Seerki noted humans are social beings and need a sense of connection and connectivity. To help maintain that, it is important for kids to still interact with their peers and attend their groups in a safe, virtual manner.Unemployment

As businesses closed due to mandates and health concerns, unemployment spiked to a rate unseen in a decade. According to the Bureau of Labor Statistics, after holding roughly at 3% during January through March, the Indiana unemployment rate shot up in April to 17.5% and began to fall to 12.3% in May and 11.2% in June as some businesses began to open back up in stages.

The sudden loss of work, like other effects of the virus, has led to mental health crises.

The Mayo Clinic says some of the common feelings related to joblessness are a loss of identity or sense of purpose; feeling unappreciated or unessential; and a feeling of being lost and not knowing what to do next. Being angry, scared and jealous of those who can still work and worry over providing for yourself and family are also causing mental health to deteriorate.

“If you’ve lost your job permanently or temporarily, grief is one of the most significant emotions you may feel,” the Mayo Clinic’s website states. “You may already know the stages of grief: denial, anger, bargaining, withdrawal and acceptance. You may experience stages of grief in the same way you would the death of someone you love. Address feelings of grief as you would with any other loss.”

Realizing self-value is recommended during a time where job loss may diminish self-worth. If that happens, it’s recommended to examine positive qualities or even make lists on positives subjects. like your strengths.

Howard Regional Behavioral Health Services manager Matteson said many individuals he talked to found help in the roughly $600 extra available in unemployment available from the CARES Act and the stimulus money sent out as part of economic stress relief.

“If they didn’t have unemployment and they weren’t eligible for that, unemployment was a big stressor,” he said.

Maintaining mental health

Many organizations have offered suggestions and strategies on how to maintain mental health during the stressful COVID-19 pandemic.

Matteson recommends being present in your neighborhood and remembering to find local information and not just national news about the virus —especially for the elderly. He noted that group is more likely to stay home and often spend time watching more national news coverage, which can often lead to declines in mental health.

He views any activity that can keep someone in the present rather than dwell on the situation surrounding them as a great way to maintain mental health. That can be anything from putting together a 1,000-piece puzzle to building LEGOs or playing board and video games.

In her article for Harvard Health blog, McCarthy suggests making sure to put self-care as a top priority by keeping a realistic schedule, making sure everyone gets enough sleep, prioritizing exercise like a daily family walk, connecting with others via technology and trying to schedule some fun into the daily schedule such as playing a game or watching a movie.

IU Health Behavioral Health therapists Potts and Trisha Palencer said there are multiple signs that could signal the need to seek help, including an inability to sleep or take care of family or do daily tasks; marked differences in personality or behavior; emotional outbursts or violent behavior; any suicidal thoughts, increase in alcohol or drug use, and any long-term behavior that is distressing, such as being overly fatigued, overly tearful or having a sense of persistent dissatisfaction.

According to the Mayo Clinic, it is important to take care of various aspects of yourself to maintain mental health. Taking care of your body and mind through activities such as exercise, sleep, healthy eating choices, avoidance of addictive substances and limiting screen time while keeping your regular routine, and focusing on positives are all ways to stay emotionally healthy.

For kids dealing with virtual fatigue, it’s important to get outside and reconnect with nature by doing activities such as family walks and scavenger hunts.

Getting help

The need for mental health services will be growing over 18 months in response to COVID-19, according to Matteson. After referrals dipped at Howard Community, they have more recently started to go up as people are able to leave their homes again and need someone to talk to after the isolation and other aspects of the pandemic.

Matteson referred to the current state as “the bottom of the mountain.”

“What we predict and project … is that we’ll see more referrals than we ever have before because of the stressors that have occurred in individuals’ lives,” he said. “We’re probably just now seeing pre-COVID numbers of referrals coming in.”

The current need and eventual increased need for mental health services has led to the creation of new ways to offer help to those in need.

On July 20, the Be Well Crisis Helpline was announced and is available through Indiana 211, the Indiana Family and Social Services Administration said.

The helpline was established by FSSA’s Division of Mental Health and Addiction in direct response to the elevated levels of stress and anxiety Hoosiers are experiencing due to the COVID-19 pandemic, the agency said.

“Our intent is to provide easy and free access to counselors who can listen and help by simply calling 2-1-1,” FSSA Secretary Jennifer Sullivan said. “As Hoosiers continue to cope with the ‘new normal’ of life during a pandemic, with massive disruptions in their everyday lives, and with emotions ranging from bored to terrified, it was imperative to build a helpline that could literally be a lifeline for many.”

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