The Silent Pandemic: Mental Health During The COVID-19 Pandemic
COVID-19 has made us all comfortable with the terms “Quarantine,” “Social Distancing,” and “Physical Distancing.” Or has it? The COVID-19 pandemic in the United States has been raging for nearly a year. These practices were intended to stop the spread of COVID-19. Businesses that could, shifted to working from home and nonessential businesses were forced to close their doors, some for good. The closure of nonessential businesses such as gyms, bars, movie theaters, etc as well the cancellation of events such as concerts and various sporting events left people stuck in their homes. The social isolation of the “Stay at Home” campaign has led to another pandemic. The silent pandemic. The silent pandemic references the increasing mental health struggles that have resulted from the loss of income, disrupted routines, loneliness, and an uncertain future.
Humans are inherently social. In fact, being social is actually good for our health. Direct person-to-person contact triggers parts of our nervous system that release a wave of neurotransmitters that help to regulate our response to stress and anxiety. Social interaction can also trigger the production of dopamine within our bodies. Dopamine causes a person to want, desire, seek out and search. It increases your general level of arousal and your goal-directed behavior. In short, communicating with people face-to-face helps us to be more resilient to stress factors. A study from 2019 provided by Medical News Today showed that those undergoing chemotherapy for cancer tend to do better if they have access to social interaction and support. The study suggests that just being around family, friends, and others with similar experiences can strengthen us mentally and physically. It is no surprise that due to increased social isolation, the number of Americans reporting mental health struggles has gone up. 50% of Americans are reporting anxiety and depression when they had no prior symptoms. 47% of patients are reporting negative mental health effects from sheltering in place and 30% of Americans are reporting a phobia of big crowds and going back to work. The prevalence of anxiety symptoms is three times higher than in the second quarter of 2019, and the prevalence of depression is four times higher. Elevated levels of suicidal ideation have also been reported.
The isolation from the pandemic has led to an increased sense of emptiness that often comes with depression. The increase in time spent at home has left people with an overwhelming amount of free time where they are alone with their thoughts. Feelings of helplessness can start to creep in as people become overwhelmed with loneliness and lose hope that things will improve in the near future. People already diagnosed with a mental health disorder are now having a harder time blocking out intrusive thoughts while others are now experiencing intrusive thoughts for the first time. The uncomfortability of being taken out of a normal routine has only increased the prevalence of these distressing thoughts which has led to an increase in the severity of depression symptoms.
A 2020 study provided by Brainsway on the specific social distancing effects of COVID-19 showed this increase in anxiety and depression symptoms. The qualitative study revealed several major themes. People are experiencing a loss of motivation, meaning and self-worth due to increased anxiety over the loss of their normal routine and financial stability. There is an increased distrust of the government over ever-changing guidelines and regulations and social anxiety has increased as people are wary of venturing out in public due to others not following guidelines. The mental effects of the pandemic are also taking a toll on people physically. A KFF Health Tracking Poll from July 2020 found that many adults are reporting negative impacts on their overall well-being. 36% of those polled said they were having difficulty sleeping due to an increase in mental stress. 32% said they were having trouble eating and 12% said their chronic conditions are worsening.
People have had to substitute their normal routines as well, not only in a personal setting but also in a professional setting. The use of ZOOM and other virtual meetings have had to be implemented to suffice for the lack of person-to-person interaction. ZOOM fatigue has become yet another nuisance as much as it has become an issue for many employees. According to USA Today, “platforms naturally put us in a position that is unnatural. A combination of having prolonged eye contact and having someone's enlarged face extremely close to you force certain subconscious responses in humans.” This not only impacts middle-aged individuals in the work setting but also children whilst being virtually home-schooled.
As a whole, it’s fair to say that people are experiencing hardship throughout the COVID-19 pandemic. Children, on one hand, are experiencing this hardship differently than their grandparents and vice versa. Each age group has been impacted differently from the next. According to the NIH, children are experiencing behavioral changes ranging from excessive crying, increased sadness & depression, difficulties with concentrating, avoidance of activities they previously enjoyed, headaches/chronic pain, and changes in eating habits. Young adults (18-30) have been impacted just as hard, if not harder than other age groups due to inconsistency in school guidelines, lack of job opportunities, and general unrest. Recent research has shown that young adults are experiencing higher levels of anxiety, distress, and depression than other adult groups. Furthermore, 80% of respondents agreed that the coronavirus pandemic has made their mental health worse according to a study in the UK. Suicidal thoughts increased by 15% from 2018 to August 2020 in young adults and even higher around the country in certain states. Three in four young adults are struggling with at least one mental health problem from the beginning of quarantining to late November in 2020.
Even more worrying, parents of young adults and children are splitting telework & parenthood at the same time. This added stress and responsibility is troubling, as now not only are their young & older children suffering from poor mental health but now parents are suffering from excessive stress that could lead to declining mental health. The elderly are experiencing similar behaviors due to stress & anxiety of being more prone to the outbreak. These behaviors include irritating & shouting behaviors, changes in sleeping & eating habits, and emotional outbursts. Children, young adults, parents, and elderly people are all experiencing variants of depression, anxiety, and isolation which lead to a general feeling of helplessness and could lead to one’s own coping mechanisms.
Substance abuse also played a large part in not only America’s but the world’s mental health decline during quarantining. Throughout the first two months of the pandemic, the Addiction Policy Forum conducted a survey of over one thousand people with substance use disorders in order to find how they were impacted. Twenty percent of the participants reported either they or their family members’ substance use increased during the pandemic. Furthermore, a sample of 500,000 urine drug tests conducted by Millennium Health showed massive increases in cocaine usage (10%), heroin (13%), methamphetamine (20%), and fentanyl (32%) by early May. Locally, 39 people died from overdoses in Delaware in May 2020. This ties the previous monthly high set in August 2018. Through May 31, 2020, overdose deaths in Delaware are up 60% in comparison to 2019 and up 48% in comparison to 2018.
Variables contributing to these increases in substance use vary by age and socioeconomic position. Home isolation, job loss, loss of support & resources, and fear of catching COVID-19 are all at play when trying to cope with substances. The pressure of catching and potentially infecting your peers and family is high without having access to the proper tools and knowledge. This lack of help added pressure and fear of what to come has many implications for the future; unfortunately, most are in the long term.
The effects of quarantining, distancing, and general fear of the new pandemic may be permanent or at the very least, long-lasting. An overview of 2020’s quarantine has found an increase in PTSD symptoms as well as higher rates of anger & confusion due to the uncertainty of the future and guidelines surrounding the pandemic. Social isolation has been found to increase blood pressure, a decline in motor skills, and impaired cognition. Furthermore, loneliness correlates with poor memory, dementia, and high odds of developing new mental health problems. Physical health can take a toll as well, with smoking as a new/renewed habit or the increase of smoking being the leading factor in damaging the body. Social isolation can also mutate your genetics, all the way down to the molecular structure.
The year 2020 brought on hardship in the form of COVID-19 and its new normal. Quarantine, Social Distancing, and Stay at Home orders turned general social norms on their respective heads and in doing so changed how our future will look in the short-term. Unfortunately, the Stay at Home orders developed more mental health diagnoses as people struggled to deal with isolation and financial instability. Some people turned to substance abuse while others disregarded their physical and mental health in their entirety. In doing so they created bad habits that could last longer than the pandemic itself. Moving forward, we must work to break the stigma that goes with mental health. If you or anyone you know are struggling mentally, please call Jaclyn Tomasetti of United Medical Clinic at (302) 797-1655 or visit our behavioral health program’s website at Behavioral Health - UMACO Patient Wellness Programs (umusa.net).
Citations:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361582/#hpm3008-bib-0008
https://www.dhss.delaware.gov/dhss/pressreleases/2020/overdose_061620.html
https://www.frontiersin.org/articles/10.3389/fgene.2020.589621/full
https://www.frontiersin.org/articles/10.3389/fpsyg.2020.567484/full
https://www.washingtonpost.com/health/2020/11/23/covid-pandemic-rise-suicides/
https://www.psychologytoday.com/us/basics/dopamine
https://www.medicalnewstoday.com/articles/321019#Face-to-face-contact-is-like-a-vaccine