COVID-19 and Mental Health

As the cold air arrives and the long Chicago winter stretches out in front of us like an endless horizon, the idea of sheltering in place and staying at home may be as dismal as the gray winter sky. Although at the time of writing we currently are in December and have the immediate distraction of the holidays, in a few weeks we will be faced with the post-holiday blues and the monotony of the indoor life that winter and COVID-19 will bring.

COVID-19 brought us an epidemiological and psychological crisis. This is the largest mental health impact in modern history. The increased isolation, changes to routine, changes to our jobs and the daily confrontation with our own mortality is an overwhelming stress that impacts all of us. Frustration and boredom related to the isolation of quarantine, inadequate supplies and access to health care for some, and insufficient or contradictory information about the virus from public health officials all add to our stress levels. Suicide hotline calls have increased, individuals with substance abuse problems are relapsing more and declining mood and increasing anxiety are a reality. If your mental health was in relatively good shape prior to COVID-19, you now likely are doing less well. If you were already doing less well and had some pre-existing depression and anxiety prior to COVID-19, you now are likely struggling. And if you were already struggling prior to COVID-19, you are now likely in crisis. Basically, we all have experienced some level of mental health decline this year. 

Rates of depression and anxiety in Americans have significantly increased. Parents who now have to juggle working from home while tending to the academic needs of their children have a two-fold onus and thus double the stress. There is little reprieve when you work, attend school, have dinner and socialize with the household all within a few rooms of the house. There is no stress relief of going to concerts, eating out at restaurants, attending sport games or going on vacation.

Quarantine stress impacts us all but in different ways. Children respond to anxiety differently than do adults. Young children may not have the vocabulary to express their frustration, boredom, or the feelings of loss of not seeing their friends, playing at recess on the playground and engaging in social activities. Children will likely show you how they are feeling rather than tell you. This means that you may see more acting out behaviors in your young ones. Agitation, clingy behavior, anxiety and complaints of stomach aches and headaches can be common. It is important that as parents we limit their exposure to the news and translate the information in a way that they understand. Reassure your children that they can be safe, teach them everyday actions to reduce the spread of germs and keep up with their regular routines. Children respond to structure because structure is predictable and with predictability comes the feeling of safety. That will translate in a calmer behavior.

Adolescence, even in the best of times, is a developmental period that comes with angst, growing pains and when peer group development is very psychologically significant. This is when children start pulling away from their parents psychologically in order to become independently functioning adults. Hormones, focus on peers and social events such as graduations, proms and sport events become crucial. Teenagers have faced the loss of many of these activities. Creatively, a lot of these activities have taken on a new form such as drive-by birthday celebrations, but the feel is not the same. Encourage your teens to stay socially connected to their peers via phone, video chats and even video games which can utilize the chat function for cooperative play. 

The emerging adult group, ages 18-24, have also faced the loss of in-person milestones such as visiting college campuses, going on their first job interview and securing an internship or work-study program. These are now virtual. It is common for teens and emerging adults to feel “robbed” of these events that they grew up hoping to have one day.

With all this being said, one key thing to remember is: “It’s OK to not be OK.” Yes, we all have been affected. We are all having a normal reaction to a historically not-normal era. However, there are attainable things we can do to lighten our moods and keep the positivity going.

One way to take care of your well-being is to let go of things you cannot control. You cannot control when other people refuse to wear masks or wear them half way slung down their faces dangling from their ear like a wispy feather boa. You cannot control when others do not social distance and contaminate your personal space bubble. You cannot predict what will happen in 2021 as it pertains to the coronavirus. You cannot predict toilet paper shortages. You cannot control how long this will last. But... You can control your media exposure and decide what levels of information you can tolerate. You can control your own mask-wearing, social distancing and hand washing behaviors. Remember there are perks to face mask wearing. You don’t’ have to smile if you don’t want to. You can even sneak in a bit of a grimace and no one will be the wiser. You can control keeping a positive attitude. You can find fun things to do at home. 

Which brings me to home survival strategies. In regards to every day functioning, have some sort of routine. If you roll out of bed and shuffle with your bunny slippers to the next room with a pillow crease on your face, believe me, you will not be as productive at work as you can be. You have to transfer into work mode. That means, yes, take that shower before you log onto your computer and not during brunch or when the sun is setting and the geese are returning to their ponds. Comb your hair and put on makeup if it will make you feel more alert, even if only your dog Fido sees you and appreciates your effort. Designate only one work area for yourself. If you scatter your papers around the house like a windstorm, everywhere you look you will see reminders of work and you may have a hard time unwinding in the evening. 

Find productive and fun ways to use your time at home. You can use the shelter in place time to exercise your brain. Take an academic course like something from Khan Academy or Skillshare. Do some brain training apps like Cognifit, Lumosity or Elevate. Listen to a TED Talk. Check out Goodreads for book recommendations and book reviews with other readers. Do a self-help workbook. There are a ton of resources out there for anxiety and depression. Write in a journal, keep a gratitude journal, or color in an adult coloring book. Do some meditation through Headspace. Start that yoga routine you have always wanted. I personally recommend the You Tube channel Yoga with Adriene. She has yoga routines designed for specific body issues, such as lower back pain, and also for emotional issues such as anxiety. And she does not make me feel awkward and clumsy just because I can’t touch my toes without wincing. Keep an optimism calendar where you do one positive thing a day even when you are having one of those days when the only positive thing that happened that day seems to be “I didn’t burn dinner.”

There are also semi-mindless tasks you can do. These are my personal favorites. Mindless tasks will burn off some of the anxious energy and will keep your brain engaged. Cleaning and decluttering is a great one. Learn how to fold your clothes Marie Kondo-like. Please see Netflix for the reference. Do some jigsaw puzzles or work on that scrapbook that you started in 1999. Organize your photos. Who cares that your kid just graduated college and you are on page two of his baby photo album. Pets are another source of comfort and stress relief even though they may steal all your hand towels and use them as chew toys. I’m just saying. (I’m looking at you, Mango). Learn to cook a great soup, how to play the guitar or how to knit. 

Remember those things that are not cancelled are family movie nights, playing board games, baking cookies, and calling a friend. Remember that it’s OK to not be OK and that even though these times will be in history books we have the choice to remember this as a completely negative event or a time where we revived family walks, we learned how to cook something new, and we realized we were much more resilient than we thought because we chose to see the slivers of opportunity that came with this unique time period and we remembered that those gray winter days always lead to sunnier seasons.

Dr. Alexandra Tsang is the director of the Kane County Diagnostic Center.