Suicide

We Must Flatten the Curve—But This Time It's Our Mental Health

Stress, anxiety, and suicide are on the rise.

Posted Sep 08, 2020

We need to talk. As a nation, a community, parents, partners, and humans, we're in rough shape. The pandemic has disrupted our lives, and after five months, it is taking a massive toll on our mental health. As we prepare to mark this year's World Suicide Prevention Day, let's take time out to consider how to flatten this new and equally devastating curve.

The Pandemic's Impact On Our Mental Health

A recent Kaiser Family Foundation study found that nearly half of American adults believe the pandemic has negatively impacted their mental health. A June 2020 study by Morneau Shepell found that Covid-19 is also creating a potential "risk to the longer-term well-being of employees, which may impact business productivity, health costs, and disability absence." Worse yet, several other recent studies indicate that some demographics are suffering more than others.  

Current CDC data indicates that 18- to 29-year-olds are far more likely to currently exhibit symptoms of anxiety than any other group of adults. More than 40% of 18- to 29-year-olds say they are suffering from anxiety. By contrast, only 11 to 16% of people over 80 report anxiety. But younger adults are not the only people at greater risk. Racial and ethnic minorities, essential workers, and unpaid adult caregivers are also at greater risk.

It is too soon to know how many deaths during the pandemic will result from suicide, not COVID-19. Still, there are indications that suicide is on the rise. The CDC's June 2020 survey found that 11% of American adults had seriously considered suicide in the previous 30-day period. Again, some groups are at higher risk. In June, 30.7% of unpaid caregivers for adults, 25.5% of 18- to 24-year-olds, 21.7% of essential workers, 18.6% of Hispanic, and 15.1% of Black respondents reported having seriously considered suicide in the 30 days before the survey.

These statistics resonate with what I am hearing anecdotally in my practice. Since March, I have heard of three suicides in my circle and several other suicide attempts. Even as I write this post, a close friend is caring for her daughter after her third suicide attempt.

We have spent months talking about how to flatten the COVID-19 curve. Now it is the time to start talking about how to flatten the sharp spike in mental health challenges.

Why Suicide Is on the Rise During the Pandemic 

If mental health concerns and suicide are currently on the rise, it is no surprise. The pandemic has increased uncertainty, complexity, and adversity. Combined, these factors are increasing the risk of anxiety, stress, and depression, and in some cases, the risk of suicide. 

  • Uncertainty: Many things we once took for granted have disappeared, including the ability to plan for the future proactively. Uncertainty, especially economic uncertainty, has been known to increase the risk of suicide.
  • Complexity: The pandemic has increased the layers of complexity we face daily if not hourly. Whether you're the CEO of a global company, a small restaurant owner, or a parent dealing with homeschooling, your work just got more complex. Under most conditions, complexity is good. It challenges us to be productive and feeds our desire to keep growing. When we face too much complexity, however, it can drain our energy, increase our anxiety and stress levels, and put us at risk of suicide. 
  • Adversity: The pandemic hasn't just increased uncertainty and complexity. It has also increased adversity. Once again, we know that the pandemic has increased adversity for some demographics more than others. Most notably, the pandemic has disproportionately impacted visible minority communities. Adversity doesn't cause suicide, but it can put people at increased risk. This largely reflects the fact that adversity is often associated with loss, and loss (e.g., of a loved one or one's financial security) is associated with an increased risk of suicide.

Steps We Can Take to Flatten the Rising Mental Health Curve

There is an urgent need to flatten the curve of mental health challenges. Fortunately, we can do many things to engage in this critical work at home, in our communities, and at work.

  • Assess danger: If there is an acute risk of suicide, seek professional support immediately here.  
  • Increase self-awareness: Take time out to build self-awareness. Notice, adapt, adjust, and regulate. Also, help other people in your life do this work. Acknowledge that it is hard to practice self-care, especially at this time. 
  • Choose productive distractions: When things get hard, many people disappear. Some people even resort to old addictions such as drinking. One consumer study found that in the week ending May 9, brick-and-mortar alcohol sales were up 41%, and online sales were up a staggering 339%. Others take a less destructive but still mind-numbing route (e.g., binge-watching). If you're disappearing (dealing with the pandemic through avoidance) or you know someone engaging in this behavior, be proactive. Rather than tune out, ramp up a passion or pursuit. Moving the dial on a goal (e.g., running your first marathon or learning a new language) will not only take your mind off the time's uncertainty but also enrich you.
  • Invest in relationships: Keep tabs on the people you love. Make an effort to reach out and engage—schedule phone dates and walking phone dates. Send love notes and ping friends. In an era of Zoom, it can be challenging to maintain authentic relationships. Taking time out to invest in relationships that matter is essential. 
  • Express empathy: Reaching out and engaging with others means getting out of ourselves and our own heads. When we do this, however, there are also benefits. Often, when we care for others, we experience a surge in oxytocin. This powerful hormone serves a neurotransmitter that has far-reaching effects that include increasing trust. 
  • Embrace candor: Too often, we settle for niceties. But vapid conversations generally just increase our sense of isolation. Rather than ask, "how are you?", ask "What has become clear to you during the pandemic?" or "What have you learned from this time?" 
  • COVID lemonade: A dear friend, Elizabeth Crowell, introduced me to "COVID Lemonade." She coined this term to describe experiences that wouldn't have happened without COVID-19's arrival. A simple example is spending more time with family, but this isn't the only example of "COVID Lemonade." I recently talked to a dentist who couldn't stop raving about the health of her patients' teeth—she suspects that quarantine has forced healthier eating habits. I have also talked to CEOs who are seeing significant surges in productivity. Colleagues who work in publishing have reported a notable rise in the number of book manuscripts and proposals they are receiving.  

Adversity doesn't build character; it reveals character. These are challenging times (and they may get worse). Tackle the pandemic head-on with eyes wide open. This is a time to invest in yourself, increase your self-awareness, and take stock of who has your back.

References

Vandoros S, Avendano M, Kawachi I. The association between economic uncertainty and suicide in the short-run. Soc Sci Med. 2019;220:403-410. doi:10.1016/j.socscimed.2018.11.035