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American mental health was already dicey before COVID-19 walloped our hearts and minds, and medical and mental health experts warn that we should be prepared for more to come long after life settles into whatever the post-pandemic “normal” will be.
Before the pandemic, 1 in 5 Americans (47 million) already had a diagnosable mental illness, more than 11 million of them serious, according to the federal Substance Abuse and Mental Health Services Administration (SAMHSA).
In 2020, the Kaiser Family Foundation reported a huge jump in the percentage of U.S. adults—from 32 percent, when COVID-19 came to full public awareness in March, to 52 percent in August—who said that worry and stress over the coronavirus had negatively impacted their mental health. From 1 in 10 Americans reporting symptoms of anxiety or depressive disorder before the pandemic, the number climbed to 1 in 3.
One person whose anxiety spiked is Seth Rotberg, 30, co-founder of Our Odyssey, a group that provides year-round support for young adults impacted by a rare or chronic condition. Rotberg lives with Huntington’s Disease, a rare, inherited progressive disease that causes breakdown of nerve cells in the brain and affects physical and mental health.
HD is an anxiety-provoking condition, a challenge to stay present-focused—even without a raging viral pandemic. “The pandemic definitely impacted my mental health, especially my anxiety,” Rotberg told me. “Not being able to see friends and family as much as I typically do has been quite the challenge and has made me feel isolated at times.”
Past pandemics and other disasters left lingering mental health harm
Joshua C. Morganstein, assistant director of the Center for Study of Traumatic Stress in Maryland told the BBC in December, “Historically, the adverse mental health effects of disasters impact more people and last much longer than the health effects.” He added, “If history is any predictor, we should expect a significant ‘tail’ of mental health needs that continue long after the infectious outbreak resolves.”
Earlier disasters and pandemics have proven the point. After the SARS global outbreak in 2003, suicide rates increased 30 percent in people over age 65. Researchers found that two decades after the Chernobyl nuclear accident in Ukraine, first responders still had heightened rates of depression and post-traumatic stress disorder (PTSD). Five years after Hurricane Katrina devastated New Orleans, PTSD remained high in people who lost their home in the 2005 disaster.
“Events that are threatening, are uncontrollable, and have a lot of uncertainty, are really toxic to mental health,” said Karestan Koenan, epidemiologist and professor of psychiatric epidemiology at Harvard’s T.H. Chan School of Public Health. She emphasized that people with a history of mental illness are at risk of a relapse during this time, and those dealing with a chronic mental illness are at even more risk of feeling isolated as support systems may be unavailable during the pandemic.
Tips from people who know how to stay sane when everything feels crazy
The World Health Organization’s recommendations for safeguarding mental health, issued earlier in the pandemic, are still relevant as COVID-19 continues to ravage humanity even as vaccination programs slowly roll out across the globe. WHO emphasizes self-care and focusing on things within our control—and not driving ourselves batty by obsessing over what is beyond our control.
For Seth Rotberg, self-care has been important from the start. “At the beginning of the pandemic,” he said, “I realized the importance of self-care and making sure to take time each day for myself. Each day I would make sure to go for a walk or run to clear my mind.”
Rotberg prioritized mental health by finding a therapist and a psychiatrist who could help him find the right medication for his anxiety. He intends to continue his daily walks after the pandemic is over. “It helps me clear my mind of any anxious or negative thoughts,” he said.
Living with ulcerative colitis, Megan Starshak, 36, has found the mental health impact of the pandemic to be “extremely challenging.” A month after beginning an antidepressant, Starshak said it’s been “a helpful tool to help get me back to my baseline, or something like that. I've now been on them about a month and I feel like ‘myself’ again.”
Another of Starshak’s proactive steps was to combine exercise and connection with others. “We have a dog walk group in our neighborhood, which gives us a little socialization and gets some steps in,” she said. “We sometimes go three or four times a day, and we’re lucky because our group is full of funny people so it’s usually entertaining. What used to be a little thing we’ve done, has become a big and important thing.”
Annie-Danielle Grenier, 41, has sheltered at home since March 2020. Living with three rare diseases—Hypermobile Ehlers-Danlos syndrome, Addison’s Disease, and corneal ectasia, “as well as about a dozen comorbidities”—isolation was more familiar than it is to most people.
For that reason, she said, “I have made sure to use many of the tricks I know, some I had already been using if I had to be bedridden for long periods of time or on high-pain days.”
Trick number one: “Allow yourself to feel the emotions you feel without judgment, and don’t feel bad about not being as productive on bad days,” said Grenier. Her number-two trick is to “do things you enjoy, vent, and, as long as physically possible—aka if not bedridden—move!”
Smart advice from people who know about resilience from needing to be resilient long before COVID-19. Following it will help ensure you can better enjoy life now, even before the festive “after” that will follow the pandemic’s end.
