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Susan J. Noonan MD


Dealing With Depression During COVID-19

You can manage your depression during the coronavirus pandemic.

Source: LUMaxArt/BigStock

The COVID-19 worldwide health crisis is having a major impact on us medically, socially, and economically, with significant disruption to our lives and daily routines. It’s a cause of monumental stress, newfound fear, and anxiety, including:

  • Fear of the unknown
  • Fear of contracting the virus ourselves and in loved ones, with uncertain and potentially fatal outcomes
  • Concerns about insufficient access to routine and urgent health care, treatments, procedures, medications, and resources
  • Loneliness due to social isolation and physical separation
  • Fear and anxiety related to erratic changes in our economy, job losses, and diminishing personal financial resources

The nearly continuous media coverage magnifies our fears, especially when varied, uncertain, rapidly changing, or contradictory information is circulated.

These concerns are more profound in those who have depression or bipolar disorder. Most of the life changes that accompany the COVID-19 crisis have a negative effect on depression, our ability to manage it, and the stabilizing factors in our lives that support our emotional health. They include:

  • Social isolation with limited in-person human contact, including mental health clinicians and peer support groups
  • Lack of routine, structure, and purpose in the endless days of confinement
  • Variations in routine sleep, dietary and exercise habits
  • New sources of major stress, uncertainty, and anxiety

Dealing with this pandemic requires enormous effort by those who already have a mood disorder diagnosis and are in treatment, by the undiagnosed who are without treatment, and by those experiencing first-time depression (due to COVID-related stressors) who lack the skills to manage their illness.

You might wonder how to care for yourself during this self-isolation and/or quarantine period to effectively manage your depression and avoid recurrence? Here are some ways to handle symptoms of depression and anxiety during this stressful time.

Accept and adapt. Those who accept the reality of the COVID-19 pandemic and adapt to their new circumstances, while continuing with the things in life that provide meaning and purpose, have a greater chance of maintaining emotional stability.

Stay busy. Predictable and regular daily routines help to keep our body’s internal clock running smoothly, which is important to our wellbeing. Having structure, meaning, and purpose is key. Try to keep up with your regular family, household, personal care, and work routines and responsibilities.

Connect. Make an effort to reach out to others, by phone or video conferencing (FaceTime, Skype, Zoom, etc.). Be creative and plan special activities, like playing a musical instrument or board game with friends over social media.

Use coping strategies: Humor, hobbies, pets, music, and exercise all help in managing depression. Include a relaxation routine or yoga (online or on your own) and pleasurable moments. Try to do things with family at home or with friends virtually, such as games, exercise, music, funny movies, yardwork, or cooking and baking.

Care for yourself. Attend to your personal care: shower and get dressed in clean clothes instead of staying in your PJ’s or sweats all day.

Get regular sleep. Go to bed and get up at the same time each day, maintaining a steady sleep pattern. Staying up late or having fragmented, erratic sleep will only worsen depression symptoms. Avoid daytime naps—they interfere with nighttime sleep.

Feed your body; Feed your brain. Your brain needs fuel to operate. Eat three healthy meals at the same time each day instead of snacking or grazing all day long. This will stabilize your blood sugar, which then has a positive impact on mood and brain functioning. Ideally, enjoy your meals with another person, even if it’s virtually or on social media. Take your prescribed medications—getting a 90-day supply will decrease your anxiety about running out. Make an effort to avoid or limit alcohol, street drugs, tobacco, and excess caffeine.

Move more, sit less. Exercise is an excellent way to maintain mental and physical health. Try to stay physically active (as possible) and spend some time outdoors each day getting fresh air.

Home environment and activities: Keep your home environment organized, tidy, and clean. Clutter can cause you to feel uneasy and lethargic. Do the laundry, fold it, and even bring out the iron, which I’m told is a soothing ritual for some!

Stay informed. Learn about the coronavirus and its complications but limit your news exposure to one brief period twice a day, not at bedtime, to keep current in this rapidly changing environment. Get accurate facts from reliable sources and be wary of versions posted online or on social media.

Managing your illness. Watch for worsening symptoms of depression. Mindfulness techniques that focus on the present and CBT strategies designed to address negative and distorted thoughts, inaccurate beliefs, and unhelpful behaviors, often improve depression symptoms. Reach out to others through online support groups and chat rooms. DBSA and NAMI, national mental health support, and educational organizations with local chapters, have recently been facilitating groups online and through Zoom.

If you have an established mood disorder diagnosis, stay in regular touch with your mental health treatment team, ideally through virtual appointments (telemedicine) on a computer or by telephone. If depression is a new experience for you and/or you don’t have a mental health clinician, contact your family doctor for evaluation and treatment recommendations.

If you’re in crisis or having a mental health emergency, contact your provider directly. He or she will evaluate your current symptoms and determine the best course of action. If you don’t have a PCP or mental health clinician, call your hospital’s Department of Psychiatry or Emergency Department to see if they have established an outpatient urgent care clinic where you can be seen and evaluated. If you are suicidal, call your provider or 9-1-1 immediately for assessment and treatment or go to the ER.

Having depression does not mean that you will be unable to manage the stressors of COVID-19. Following the strategies I have outlined will enable you to cope more effectively and bounce back more readily from the medical, social, and economic threats of the COVID-19 experience.

Stay well!


About the Author

Susan J. Noonan, MD, is a physician, patient, and the author of Managing Your Depression: What You Can Do To Feel Better, and When Someone You Know Has Depression: Words to Say and Things to Do.