Mental health during COVID-19: look out for yourself and your loved ones

During this time, many people are dealing with far more than just social isolation. There is also food and housing insecurity, financial stress, overwhelmed working parents, health concerns and family stressors. All of these things and more are contributing factors in the rise of mental health issues during the pandemic.

In children and adolescents, these concerns were already on the rise and have only continued on an upward trajectory since the pandemic began, according to Dr. Leah Costello of Timberlane Pediatrics. Those who work with children have found it difficult to engage the younger ones in online play therapy, and adolescents don’t want to access therapy over Zoom and thus do not engage. “When the weather was nicer and cases were lower, we were seeing more outdoor sessions,” said Dr. Costello.

Personally, I have come to prefer my weekly Telehealth therapy sessions as it saves me an hour driving and I don’t have to worry about who is watching my boys. This isolation and a feeling of loneliness are crushing. It is as if I’m trapped in a fish bowl with no means of escape. As these feelings persist, my despair grows and soon it takes all I have to complete just one task on my list for the day. These are not feelings I have had because of the pandemic; they are feelings I’ve had over the years because of my clinical depression and my role as a stay-at-home-dad. I’m telling you about them so you know I am coming from a place of understanding and compassion.

The symptoms of depression and anxiety present themselves in a multitude of different ways says Laura Rabinovitz, LICSW. “Depression can present in many ways including tearfulness, hopelessness, apathy, irritability, changes in sleep patterns and appetite and at times include suicidal ideation,” she said. “Many people are feeling some of these ‘symptoms’ to one degree or another—they can all be mild to severe in intensity. Pandemic fatigue is very real, particularly as we head into winter. Anxiety can show up in the body (GI issues, sleep disturbance, restlessness, heart palpitations). The need to monitor cold symptoms alone can wreak havoc on one’s level of anxiety and preoccupation with health and makes us prone to worst-case scenario thinking.”

For children, adolescents and some adults, there can be an increase in temper tantrums and issues with concentration, along with more risky behavior such as drug and alcohol use.

I believe that we keep far too much bottled up inside, in part because our culture has conditioned us to think that talking about our feelings is a sign of weakness. We think that we can tough it out, that we don’t need or want to burden others. I’ve certainly thought this, but we are social creatures by design and we need each other, whether that is peer-to-peer or talking to a professional. One way to connect with others during this time and get some exercise is to reach out to a friend, family member or another trusted person and ask them to go for a walk. This provides you and your companion fresh air and exercise but also a chance to talk about what is bothering you, what brings you joy, or perhaps just listen.

Regardless of the topic of conversation, Rabinovitz encourages authenticity, which can be hard, especially when we feel embarrassed or foolish about our feelings or we don’t want to upset the other person by bringing up your concerns about them.

As adults, we set the tone in the household. If we are not taking care of ourselves and are constantly thinking negatively, our children will act accordingly, and so we must model healthy behavior as best we can. I once had a therapist tell me that I could not take care of my family if I did not take care of myself first. I have carried that advice and passed it out freely ever since.

We know getting outside and moving is extremely important, as is good nutrition, hydration and sleep. Picking up a new or set-aside hobby is another way to help during these times. I know you’re thinking that you have no time to start or return to a hobby. Expanding outward to the family, Dr. Costello suggests setting up a family challenge to engage in a daily mindfulness activity and to set up a schedule for outdoor family activities to encourage some movement. Engage and learn about an activity that your child enjoys (even if you don’t).  Set mini goals, such as learning a new skill as a family. Set up a worry jar for your child or a worry journal.

“But it’s just all too much,” you think to yourself, “it’s all so unmanageable.” When things get this way for Rabinovitz she does the following: “In my own mind, I often try to think/plan/take things in small chunks: the next two days, the week to come, maybe the next hour to keep the overwhelm at bay. Sending love and compassion to others helps as well either by sending it ‘out’ from the heart and mind or getting involved in a cause.”

When I went to the Mood and Anxiety Clinic at UVM Medical Center we would start each group therapy session with “what’s not wrong.” This involved going around the room and each person would say one thing that was not wrong with the day. You can do this at home by keeping a list—it is like a gratitude journal only simpler. One gentleman always referred to the weather as his what’s not wrong, while a woman mentioned her coffee. Give it a try. You will be amazed at how it can change your perspective.

Both Costello and Rabinovitz suggest meditation as a way to help with our current situation. If you can breathe you can meditate. Just sit comfortably, making sure your back is straight and you’re in a fairly quiet place. Now, focus on your breath. When your mind wanders, and it will, just come back to your breath and begin again. Try sitting for three minutes and work up from there. There are many apps available to help with meditating, like Insight Timer, Calm, Headspace, and 10% Happier.

For those who are struggling, please do not put off reaching out for help. I have done that and it is not worth it. I’ve self-medicated with alcohol, I’ve spent days thinking up worst-case scenarios, I’ve turned my despair into anger that I have unleashed on my children and my wife. I’ve sat down on the couch and been unable to get up. I’ve thought about suicide enough that I have both First Call for Chittenden County and the Vermont Crisis text line (listed below) in my speed dial. There is no shame in feeling this way. There is help out there and far more people who are feeling exactly as you are. I know you feel alone, but you are not alone. There are friends, professionals and random people, like me, who are willing to help.

Jorden Blucher writes a weekly blog about the nuances of life and his journey with depression at his website, Quietly Making Noise.

Resources
Contact your or your child’s primary care doctor for local therapist recommendations.
Psychology Today is the easiest way to find a therapist. You can also ask friends and family for recommendations.
Two resources for children are Kids’ Mental Health  and  Healthy Child.

24-hour Crisis Hotlines
First Call for Chittenden County: (802) 488-7777
Vermont Crisis text line: 74174
Crisis Services of Addison County: (802) 388-7641
National Suicide Prevention Hotline: (800) 273-8255
Howard Center is an excellent resource on a variety of social issues for those in Chittenden County. They also run the First Call hotline.
Vermont 211 is a free and confidential service, serving Vermonters statewide with information and resources to help maintain and improve their health and well-being. You can also call 211 for help.