31 Aug Grief, Isolation, and Stress: Mental Health and the COVID-19 Pandemic

The global coronavirus pandemic has had worldwide mental health repercussions. Long-term stress has exacerbated existing behavioral health conditions, and social isolation has increased feelings of loneliness, anxiety, and depression. Chronic stress and economic instability have created a breeding ground for psychological distress. When it comes to reaching isolated populations, teletherapy has proven to be an invaluable tool during this public health crisis. 

Grief 

Since the start of the pandemic, people have lost loved ones, social connections, economic stability, and a sense of normalcy. Uncertainty about the future makes people feel unsafe. Others experience anticipatory grief, a condition where a person thinks something terrible is coming, but can’t see it. Loss associated with the coronavirus pandemic is both intimately personal and profoundly mutual, and the level of collective pain is unprecedented. Individuals and small groups have shared grief, but never on such a global scale.

Grief is a natural part of loss. It can trigger or worsen anxiety, depression, and other mental health issues. Some individuals can manage it with help from friends and family, but in this time of physical isolation, typical support structures aren’t always present. Group or individual therapy may be beneficial, especially for those whose distress interferes with daily functioning. In the absence of in-person office visits, individual or group teletherapy can help clients learn healthy ways to react to events outside of their control. 

Loneliness and Isolation

Loneliness often occurs when people lack the resources and support to meet their social needs. As people stay home for extended periods of time during the pandemic, clinicians may see an increase in isolation and depression. According to the CDC, loneliness is associated with higher rates of depression, anxiety, and suicide. Likewise, isolation heightens the risk of Substance Use Disorder (SUD), dementia, heart disease, and stroke.

It’s important to pay extra attention to older adults and immigrants—these groups are at higher risk for loneliness. People over the age of 50 have a greater likelihood of social isolation, and a global outbreak exacerbates the problem. COVID-19 has proven more severe and deadly among senior citizens, leading to increased anxiety for an already vulnerable population. Likewise, first-generation immigrants often have fewer social ties than their US-born counterparts because of language and cultural barriers.  

Chronic Stress

The spread of COVID-19 is an invisible force outside human control. Economic instability and fear of the unknown cause many people to live under a continual fight-or-flight response. Chronic stress disrupts physiological and psychological functions. Prolonged exposure to cortisol hormones can cause anxiety, depression, sadness, irritability, and social isolation. It also disrupts sleep, digestion, immune systems, and cardiovascular health.

Mindfulness-Based Stress Reduction (MBSR) can ease symptoms of anxiety, depression, and stress. This practice incorporates Eastern meditation into cognitive-behavioral treatment plans. Mindfulness helps people learn to focus on the current moment while maintaining a positive outlook. The idea is that clients learn to be more reflective and less reactive to stressful situations. MBSR helps people cope with clinical depression and anxiety. Plus, it can mitigate the damage from prolonged stress in otherwise healthy adults.

Frontline Workers

Compared to the general population, healthcare providers suffer from higher rates of psychiatric disorders and suicide. For many providers, the COVID pandemic has exacerbated their feelings of helplessness, fear, and anxiety. Limited resources, high death rates, and risk of infection are the new reality for medical professionals. Plus, new restrictions force frontline workers to make morally distressing decisions without input from patients’ families. Long-term stress from this pandemic will undoubtedly have a lasting impact on frontline workers’ psychiatric well-being.

At this time, we do not know the full psychological toll the pandemic will have on frontline workers. Nevertheless, it’s crucial to monitor and support those who are experiencing mental hardship. A recent article outlines key elements for protecting the mental health of frontline workers:

• • • Acknowledgment of hardships — Gratitude, recognition, and support go a long way in fostering resilience.
    • Contact when absent — Avoidance is a symptom of traumatic stress. So, when employees don’t show up, supervisors need to check in with them. 
    • Self-Check Tools — Encourage the use of anonymous web-based questionnaires that generate tailored information regarding self-help and professional care access.
    • Schwartz Rounds — A structured forum for discussing social and emotional aspects of work will likely reduce psychological harm.

     

Teletherapy 

The pandemic has caused many clinicians to move to a virtual therapy model. Teletherapy complies with stay-at-home orders and physical distancing guidelines. Virtual sessions help therapists stay connected with isolated clients, and they help alleviate client anxiety related to the virus’s spread. Video check-ins also provide an affordable care option for those who may be facing economic distress due to a job loss, furlough, or reduced hourly work.

To help get you started, HIPAA-compliant video conferencing tools are a must for any clinician offering teletherapy services. A behavioral health-specific Electronic Health Record should include secure video options and be integrated with the client chart. You’ll also need a stable internet connection and a distraction-free environment. Make sure your space is private and secure, especially when working from home. Turn off all notifications during your sessions, and stay focused on the client.

Additional Resources

Many official bodies released information to support mental health. Here are just a sampling of our favorites: 

• • • • United Nations: COVID-19 and the Need for Action on Mental Health
      • CDC: Coronavirus Disease 2019, Coping with Stress
      • WHO: #HealthyAtHome — Mental Health
      • SAMHSA: Leveraging Existing Health and Disease Management Programs to Provide Mental Health and Substance Use Disorder Resources During the COVID-19 Public Health Emergency

       

Maintaining psychological wellbeing is a part of being healthy at home during this crisis. Unless we address behavioral healthcare needs now, the fallout could have devastating long-term consequences. Fortunately, with the help of healthcare technology, mental health providers are uniquely poised to create a safety net to mitigate long-term damage to individuals, families, and society.