Most of the world’s focus has been on helping those infected with COVID-19 and preventing further contagion. While successful, social distancing and self-isolation have been hard to bear, leaving more people contending with mental health issues.
I had an opportunity to speak with Elisabeth Mandel Goldberg, a family and marriage psychotherapist based in New York, about how these measures and the experience of the pandemic are affecting those with mental illness, a misunderstood and often stigmatized population.
According to Goldberg, the most common mental health conditions being affected are obsessive-compulsive disorder, anxiety, depression, bipolar disorder, and addiction disorders—in ascending level of severity.
OCD and Anxiety
For those with obsessive-compulsive disorder, the measures to prevent infection and spread of the virus such as the washing of hands have normalized some symptoms of the disorder.
Goldberg suggests that those with OCD remind themselves that this situation is temporary, and even though some obsessive behaviors are being encouraged at the moment, that this pandemic will not last forever.
For those who struggle with anxiety, the uncertainty of this time has exacerbated the condition.
“People are losing sleep because they don’t know who’s going to get affected, they don’t know who’s going to die,” Goldberg said.
Goldberg advises those who stuck at home, struggling with anxiety who are stuck at home to clean their homes and themselves thoroughly. The act of cleaning itself allows someone with anxiety to remind themselves that they are doing everything that they can in the moment to help themselves and alleviates their compulsive worries of what might happen in the future.
One of the main symptoms of depression is social isolation, and social distancing has exacerbated this symptom. For people who are trying to manage depression, social distancing allows them to sleep in more than they should, to not go outside, and to cry because the media is sending the message that the world is ending. Most importantly, since those with depression are isolated, the potential for suicidal thoughts increases.
“When you describe the symptoms of depression it’s like a biofeedback loop because it fuels itself, so it’s a downward spiral of darkness and hopelessness encouraged by social distancing,” Goldberg said.
Goldberg recommends that those who are struggling with depression find a creative outlet to help alleviate their symptoms. Reading, writing, and music are all good creative activities. Exercise is also helpful, however those suffering from depression may not have the motivation to do so. Therefore, Goldberg recommends stretching, maintaining personal hygiene, and eating a balanced diet. If you know someone who is depressed and you call them they may not pick up, so sending an uplifting text message is a good idea, Goldberg said.
According to Goldberg, the pandemic is exacerbating hypomanic, manic, and mixed episodes for those with bipolar disorder.
For instance, the shortage of basic necessities is enabling those with bipolar disorder to search frantically for them, and they may get a high from spending, which could potentially induce a hypomanic episode.
Furthermore, significant life transitions can be a catalyst for manic episodes, Goldberg said.
Goldberg suggests that those with bipolar disorder should pay close attention to their spending habits, keep track of their supplies, and make a budget.
Those who are struggling with drug and alcohol addictions are the most vulnerable population. Whether someone is at home alone, with their families, or with their significant other the pressure of having to be stuck in the same home can exacerbate addictive tendencies. They also may be out of work and lack a schedule. The only message they hear is stay home and don’t go outside, and that creates a lack of accountability for someone who has addictive tendencies.
“They feel like they have an excuse. They can say to themselves ‘I’m not doing anything wrong, I’m doing something right. At least I’m numbing the pain whereas other people have to deal with fear and anxiety, so I have a means of escape,'” Goldberg explained.
Goldberg believes that family members and friends can help a loved one who is struggling with addiction by sending uplifting text messages to them. If they live in the same home, Goldberg suggests family keep an eye on their loved one, engage in family activities, and keep track of the alcohol in the home.
Overall, Goldberg suggests keeping track of one’s finances, not sleeping too much, and limiting the amount of time they spend reading and watching the news about the pandemic. She also recommends limiting alcohol consumption and keeping in touch with family members. Remind yourself this is temporary, think about how you can feel a sense of control over your immediate surroundings, do something creative and enjoyable, and stay connected with friends and family.