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No one will dare to deny that we are navigating unprecedented times; we are in the midst of a global health crisis, and anxiety is understandably high. There is a real tragedy in the world as tens of thousands of people have lost their lives and even more have gotten sick. As the pandemic unfolded, months ago, I thought: Where is the mental health dialogue?
And then it started—a good thing.
Most of us have been reminded that mental health is an inextricable part of the human experience. We can’t avoid it. When we shake hands or receive a hug from a trusted friend or loved one, oxytocin and dopamine are produced in the brain that help us feel emotionally connected. However, elbow bumps and foot taps, modifications to reduce casual contact in the wake of COVID-19, were welcomed early on with humor and curiosity.
Then, many people around the country transitioned to a period of denial; we heard public health officials and politicians pleading to people (especially young people) to take social-distancing recommendations seriously. We saw gatherings on beaches and parties in bars in defiance of what we were being told to do to save each other’s lives.
As the weeks have passed, and most of us are spending our days at home, reality has started to sink in: This is really happening; anyone can get this. We were, and continue to be, cognizant of the mental health implications of social distancing and the importance of finding other ways to stay connected. Zoom, FaceTime, telephone calls, active listening, and choosing our words wisely can go a long way in helping us feel less isolated. Some people (seniors and people who live alone) are already at an increased risk for feeling more disconnected, so we can reduce the chances of isolation spiraling into a major depression by finding safe ways to connect with people who may fall into high-risk groups.
A newly released Express Scripts report shows a recent surge in prescriptions for antidepressant medications and anti-anxiety prescriptions (particularly benzodiazepines). Other reports have suggested an increase in alcohol purchases; liquor stores in many states remain open. Some in the political arena are considering and even speaking publicly about the possibility that sustained economic hardship may impact suicide rates.
Racial disparities in health care access and outcomes have been elucidated. African Americans are dying more from the novel coronavirus compared to other groups. These issues are not new, but the public discussion—on television, on the pages of magazines, and at the dinner table—might be.
As a psychiatrist and wellness advocate, I can appreciate that most people are thinking about mental health, even if they aren’t talking about it.
Now, the conversations are happening—also a good thing.
I won’t deny that people are struggling, they are, and I am seeing this on the frontlines of mental health care as I (and other mental health care professionals) help people make sense of the myriad of emotions they are experiencing right now: confusion, fear, and uncertainty. But I am also hearing stories of stillness, mindfulness, connection, and clarity.
A patient I spoke with this week told me, “I’m a little embarrassed to say this, but the shelter-in-place order is probably the best thing that could’ve happened for my mental health and well-being.” I have actually been surprised by the number of patients who have asked me to reduce their medication dose, or have shared that they feel closer with their husband or wife or more optimistic about returning to life when the dust settles, as it were.
An important part of the mental health dialogue should include a discussion on how we can make the most of this time and how we might emerge from our collective grief as more mindful people. It is my belief that uncertainty is driving individual anxieties. The way to navigate uncertain times is by holding on to things that we have control over: washing our hands to reduce the risk for transmission, wearing a mask in public, physical distancing, continuing to find ways to move our body through virtual workouts, and finding stillness in the breath. People are dusting off books they’ve been meaning to read or spending time cooking with their family. In clinical conversations, I’m hearing that modifications like these are allowing people to understand that they have more control over their minds than they thought.
People are slowing down. Personally, I have noticed I’ve been substituting my run for a walk—likely to protract the time I have outside. Soaking in the bath rather than a quick shower, or starting the day with 15 minutes of meditation (there are some great apps for this). We are kinetic people, and many of us spend hours commuting to and from work every day. If we’re being told to stay at home, we have extra time in our day for stillness. Stillness doesn’t have to translate to boredom; it can produce calm and clarity if utilized appropriately.
Finally, I am sensitive to the fact that socioeconomic disparities (some people don’t live in neighborhoods that are safe enough to go for a walk outside) and for people who are victims of domestic violence, being told to stay at home produces an unfortunate and nightmarish reality. But, if there’s a reason for hope, it’s that our humanity is what draws us together. Mental health professionals, as well as others, are still here to help.
