Mental Health News

Not breaking news, but COVID-19 is impacting us all.
Everyone is familiar with various intrusions of COVID-19/Sars-CoV-2. There are mask requirements, restaurant closures, videoconferences, social distancing, and more. Most recently, the news has been replete with debate regarding the mental effects of the Coronavirus shift to remote learning; there are concerns about students. Publications such as NBCUSAToday, the British Broadcasting Corporation (BBC), and National Public Radio (NPR) have discussed the challenges. 
An email I recently received is intriguing. Having just survived Hurricane Sally, a colleague said "Hope everyone is getting back to - I was going to say normal - but things were anything but normal before the hurricane!" It is a reminder, perhaps, of how we have become accustomed to the challenges that are COVID-19, a reminder of how we have each personally adapted and adjusted in 2020?. 
Last March, when this Sars-CoV-2 was starting, I penned Stress in the Time of COVID and suggested that we all tend to our mental health. I continue to advocate for people to get outside daily, see the sky, lay in some grass, play with a pet, etc. You can remain socially distant and yet enjoy some exercise and sunshine. That may become more difficult as seasons change, but for now it still seems solid advice. This pandemic is affecting us, see Desensitized to Death
But, more recently, there is some focus on the mental effects of COVID beyond the student. A New York Times article in September describes a dentist's reaction to COVID, and a closure of her practice in March. She continued to see emergencies, but the day-to-day care was minimized. Shortly, she realized an increase in dental fractures. She noted to a friend: “I’ve seen more tooth fractures in the last six weeks than in the previous six years.”
This dentist concluded that an "obvious answer" to the increase in fractures is simply stress. Whether from the anxiety of Sars-CoV-2 exposure, or contracting COVID-19, or a family member suffering, or the related impacts on family life, work, community gatherings, social interaction, and more. The specific source of our particular anxiety, the precipitating cause, or root, comes back to the Sars-CoV-2 and its potentials to impact us. The dentist postulates "that pandemic-related anxiety is affecting our collective mental health. That stress, in turn, leads to clenching and grinding, which can damage the teeth."
This summer, we saw some begin to question the impact of COVID-19 on relationships. In July, the Business Insider noted the potential for increased stress and pressure on marriage. The author reported concerns "that divorce rates will spike post-pandemic when courts are open." That hypothesis was demonstrated in September with reports that divorce in America was "34 percent higher from March through June compared to 2019." The headline of that article said "divorce rates skyrocket(ed)." 
The idea of COVID stress is not new. The Center for Disease Control includes information on its website. It notes that "pandemic may be stressful for people." The sources noted there are primarily fear and anxiety. but there is discussion worthy of consideration. QJM An International Journal of Medicine noted recently that "Multiple lines of evidence indicate that the coronavirus disease 2019 (COVID-19) pandemic has profound psychological and social effects." BioMedCentral recently suggested connections between stress and suicide risk. 
The Kaiser Foundation notes the negative effects of COVID, but also stresses how it "created new barriers for people already suffering from mental illness and substance use disorders." It focuses our attention on social isolation, job loss, and stress. This is expressed as a worry about those with existing issues and exacerbation, as well as for those who may develop new issues as a result of both virus and sequela. 
That is perhaps an important distinction to remember. There may be mental issues that are a direct result of COVID-19. NBC recently reported on a patient (who is also a front-line physician) and his mental health challenges related to infection. Or, it may be a more troublesome concern for those who have pre-existing challenges with stability, stress, and otherwise. 
Wired noted more recently that "mental health in the US is suffering." That restates the hypothesis. But, of concern, is the struggle to determine "whether this is a normal response to a difficult situation or actual pathology." The article cites various survey results that suggest more people are self-reporting symptoms and complaints related to mental health challenges. But, will that persist beyond the immediate stress of the pandemic? The authors seem to contend that it is too early to tell. 
It is possible that the topic is coming to the fore because September is National Suicide Awareness Month. News outlets are reporting on the mental health aspects, with some concluding "young people, minorities, essential workers and the elderly are at a greater risk of experiencing these symptoms." The QJM authors contend that the current situation is increasing "distress, anxiety, fear of contagion, depression and insomnia." They focus on the suicide threat and advocate for addressing these symptoms and specifically "loneliness" to strive against that. And, this is all without the potential for other events (wildfires, earthquakes, hurricanes, school event cancellations, and beyond) to further stress populations. 
Troubling issues all. Fox News reported recently that we are largely also in denial about the mental health impact of the pandemic. About half of survey respondents elected not to seek mental health care "due to cost or lack of access and time." Many are busier than ever recently with family, work, community, and more calling upon us. The virus alone is not singularly cited as a causing people anxiety, but it is an element among other issues. There is a longing for return to normal: "people want to feel good, they want to go back to their pre-pandemic lives." And, as noted above, we may be somewhat flexible in our personal definition of "normal."
As we spent the summer and fall watching the National Hurricane Center predictions and prognostications, there were those who suggested that storms "in the midst of a pandemic" could increase stress, struggle, and mental health. That threat has come to pass in Louisiana with Laura's landfall, in Alabama (and beyond) with Sally, and we watch Beta crossing the region now. A very active hurricane season was predicted and has delivered. Less expected, much of the west is burning. There are dead, displaced, dispossessed, and fearful. That some of those fires were potentially set by people intentionally has further elicited angry emotions and reactions. 
The impact may not be universal or uniform on each of us. It is entirely possible that some segments of society may be more at risk than others. The Chicago Tribune suggests there are specific populations at increased risk. And, the Milwaukee Journal Sentinel suggests that the impacts may persist beyond the pandemic. It is possible, they say that return to normal may be good, but not necessarily a cure for all that ails us. 
Is there more that we can each do beyond paying attention to our own mental status? Certainly, I stand by my advice to get outside, to engage in socially-distant activities, exercise, and interaction. But, psychologists have other suggestions. First, this one suggests that one does not simply have issues or not, but that issues and challenges are on a "spectrum" (we may each have a little or a lot). 
She suggests also that social media may exacerbate issues, and to remain aware of that potential. But, she encourages the sharing of feelings in an effort to commiserate, acknowledge pains or complaints, and engaging in mindfulness and self-forgiveness for any shortcomings. Finally, she supports your engagement of others, to check on their challenges and well being can be healthy for you. Your practice of compassion and concern may boost your well being while it reinforces and supports those around (or emotionally close to) you. 
When you get out to exercise, sun, and recharge, get someone to go with you. Call someone who is isolated (old, ill, scared, furloughed, etc.). Contact them by video if you can to share a smile and the laugh. Perhaps find some solace in discussing things that are unrelated to COVID-19. That is, discuss a recent sporting event, play, or outcome without discussing "the bubble," or demonstrations, or activisms/positions of leagues, players, or fans. Focus on the game itself and leave the pandemic out of it for now. 
That said, I am not a psychologist. If you are feeling out of sorts, down, or worse, I encourage you to seek help. Search "depression resources" online for a raft of ideas including hotline numbers. In fact, there are hotlines for about any word you want: "stress hotline," "anxiety hotline," "suicide hotline," you name it. The simple fact is that COVID-19 is a temporary situation (as is hurricane recovery). If you are finding yourself challenged by it, by its effects, by your perceptions, why not reach out to one of these and get some help? Seeking help does not mean you are weak, it means you are wise. 
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    About The Author

    • Judge David Langham

      David Langham is the Deputy Chief Judge of Compensation Claims for the Florida Office of Judges of Compensation Claims at the Division of Administrative Hearings. He has been involved in workers’ compensation for over 25 years as an attorney, an adjudicator, and administrator. He has delivered hundreds of professional lectures, published numerous articles on workers’ compensation in a variety of publications, and is a frequent blogger on Florida Workers’ Compensation Adjudication. David is a founding director of the National Association of Workers’ Compensation Judiciary and the Professional Mediation Institute, and is involved in the Southern Association of Workers’ Compensation Administrators (SAWCA) and the International Association of Industrial Accident Boards and Commissions (IAIABC). He is a vocal advocate of leveraging technology and modernizing the dispute resolution processes of workers’ compensation.

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