When 23-year-old “Laura Smith” first began working as a veterinary technician in Franklin County, one thing she hadn’t counted on was being yelled at on a daily basis. But then COVID-19 came along.
As a precautionary measure, the veterinary hospital where Smith works implemented a face mask requirement and, nowadays, customers who don’t like it regularly unleash their anger on Smith.
On top of that, the veterinary clinic has been unusually busy since the coronavirus pandemic began, increasing Smith’s workload and compounding her stress. “It’s been really draining and hard to deal with,” she said. (“Laura Smith” is being used as a pseudonym to protect the subject’s privacy.)
Smith, who has struggled with anxiety in the past, said she experienced some anxiety in the early days of the pandemic, worrying, for instance, that she might not be able to find basic supplies, such as toilet paper or dog food. Since then, her anxiety has subsided at times, but as the pandemic stretches on, she worries about the “what ifs.” “What if everything closes again?” she said. “What if I contract COVID?” Stress and worry are always simmering near the surface.
Smith is in no way alone. Mental health experts, both nationally and locally, have seen a marked increase in the number of people experiencing stress, anxiety, loneliness and depression, as a result of COVID-19.
“Many people were able to manage their symptoms of depression and anxiety without any treatment,” prior to the pandemic, said Dr. Binu Chakkamparambil, psychiatrist at Mercy Clinic Psychiatry in Washington, an outpatient clinic that opened in mid-September. Because of COVID-19, however, Dr. Chakkamparambil has seen patients who have needed medication for the first time. Some of her other patients have had “a worsening of existing symptoms,” and she’s had to adjust their treatment, she said.
Given COVID-19’s contagiousness, some of Dr. Chakkamparambil’s patients who were already struggling with obsessive compulsive disorder (OCD) or who were prone to delusions are having an especially rough time now. Since the pandemic emerged, those patients’ symptoms have gotten worse, and they’ve had “obsessive thoughts over cleanliness and germs, to the point of being delusional,” she said.
Overall, anxiety, depression and a sense of hopelessness are the most common coronavirus-related mental health issues plaguing her patients, Dr. Chakkamparambil said. Other mental health experts in Franklin County have made similar observations, particularly when it comes to anxiety.
“I have definitely seen an increase in anxiety big time,” said Darlene Cox, a provisional licensed professional counselor at Diversified Counseling in Union. Cox sees clients aged 14 and up. “I think that it (anxiety) is something that probably everyone is experiencing, and then maybe I’m seeing more of it because I specialize in anxiety,” she said.
Another local therapist points out that with or without COVID-19, the most common mental health disorder in the U.S. is anxiety. “Just a little under 20 percent of the U.S. adult population is experiencing clinical anxiety in any given year, and there’s no doubt in my mind that it’s significantly higher in 2020,” said Matt Gildehaus, licensed professional counselor (LPC) and owner of Life Delta Counseling in Washington.
What COVID-19 has largely done is intensify his clients’ anxiety, said Gildehaus, who sees men aged 16 and older and women 18 and up. “For anybody who has a propensity to feel anxious — to have worrisome thoughts, fears, negative thoughts — COVID just exacerbated that ... I have seen a pretty significant spike in people feeling overwhelmed, stressed and anxious.”
Timothy Jones, MA, behavioral consultant in Washington, said for some of his clients, COVID-19 may have been the “straw that broke the camel’s back,” compelling them to seek his guidance sooner than they would have otherwise. Jones, who sees adults and kids as young as 2, noted, however, that his clients haven’t explicitly expressed concerns over COVID-19’s impact on their mental health.
“I don’t have any clients who are coming in to see me specifically as a result of being impacted by COVID,” he said. “It’s more of an ancillary issue, I’d say, added to the anxiety they’ve already been having.”
While COVID-19, one way or another, has taken its toll on many people’s psychological health, Gildehaus points out that other adverse conditions today, such as economic uncertainty, political divisiveness and social conflict, also are impacting people’s mental health. “How much is due to COVID and how much is related to those other factors, I don’t know,” he said.
Even so, some factors affecting people’s psychological well-being can be pinned exclusively on COVID-19. For some, the virus has meant the sudden loss of activities that had always given them joy — whether it was attending a live concert or sitting in a packed stadium watching a baseball game. One client of a local mental health care provider was convinced that his depression was worsening because he couldn’t attend St. Louis Cardinals baseball games, as he often had in the past.
People also are feeling stress related to their jobs, with COVID-19 upending the logistics of how, where and even whether they work. Some couples forced to share workspace at home have felt added stress, Cox said. Parents with school-aged kids have, as well. Early on in the pandemic, Cox said, some parents had to “quit their jobs and sell off property” in order to afford to stay home with their kids when schools switched to online learning.
Others are worried about the sheer safety of their workplace. Gildehaus said he has a couple clients who have resisted going into work because they don’t feel appropriate safety measures are in place. “And they’re conflicted because they feel shame and guilt about not going,” he said.
As the pandemic drags on and people spend an inordinate amount of time at home, relationships with family members or significant others have become strained for some. “I’ve seen a definite increase in romantic partner stresses and relationship challenges,” Gildehaus said. Parents and kids have had their share of challenges, as well. “I’ve had parents be completely honest and say, ‘Hey, I’m lashing out at my kids — I’m shouting at them,’ ” Gildehaus said. Afterward, those parents have recognized that their irritability had nothing to do with their child’s behavior but that they had just reached their limit with everything else going on, Gildehaus said.
For others, so much time spent at home has led to loneliness and, sometimes, depression. According to Cox, loneliness has been an issue for her clients who live with elderly family members; those clients go out as little as possible in an effort to avoid contracting COVID-19 and passing it on to an aging parent or grandparent. “Even going to the grocery store is a big deal,” for those clients, she said. “The more limited they are (in leaving home), the more they’re feeling isolated and lonely.”
Gildehaus said the isolation wrought by COVID-19 can be especially hard on extroverts, like himself, who are energized by being in social situations. “That’s largely been taken off the table for us, and that’s a big void in our lives and causes all kinds of withdrawal symptoms,” he said.
On the other hand, for people who tend to be introverts — especially those who were lonely or withdrawn even prior to the pandemic — today’s “new reality” has been a source of comfort almost. “I’ve had at least six clients tell me that if everybody is quarantined and isolated ... they don’t feel as unusual or odd because everybody else is doing what they’ve been doing all along,” Gildehaus said.
Cox, who considers herself a homebody, said there’s some truth to that phenomenon but, in her view, it was more prevalent earlier in the pandemic. “I think that even the most introverted of us ... at some point said, ‘OK, this is actually pretty miserable — I have to be with other people now,’ ” she said.
Taking Stock and Looking Ahead
Of course, there are those whose mental health, by and large, has been unaffected by COVID-19. For others, COVID-19’s impact on their mental health might not even have registered yet. Among those people are first responders, “from our surgeons and nurses to our police officers and paramedics,” said Tom Duff, a therapist and the executive director of St. Louis Counseling, which has a clinic in Union. In Duff’s view, many first responders are “still amped up on some level,” taking care of others. “A lot of times when you’re in those roles, you don’t want to allow yourself to even feel,” he said, “because you know the next day you have to go back into it.” Only much later, he said, “can you finally take a break and begin to heal.”
If COVID-19 has done anything positive, it has helped many people become better at coping and revealed their resilience. For some of Cox’s clients, their anxiety “comes in waves” now, rather than remaining constant, she observed. “I think it (the pandemic) has really forced people to think outside the box and get comfortable with being uncomfortable,” she said.
And there may be another silver lining, according to Duff, who said COVID-19 has “opened the door” for people to take stock of their mental health, to admit “that maybe they’re not feeling OK” and to seek help.
Borrowing a line he heard from a client, Jones finds a silver lining, as well: “Crises have a way of making things more clear.” He explains, a crisis like the coronavirus pandemic underscores how much of life we’ve taken for granted and the value, going forward, of living in the moment. “There’s a lot of joy, a lot of good, wholesome things in every moment. And there always has been,” he said.
Recommendations and Resources
Limit time spent tuning into news and social media. Too much “just adds to anxiety and paranoia,” said Dr. Chakkamparambil.
Ward off isolation and feelings of loneliness by carving out time to talk with friends and family over the phone or virtually.
Practice mindfulness and relaxation techniques. Mindfulness exercises, available on many apps, allow people to escape worrisome, negative thoughts and to “just be present in the moment,” Gildehaus said. Deep, diaphragmatic breathing also is helpful in combatting anxiety, he said. Jones — a proponent of the HeartMath Institute’s form of biofeedback, recommends the institute’s “heart-focused” breathing technique (heartmath.org).
Focus on the mind, body and spirit. Seek out books and movies with a positive bent, eat nutritious foods and exercise, said Jones. “Any kind of aerobic exercise will stimulate endorphins and make you feel better,” he said.
Consult the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) websites (cdc.gov and who.int) for information on COVID-19.
Consider seeking professional help. In order to curb the spread of COVID-19, many therapists and psychiatrists have begun offering the option of virtual visits.