May 15, 2020 8 min read

As the COVID-19 outbreak continues its hold on the country, mental health issues are on the rise. From panic attacks to loneliness and depression, Americans are feeling the pressure and stress surrounding the coronavirus pandemic.

Take Jennifer Hitchcock, of Berkeley County, W.Va. A headache for her marks the excruciating end of a panic attack. Before that point, she endures much more.

“Mine present in not the classical way,” she said in a recent interview. “It feels like someone’s sitting on your chest. It’s an intense pressure. I have to tell myself to breathe.”

While the world converses on the serious symptoms of the deadly coronavirus, medical professionals and counselors are imploring the public to not ignore the serious and often physical symptoms of mental health during the pandemic.

“Mental health and physical health are very closely connected,” said Dr. Stephanie Rushton, a behavioral health physician with UPMC Williamsport. “We are sort of in a crisis situation, and most crisis situations don’t last for weeks and weeks and weeks. It is equally as important to address mental health as physical health.”

For Hitchcock, those weeks and weeks of working at home and teaching her kids at home, coupled with statewide stay-at-home orders, have meant heightened levels of anxiety and restrictions on her usual coping mechanisms.

Hitchcock is a special education teacher for a district in Loudoun County, Virginia. She has four children, some of whom are also special education students. In mid-March, when her district shut down, she abruptly had to shift to teaching distance learning with her students, while helping her own children learn at home.

In the last two months, her 18-year-old daughter was exposed to the virus and she quarantined for two weeks, though she never showed any signs of infection. Hitchcock’s husband, Jerry, also went through a period of job insecurity, which added to her anxiety.

She said that her usual coping mechanism is to have someone watch her children while she gets out of the house for a while, but she wasn’t able to do that due to social distancing and stay-at-home orders.

“Everything was being taken away, and all of my control was removed to be able to handle certain situations,” she said. “I find water soothing, so when the panic attacks start, I’m supposed to run warm water over my hands to refocus my brain off of what’s causing the attack. The point is to try to focus on what I can control.”

She started therapy sessions through telehealth, and as is the case for so many, it can be very difficult.

“It’s still really new,” she said. “I have to force myself to go.”

Rushton, meanwhile, said her practice transitioned quickly to telemedicine and video therapy sessions as soon as the pandemic hit.

“We’ve been doing telephone and video conferencing with our patients to help them be able to kind of process through what they’re experiencing,” she said.

“The anxiety is there for safety and health,” Rushton said. “We tend to function the best when we have routine, consistency and predictability. The fact that there’s so much of the situation that we can’t control, people are struggling coping with that.”

Dr. Dean Aslinia, psychotherapist and the graduate counseling program chair at the University of Phoenix, Ariz., echoed that sentiment.

“Overall, the research is showing that there seems to be a huge concern when it comes to loss of control for many Americans,” Aslinia said.

He explained that being confined for more than a month, with no end in sight, is an adjustment many people are finding difficult to accept.

While many are worried about finances, even those with steady income are experiencing challenges to their mental health due to being confined to their homes. He said people are reporting loneliness and anxiety regardless of it people are around them.

“There are some that are reporting isolation, which means they are obviously physically separated from others that they can’t engage with, and that’s creating one layer of issues, mental health-wise,” he said. “And the other tier is feelings of loneliness, but not related to isolation.”

What that means, he said, is while some are interacting and engaging with people via phone and video chat, “they’re emotionally feeling drained and lonely because they’re not connecting with people where their emotional needs are met. Meaning, they’re talking about all the surface-level things that they need to do to get by every day … but they’re really not going any deeper than that.”

“They feel there are people around them,” he concluded, but “they just can’t connect with anybody.”

His advice to combat that loneliness is to focus on the quality of conversations people have, rather than quantity of interactions. He said checking in with friends and family to ask how they are really doing is the first step into going deeper into those relationships, which will help curb the loneliness.

The stress surrounding the loss of control and the uncertainty created by the pandemic can be overwhelming for even those who have never experienced mental health issues such as depression and anxiety.

“Obviously, all these different issues are creating stress,” Aslinia said. “And so, what’s happening, when we understand stress from a psychological perspective, stress is immediate. There’s usually an identified trigger with it.”

He said a common trigger right now could be news sources reporting the death toll of the virus, and the fact that an end to the pandemic has not been defined.

“So it shoots up anxiety, which is our body’s reaction to fighting off a potential threat,” he said. “And usually with that, the body responds in three different ways from that anxiety – it either goes into fight mode to fight it, flight mode to run away from it, or to just simply freeze and do nothing about it.”

He said when a person’s reaction to that anxiety is to freeze and do nothing, they are likely to spiral into a depression. That’s what he believes is happening to a lot of people right now, he said.

Some symptoms of depression are changes in appetite or sleep – either eating or sleeping too much or too little. Constant fatigue, physically or cognitively, would be another sign of depression as well.

“Mental fog, or lack of concentration, or memory recall, those are some more signs,” he noted. “If there is a loss of pleasure in doing things that they used to find pleasurable, that’s usually another significant symptom or signal. And then, last but not least, if there is excessive emotional output … crying all the time, or if they’re irritable a lot of times.”

Aslinia recommended that anyone experiencing the aforementioned symptoms seek professional help from a psychiatrist, therapist or counselor, before adding that depression doesn’t go away by itself – even if the stressor involved goes away.

He said the main difference between an anxiety-inducing stress incident and actual depression is that during the stress incident, the anxiety “is immediate but it will subside once a resolution has been reached.” With depression, the feeling of hopelessness lingers even after the incident has been resolved.

He said there is never any reason to be embarrassed or ashamed to ask for help.

“We’re moving in a direction that mental health is becoming just as important as any other medical health issue,” Aslinia said. “And so, just as you wouldn’t feel ashamed or guilty for telling somebody you take medication for cholesterol, you shouldn’t be worried … when you say ‘I’m taking an antidepressant or antianxiety medication.’ We all, on some level, struggle with emotional regulation.”

He added that 1 out of 4 Americans struggle with mental health issues, and in order to achieve better mental health, Aslinia offered a few pieces of advice.

“First and foremost, I would say limit or regulate your information intake,” he said. “If you’re experiencing high levels of anxiety by the constant pouring of 24-7 news cycles, then to limit that intake.”

He said setting aside designated times of the day to consume news by reading a local newspaper or watching local news would be a better option than having the TV on all day, “to constantly trigger your anxieties.”

Getting eight hours of sleep per night also factors into better mental health, he added. An exercise routine is also key, even if it’s just walking around the neighborhood.

“What’s important with that is releasing the endorphins, which are the brain’s ‘feel good’ hormones,” he said.

He said that adding mindfulness techniques such as deep breathing, yoga or meditation will help “to be able to calm down the anxieties and the chronic worries in the brain.”

He then added that eating healthy also factors into an overall wellness plan.