Concerning Mental Health Trends Due to COVID-19

The COVID-19 pandemic has caused extreme disruption in the lives of people all over the world. Citizens are dealing with uncertainties related to a new disease, plus lockdowns, social distancing, closed businesses and schools, increased unemployment and more. The number of infected individuals and COVID-related deaths continue to climb, with more than 200,000 deaths in the United States alone.

In addition to the physical manifestations of the disease itself, mental health professionals are reporting a general increase in cases of anxiety, stress, isolation, substance abuse and fear. And for people already suffering with mental health disorders, the disruptions caused by the pandemic can quickly exacerbate their illness.

Physicians and other healthcare workers are also suffering more mental health issues due to their close work with the disease and the affected patients.

Some key mental health trends related to the COVID-19 pandemic 

According to David Cates, PhD, director of behavioral health, Nebraska Medicine, and vice chair of clinical operations, Department of Psychiatry, University of Nebraska Medical Center, data from the Centers for Disease Control and Prevention (CDC) from late June suggests increasing rates of anxiety and depression symptoms as well as trauma and stressor-related disorder symptoms.

“Rates of suicidal ideation have also increased,” Cates said. “And rates of individuals’ starting to use substances or increasing the amount of substance use are also increasing. Those already in treatment for psychiatric conditions appear to be disproportionately affected. And I should note that the stress and psychological impacts appear to be disproportionately affecting young adults, Latinx persons, Black persons, essential workers, and unpaid caregivers.”

Physician mental health due to COVID-19 

Healthcare workers—especially physicians, nurses and others working on the COVID-19 front lines—are seeing an increase in burnout and other problems caused by on-the-job stress.

“Frontline healthcare workers face a range of stressors, including increased workloads, fear of contracting COVID and transmitting it to family and friends, changes in workflow and responsibilities, and witnessing the death of patients without their family members present due to hospital visitation policies,” Cates said.

“A variety of studies in the United States and other countries indicate substantial psychological distress among healthcare workers, including emotional exhaustion, difficulty sleeping, and, in some cases, psychiatric conditions, including anxiety, depression and post-traumatic stress,” he continued.

Cates said healthcare workers battling COVID-19 can be proactive and take steps to avoid developing mental health issues.

“On an individual level, healthcare providers can learn skills to manage stress, such as deep breathing, mindfulness, and muscle relaxation; focus on things for which they are grateful; maintain healthy eating, exercise, and sleep habits; and perhaps, most important of all, connect with their sources of social support,” he said.

But organizations have an obligation to protect their providers’ mental health, as well.

Healthcare organizations must have strong leadership and clear policies designed to ensure clear and timely communication, adequate training, opportunities for healthcare workers to participate in decision-making and development of protocols, adequate PPE, rapid access to testing, and support for those working long hours or in quarantine (e.g., lodging, meals, assistance with childcare).  

Staying aware of your mental health 

Cate encourages physicians and other healthcare workers who have worked or are still working on the COVID front lines to recognize the following signs of stress that may indicate a need for social support and stress management:

  • Physical signs include muscle tension, headache, changes in appetite, sleep disturbance, and fatigue;
  • Emotional signs include irritability, sadness, anger, anxiety, fear, guilt, and hopelessness;
  • Cognitive signs include difficulty concentrating and feeling confused;
  • Behavioral signs include snapping at others, overworking, withdrawing, impulsivity, poor self-care, and using drugs or alcohol more than usual.

  • In addition, Cates noted that the following signs indicate the affected person should consider reaching out to a mental health professional:
  • Intrusions (nightmares, flashbacks, intrusive thoughts)​;
  • Ongoing hyper-arousal (anxiety, insomnia, irritability, etc.);​
  • Avoiding reminders of a traumatic event​;
  • Avoiding feelings by using substances​;
  • Feeling numb, spaced out or like things aren’t real​; and
  • When daily functioning is affected​.

  • Resources for physicians navigating the mental health trends relating to COVID-19: 
  • How the Pandemic Casts Physician Burnout in New Light - AMA
  • How to Protect Your Mental Health During the Coronavirus Outbreak - NAMI
  • How to Cope with Stress and Build Resilience During the COVID-19 Pandemic - CDC
  • Pandemic Weary? 5 Keys to Keep Medical Teams Engaged – Staff Care

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