By Joseph Duffy, contributor Oct 19, 2020
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.
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 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
Some key mental health trends related to the COVID-19
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
“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
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
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
Ongoing hyper-arousal (anxiety, insomnia,
Avoiding reminders of a traumatic event;
Avoiding feelings by using substances;
Feeling numb, spaced out or like things aren’t
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
to Protect Your Mental Health During the Coronavirus Outbreak - NAMI
to Cope with Stress and Build Resilience During the COVID-19 Pandemic - CDC
Weary? 5 Keys to Keep Medical Teams Engaged – Staff Care
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