How do you know it’s time to seek professional help for coronavirus depression and anxiety?

It’s a meme now, how stressful 2020 has been. If the coronavirus pandemic, wildfires and political and economic upheaval have kept you up during a couple of sleepless nights, you aren’t alone.

As depression and anxiety during this time of isolation and fear mount, how do you know when you should seek professional help?

The first step, said Dr. Alan Teo, an associate professor of psychiatry, at the Oregon Health and Science University School of Medicine, is to take a test.

While some level of situational blues is normal and expected, it’s important to distinguish between that and sustained mental health issues that are getting in the way of normal activities.

A test can help determine which you are experiencing, Teo said.

“For depression, if you or a loved one is worried you can take the PHQ-9,” Teo said. “For anxiety, there’s an online resource GAD-7 that was originally designed specifically for generalized anxiety.”

Those tests are available online in a variety of forms. The PHQ-9 asks the test taker to answer questions about appetite, sleeping habits and interest in doing things, while the GAD-7 focuses on things like fears, worrying and irritability and how those symptoms might be getting in the way of normal activity.

Tests are a good place to start to see if what you’re feeling has crossed into clinical territory, Teo said.

But there are also red flags, he said, that don’t require a test and indicate it is time to urgently seek help, Teo said.

One of the most concerning red flags is a lack of “future-orientation,” or being unable or unwilling to think about what lies ahead, Teo said.

“If they’re thinking why go on? If they stop caring about the future or a more extreme version would be having suicidal thoughts or not wanting to wake up,” he said, that would be “a real concerning level of depression.”

If you or someone you know is experiencing suicidal thoughts, you can call the National Suicide Prevention Lifeline at 1-800-273-8255.

Other red flags to look out for are feelings of worthlessness or being a bad person.

“Not just a thought for an hour or even a day but if this is stretching over a week, two weeks or three weeks,” Teo said, it would be time to look for help.

One place to start looking for that help is a recently launched project from the Oregon Health Authority called “Safe + Strong.” The project aims to support Oregonians’ mental and emotional health during the pandemic.

“If someone feels like they need help, they can call the Safe + Strong Helpline, a new resource from OHA and Oregon-based nonprofit Lines for Life, at 800-923-4357 (800-923-HELP),” said Sarah Kelber, a spokesperson for OHA.

That line offers free emotional support and resources 24 hours a day, seven days a week, she said, not just for people experiencing a mental health crisis.

The helpline project was “a response to needs for emotional support around disasters like COVID-19 and wildfires” she said, and was funded by the CARES Act.

The mental health section of the Safe + Strong website also offers information and resources for mental and emotional health support and guidance on how to have conversations with others who may be struggling.

Kelber also suggested reaching out to your insurance provider or primary care physician for help in finding a therapist.

“If someone has insurance through their job,” she said, “they may have access to an Employee Assistance Program — EAP — that offers counseling and other mental health treatment options. They should contact their employer for more information about EAP.”

“People who need health insurance can apply for the Oregon Health Plan, which offers free health coverage for people who qualify,” she added. “Through OHP, they can get mental health benefits at little or no costs.”

If you do decide to look for a therapist, Teo said, ask the provider what kind of treatment they would use for whatever your concern is.

“If the therapist is wishy-washy or vague,” he said, “I’d be cautious.”

Not all anxiety or depression necessarily rises to a clinical level, Teo said.

If that’s the case, you can still look for someone to talk to, but there are other steps you can take too.

A big one? Remembering what you do have.

“We always have to remind ourselves of the gratitude,” Teo said. “It’s very easy in the COVID year to focus on the negative.”

Teo said focusing on what is good — actual, concrete examples of the things you are grateful for — can really help.

“Essentially you’re training your brain to think in a more positive way,” he said.

“It’s not like it’s easy,” he added, “but the evidence does say that if we practice that it actually can have a measurable benefit in terms of our mood.”

— Lizzy Acker

503-221-8052, [email protected], @lizzzyacker