ASHBY – Danny Quin craves consistency. The pandemic has not been easy.
“With consistency comes relaxing,” Quin, 32, said in an interview last week. “But when you kind of throw into the equation (children’s) remote schooling and that my wife was furloughed and everything was on my plate … and I was kind of running around from place to place – things were hectic, things were essentially thrown into a blender.”
So Quin has sometimes found himself on the floor playing with Legos, or writing, listening to music or learning a new skill on YouTube – anything to deal with the uncertainty and changes presented by life during COVID-19.
“Kind of finding ‘me time’ is key for me,” Quin said. “It’s a challenge, but putting focus into a building activity like (Legos) can be an act of meditation if you look at it less as a toy and more of a relaxing activity.”
Quin is not alone in his anxiety.
Nearly one in five adults in the United States – or 46.6 million people in 2017, the latest year available – live with a mental illness, which is defined as a mental, behavioral or emotional disorder that can vary in impact from no impairment to mild, moderate and even severe impairment, according to the National Institute of Mental Health.
COVID-19 isn’t helping.
According to the Centers for Disease Control and Prevention, during January to June 2019, 11% of adults had symptoms of anxiety disorder or depressive disorder. Weekly surveys between April 23 and Sept. 14 show this has increased to roughly between 33% and 42% of adults.
As a snapshot, a study from June 24 to June 30 found 40.9% of 5,470 survey respondents reported an adverse mental or behavioral health condition. This included 30.9% of respondents who reported symptoms of anxiety disorder or depressive disorder, 13.3% who reported having started or increase substance use to cope with stress or emotions related to COVID-19, and 10.7% who reported having seriously considered suicide in the preceding 30 days.
“(COVID’s) weighing on pretty much everyone’s mind, even though it’s often not the stated reason for the referral,” said psychologist Robert Carey, director of adult outpatient psychiatry at UMass Memorial Medical Center. “For the past six months it’s been one of the top stressors that people are facing once we get in depth with them.”
Carey said that it is not clear whether referrals are up – the clinic is “always busy.” But he said that the pandemic is affecting people “at multiple levels.”
“Anxiety is probably the most obvious thing, and depression,” Carey said. “Sometimes it’s more indirect because people’s routines and schedules have been so disrupted: changes in sleep, alcohol use, food intake, limits in exercise options, all contribute.
“It’s a challenge for any one of us to reinvent our routines in a positive way,” Carey continued. “Then there is the worry of infection – with friends and family being infected and some even dying, that’s a huge stressor.”
He added that social justice issues have also emerged as a key stressor during this time.
The pandemic’s endurance and possible resurgence also add concern.
“Over the next 12 to 18 months things in terms of mental health may be harder than thus far,” said Kathleen Marchi, executive director of Samaritans.
Samaritans runs a 24/7 statewide crisis hotline, and Marchi reported an almost 50% increase in call demand and a 74% increase in texts this March compared with March 2019. Overall this year, calls are up 30% and texts up about 70%, Marchi said.
Anyone in need can call or text (877) 870-4673 for help, Marchi said.
Marchi said that, although they don’t collect data on callers’ concerns, they are still hearing themes of COVID, the pandemic, stay-at-home orders, as well as about relationship challenges, drug and alcohol abuse, anxiety or depression. In May, there were additional concerns of George Floyd and police brutality, Marchi noted. In January, the organization received roughly 960 texts; in May, they received 1,700, she said.
And while there have been other times of high stress – for example, 9-11, and the Boston Marathon bombings – these have been intense albeit relatively short events compared with the pandemic, Marchi said.
“This is a really long, sustained period of stress on people, and the financial impact with it may very well lead to more mental health concerns and more people who are desperate and despairing,” Marchi said.
Interestingly, one place that hasn’t necessarily seen a big spike in referrals is Spectrum Health Systems Inc., which provides addiction treatment services statewide.
That’s a concern.
“With substance-use disorder really being a disease of isolation, if you stop social gatherings, or weddings or all of these things where family comes together and might notice that you need assistance … we could be creating the situation where isolation may cause (a substance-use disorder sufferer) to go back to using,” Sherry Ellis, chief operating officer of Spectrum, said.
Moreover, Ellis noted that methods of successfully treating substance-use disorder often involves a social setting or a social relationship.
“The other thing that worries me is the social isolation and that people who do use usually have others they use with and some safety nets when they use with one other person,” Ellis said. “My biggest fear is that if you’re isolated and alone and use, the overdose rates and fatality rates connected to overdose may shift again. We did a great job with training use of Narcan … but if more and more people are alone, isolated and using alone, what are the numbers going to look like?”
The latest statewide data on opioid-related overdose deaths goes up to March and doesn’t cover much of the pandemic.
But among the uncertainty, supporters have adapted to help.
Spectrum developed a hospital unit where it could treat substance-use-disorder patients who also had COVID-19, for instance.
Both Spectrum and UMMC also reported a greater use of telemedicine and praised its flexibility and accessibility.
“Kind of ironically, the telehealth option has made it easier for patients to access care because they don’t have to get here,” Carey said. “So the no-show rate is at an all-time low, it’s a minor silver lining.”
Ellis concurred, noting that group meetings and support sessions are now more available to rural residents and people anxious about leaving their home, whether due to general anxiety or the pandemic.
Most importantly, supporters stressed that help was available. And they understand the need.
“A variable has been added to people’s lives and it’s just come out of the blue,” Carey said. “Life was challenging enough before COVID for most people.”