Back in March, as the coronavirus began picking up steam in Georgia, Sarah Summers and her family put a plan in place: Cease all playdates. Cancel gatherings with friends. Limit outings.
The nine weeks left in the school year, when the East Cobb mother would have to find lessons and activities to keep her three school-aged children occupied, “seemed like an eternity,” she said. But, she told herself, just get through the next few months and slowly life would return to normal.
But, with another school year quickly approaching, that has yet to happen. The pandemic rages on. COVID-19 infections are on the rise. And even those who aren’t ill with the virus are feeling the effects.
Credit: Contr
Credit: Contr
Experts say many Americans are experiencing unprecedented levels of stress, trauma and grief brought on by the pandemic. Not only have lives been upended, but the mechanisms that people use to cope with adversity — like surrounding themselves with family and friends, turning to church, or distracting themselves with activities like sports — are off-limits or greatly altered.
And no one knows when it will be over. “In the beginning, I thought we knew the end,” Summers said. “But now we don’t know there will be an end.”
These days, Summers struggles to fall asleep. Sometimes, her heart races as she thinks about what the future might hold.
That’s not surprising, said Alyza Berman, an Atlanta psychotherapist. “When you know the end date, you know how to work within those boundaries,” Berman said. “When you don’t know when it’s going to end, it’s hard to remain healthy and mentally and emotionally stable.”
Nearly 90% of Americans are experiencing one or more symptoms of post-traumatic stress, such as recurring nightmares, irritability, anger and fear, according to the preliminary results of a Case Western Reserve University study.
Credit: Curtis Compton
Credit: Curtis Compton
About 27% of respondents met the criteria for a diagnosis of post-traumatic stress disorder. To put that in perspective, normally 5.3% of the general population is estimated to suffer from the disorder and 7.6% of military service members deployed in Afghanistan and Iraq, said Megan Holmes, associate professor of social work at Case Western Reserve.
“There are concerns that this coronavirus pandemic could cause emotional trauma and PTSD at a level we’ve never seen before,” said Holmes, who is also founding director of the Center on Trauma and Adversity at Case Western Reserve. “There’s grief and loss, and not just the loss of life, but a loss over having less of a connection among people and a loss of the life we lived before.”
The American Psychological Association’s annual Stress in America poll, which was conducted in April and May and focused on the impact of COVID-19, found 7 in 10 Americans say the economy and work are a significant source of stress. Roughly the same number of people cited the disruption of the lives of children and managing online learning.
The psychological fallout from the pandemic is affecting people of all ages. Older adults are often isolated from their loved ones, making loneliness especially common.
‘Over it'
Berman, the founder of the Berman Center, an outpatient treatment center in Atlanta, is booked through mid-August. Her phone has been ringing incessantly since March.
Early on, she said, some of her clients, particularly adolescents, welcomed the break that the shutdowns brought. Instead of powering through overscheduled days, they got more sleep, more time with family and more time to just “be,” she said.
But now, “they are over it. They miss their friends, and anxiety and depression are coming back. And now there’s this fear of the unknown,” Berman said.
She’s seeing people who have never sought therapy before.
“One client says, ‘I’ve never had a rapid heartbeat, and I am having crying spells for no reason. What is going on with me?’” said Berman. “The truth is, this all happened so fast and so intensely, we couldn’t prepare. It’s like, one day you have a house and then you have a hurricane and you have to figure out how to cope with it fast.”
Berman, a therapist for about 15 years, said she can relate to her clients’ emotional challenges. She’s been feeling it, too.
“For my new clients, I am not going to label anxiety right now. It’s a situational thing, and there is no diagnosis right now. It’s just what it is,” she said. “I get it. We all get.”
Credit: JOHN SPINK / AJC
Credit: JOHN SPINK / AJC
Suicide risk rises
Some experts are saying the wave of new stressors could be a “perfect storm” when it comes to the risk of suicide.
It will take time before the actual impact on the nation’s suicide rate is known.
Even so, “absolutely, without a doubt, there is a heightened risk,” said Nadine Kaslow, an Emory professor of psychiatry and behavioral sciences. Kaslow is leading an effort to provide mental health support to front-line health care workers and the public.
“You have multiple things going on together,” she said, listing a wide range of economic and emotional stressors combined with other factors, such as increases in substance abuse and gun sales.
Her department has already handled more than 550 telehealth appointments, and Kaslow said there’s a recent rise in appointments with the number of cases of COVID-19 surging again.
The Georgia Crisis and Access Line has seen a slight uptick in calls in recent weeks. Meanwhile, another call-in service has been started for Georgians who aren’t in crisis but need to talk. Georgia COVID-19 Emotional Support Line has fielded about 660 calls so far.
Callers include young adults starting college or trying to enter the workforce to parents of school-aged children and older adults living alone.
Experts say people should try to focus on what they can do, not what they can’t do.
It’s important for people to be able to look forward to fun activities and outings, Kaslow said. She and a friend recently went on a scenic drive and enjoyed a picnic on a pretty spot near the side of a road. She also hosts physical distanced get-togethers.
“It’s good to figure out things you can put on the calendar and recognize you are not alone in this,” Kaslow said.
Berman pointed to drive-by birthday parades and picnics where people can keep a safe distance as creative ways to celebrate and connect.
“People thrive off human connection,” she said. “It may need to be one person or 10 people, but what I tell my clients is, find someone in your life you can talk to.”
Phillip Burgess, 75, is the primary caregiver for his wife, who has Alzheimer’s. It’s a never-ending, draining job, and he misses the emotional support he found in going to church and seeing friends, many of whom live in nursing homes and aren’t allowed visitors. Mostly, he stays in his Lawrenceville home and that’s taking a toll.
The pandemic has been distressing for his wife, who struggles to understand the changes in their routine. When she was recently hospitalized for a brief time, he was unable to be by her side because of visitation restrictions.
“I know I internalize more than I should,” he said. “People compliment me on my smile and my laugh – I probably do that to keep me from crying.”
Alison Belgrave, a single mom to two children, ages 3 and 5, felt enormous stress on the job and caring for her young children.
“My kids were abruptly pulled out of their routine, and I felt like I was expected to work as usual,” said Belgrave, who is the director of business operations at Emory’s Advancement & Alumni Engagement. “Kids can get antsy, and they need so much attention. It’s not their fault. They want to get out and play and go on vacation. Normally, every Friday, we would go to Wal-Mart, and I would let them pick out a toy. We haven’t even been able to do that.”
She said she tries to take breaks throughout the day and stop at about 5:30 p.m. to be with her children. But, in order to get her work done, she gets back on the computer after her children go to bed and sometimes works until 2 a.m., or even later.
“I don’t think I’ve ever worked this hard in my life,” she said.
She’s taking advantage of an employee assistance program that provides access to licensed therapists.
In the past few months, she’s met with a therapist three times over Zoom.
They’ve discussed coping techniques, including deep breathing exercises and mindfulness. It’s helped, she said.
“I can’t get with my girlfriends and laugh at the top of my lungs, but I can do deep breathing exercises,” she said.
COPING STRATEGIES FOR THE COVID-19 PANDEMIC
J. Kip Matthews, an Athens psychologist, and Nadine Kaslow, an Emory psychiatrist, gave the following tips for coping with the COVID-19 pandemic:
- Maintain a schedule or routine.
- Try to focus on what you can do, rather than what you can’t do.
- Keep a gratitude journal
- Get outside and try to enjoy nature
- Connect with others virtually
- Limit your media intake of COVID-19 coverage.
- Don’t be afraid to get help from family, friends or religious leaders. The Georgia COVID-19 Emotional Support Line, 866-399-8938, is available 8 a.m.-11 p.m. for those who need to talk. For those in crisis, call 1-800-715-4225. It’s staffed all the time.
- Try to eat a balanced diet and get regular exercise and consistent sleep. Limit alcohol intake.
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