An epidemic within the pandemic

The many stressors brought on by the coronavirus pandemic have led to increased substance use, mental health issues, and disordered eating behaviors. Experts predict that the pandemic may lead to an increase in deaths of despair, a term for early deaths among young and midlife Americans, from suicide, drug overdoses and alcoholism. (Dreamstime/TNS)
The many stressors brought on by the coronavirus pandemic have led to increased substance use, mental health issues, and disordered eating behaviors. Experts predict that the pandemic may lead to an increase in deaths of despair, a term for early deaths among young and midlife Americans, from suicide, drug overdoses and alcoholism. (Dreamstime/TNS)

Credit: TNS

Credit: TNS

At a personal level, it is important to view mental health issues resulting from the pandemic as a normal reaction to a completely abnormal situation.

On March 11, we passed the 1-year anniversary of the World Health Organization declaring COVID-19 a global pandemic. Immediately the world changed, and billions of people began to shutter and socially isolate. In March of 2020, over 316 million Americans, 96%, were quarantined.

We are well aware of the physical toll on lives here in the U.S. caused by COVID-1,9 which has killed over 530,000 and sickened more than 29 million as of March 11. Today, as the pandemic continues, the mental health issues are reaching epidemic proportions. The mental health epidemic will likely be with us long after the virus has been tamed.

The mental health toll from the COVID-19 pandemic cannot be ignored or underestimated. Dr. Arthur C. Evans Jr., CEO of the American Psychological Association (APA), stated, “We’ve gone through a collective trauma.” Its immense importance is emphasized by Surgeon General Dr. Vivek Murthy, who earlier vowed that if confirmed, “my focus … will be on COVID, on mental health and substance use disorder.”

Most, if not all Americans have been grappling with changes to their mental health over the last year. The impact of fear, anxiety, loneliness, social isolation, financial worries, boredom, trauma, change in routines at work and home, grief and loss, and an ongoing sense of uncertainty has affected everyone’s emotional well-being, resulting in chronic stress and various mental health conditions.

DR. JANET COX
DR. JANET COX

Credit: contributed

Credit: contributed

Reportedly, the most common mental health problems therapists are seeing because of the pandemic are depression, anxiety, grief, trauma and early signs of PTSD, panic and agoraphobia, substance misuse and dependence, eating disorders, and compounded mental health issues.

Mental Health America screened 315,220 people for anxiety between January and September 2020 and found a 93% increase from the total anxiety screenings in 2019. At the same time, depression screens showed a 62% increase over the 2019 total number for more than 530,000 participants. The Substance Abuse and Mental Health Services Administration (SAMHSA) reported that, in 2019, there were an estimated 51.5 million adults in the U.S. with an Any Mental Illness designation, or 20.6% of all U.S. adults. It is reasonable to expect this statistic to increase for 2020 and beyond.

The APA in their October 2020 report, “Stress in America 2020: A National Mental Health Crisis,” issued a warning about the impact of stress events on long-term physical and mental health.

Key findings in their most recent survey, conducted by The Harris Poll, found that, since the beginning of the pandemic, 61% of adults reported experiencing undesired weight changes and 2 in 3 Americans, or 67%, said they are sleeping more or less than they wanted. Nearly half of Americans, 47%, said they delayed or canceled health care services and nearly half of parents, or 47%, said the level of stress in their life has increased.

Essential workers were more than twice likely as those who are not to have received treatment and been diagnosed with a mental health disorder. Black Americans were most likely to report feelings of concern about the future, and Gen Z adults, at 46%, were the most likely generation to say that their mental health has worsened.

It is well-documented that we had a substance use epidemic long before COVID-19. Prior to the pandemic, more than 20 million people in the U.S. had a substance use disorder, and approximately 2 million will receive professional treatment in a given year. The pandemic has been hard on both those who already had a substance use disorder, as well as those at risk of developing one.

The latest figures from the CDC state that fatal drug overdoses nationwide have surged roughly 20% during the pandemic, killing more than 83,000 people in 2020.

Millennium Health, a national laboratory service, saw a 32% increase for nonprescribed fentanyl, 20% increase for methamphetamine and 10% increase for cocaine from mid-March through May of last year. So far, alcohol sales have risen by more than 25%.

Experts and critics agree that as a nation we were unprepared for the COVID-19 pandemic on many levels. Likewise, we are unprepared for the mental health epidemic happening now and for years to come.

We don’t know the long-term effects of collective, sustained grief and trauma. We do know from longitudinal studies that survivors of Chernobyl, 9/11, and Hurricane Katrina show elevated rates of mental-health problems, in some cases lasting for more than a decade.

. It is also okay to not be okay. Acceptance of what has been and is still happening is a way to build resilience.

Proper self-care is critical during these times and involves the physical, mental, emotional and spiritual. If mental health issues are interfering with your quality of life, reach out for professional help.

At the family, community, city, state and national levels, solutions are key. They include solutions to integrate mental health care into primary care, to increase insurance for mental health care, to improve access to mental health services, to invest in early mental health screening in our K-12 educational system and provide mental health counseling to our kids. Also needed now is to expand prevention and treatment for substance use disorders, remove disparities and barriers to receiving mental health treatment and training more mental health providers.

Immediate action must be taken to address the mental health epidemic affecting all of us.

Dr. Janet Cox, Ph.D., is clinical/program director with Synapse LLC, and is a clinical psychologist licensed in Georgia.

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