Mental health issues are not just a serious concern for struggling individuals but also for communities and nations at large. Ashok J Bharucha, a psychiatrist from Lackawanna County, PA, believes that mental health at a population level is an important indicator of a nation’s well-being, and reflects the priorities of those in power to effect positive change. With so many individuals currently affected by COVID-19 (coronavirus), we must consider how this pandemic has impacted the already limited mental health services of society as a whole.
Mental Health is unquestionably one of the most neglected areas of health globally. This was true before COVID-19 (coronavirus), but the pandemic has further exacerbated the mental health and social well-being, especially among those who are very young, very old, or medically frail. Treatment of mental illness requires time, patience, and a multimodal approach that combines psychosocial and pharmacological interventions. Just as a person cannot “snap out” of a physical illness, the same holds true for mental illness.
Mental health across the globe has been greatly compromised due to COVID-19 (coronavirus) over the past two years. Rates of anxiety and depression are skyrocketing, while the trauma associated with multiple losses and tethered social bonds also adds to varied forms of mental and physical distress. To complicate matters, the stigma associated with mental illness often prevents individuals from seeking out effective treatments that could greatly ameliorate their problems. Such help avoidance behaviors diminish hope for a brighter future and give rise to despair in the present moment. Some examples of the types of mental distress experienced over the past two years are presented in the following discussion.
The most common mental illnesses, anxiety disorders, are characterized by fear, dread, worry, tension, unease, and a range of physical symptoms. These feelings can be sufficiently intense to interfere with a person’s day-to-day activities. Ashok J Bharucha explains that anxiety disorders can manifest in different forms, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder, and obsessive-compulsive disorder (OCD).
Anxiety disorders are highly treatable but early recognition and management is key to longer term benefits. Unfortunately, due to the stigma attached to mental illness, a vast majority goes undiagnosed and untreated. Multiple interacting stressors since the onset of the pandemic (working from home, childcare, COVID-related illness, loneliness, etc.) likely contribute to the increased rates of anxiety.
Ashok J Bharucha cites depression as the leading global cause of illness-related disability. It is characterized by feelings of sadness, hopelessness, and inability to experience joy/pleasure, along with disruptions in sleep, appetite, energy, and focus. Untreated, a bout of major depression typically lasts about 9 months, and the risk of the condition becoming chronic increases with lack of treatment. Depression is well-known to adversely affect physical health, and greatly increases the risk of suicide. Many of the previously cited stressors also contribute to the risk for depression.
Stress is an expectable response to challenging situations, however, Ashok J Bharucha states that it can become a serious problem when it persists for long periods of time. Stress is highly correlated with a host of physical and psychological problems, including anxiety, depression, and chronic pain.
An inexhaustible list of stressors has complicated people’s lives since the onset of the pandemic. These include: altered work arrangements, loss of employment, lack of child care, COVID-related illnesses, social isolation, financial difficulties, and having to care for ill relatives, to list a few.
General Strain on Society
The pandemic has had a profound impact on society as a whole. In addition to the physical and psychological effects of the virus, the lockdown measures and social isolation have taken a toll on people’s mental health. The adverse mental health effects of social isolation and loneliness are well documented and have been highly prevalent during the last two years.
Panic disorder is characterized by sudden and repeated episodes of intense fear. The fear can be so overwhelming that it interferes with a person’s day-to-day activities. Individuals with panic disorder often worry about experiencing another attack and frequently avoid places, situations, or activities that they believe may trigger another attack. Not surprisingly, panic attacks have been more prevalent over the past two years as well.
Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is a condition that can develop after exposure to a traumatic event in which the safety or security of an individual is seriously threatened. PTSD is characterized by intrusive thoughts, flashbacks, and nightmares about the event. Avoidance of individuals, places, and situations that remind the individual of the trauma is quite prominent. In the event of an actual or imagined trigger, heightened physiological responses such as increased heart rate, sweating, etc. are noted. Moreover, a range of negative moods and cognitions that affect one’s sense of self and ability to feel positively about themselves and life emerge.
Eating disorders are characterized by a distorted view of weight and body image. This, in turn, leads to unhealthy eating habits that can have devastating physical and mental health effects. Eating disorders often contribute to or co-exist with other mental health issues such as depression or anxiety. The stress of the pandemic has increased rates of eating-disordered behaviors as well. Often, the dysfunctional behavior is an attempt to exert control over themselves where control over external circumstances is not possible. Needless to say, with a growing list of stressors that elude our control since the onset of the pandemic, individuals with eating disorders have struggled deeply.
The pandemic has had a profound impact on society as a whole, in addition to the physical and psychological effects of the virus. Many are doing their best to cope with a plethora of stressors that two years ago would have seemed unimaginable. Not surprisingly, the rates of mental distress have dramatically increased. To make matters worse, for many, the ability to access mental healthcare has also been adversely affected. Telehealth and other electronic platforms are substituting for in-person care, generally with high satisfaction ratings, but are not always a substitute for the human bond that is at the heart of any medical care. Indeed, the fraying of social bonds during the pandemic has been a critical part of the problem for many, and the persistence of COVID despite effective vaccines contributes to demoralization at the least, and despair at the worst. Despite these challenges, Ashok J Bharucha reminds us that mental illness is highly treatable, and early, proactive care can not only provide much needed relief, but also potentially prevent the condition from becoming chronic. Every effort should be exerted to seek treatment at the earliest.