A secondary health challengeis sweeping the country due to a domino effect fromthe coronavirus pandemic, anti-racism protests and a recession: increased bouts of depression and anxiety.
Calls from across the nationto the National Alliance on Mental Illness helpline asking for help increased 65%between March and June.Additionally,Americans reported they are theunhappiest theyve been in 50 years, according to a COVID Response Tracking Study released Monday. The nation's future is a significant source of that stress for more than 80% of the country's adults,according to a report released Thursday from the American Psychological Association.
In the Coachella Valley, the Eisenhower Health behavioral health clinic has experienced an increase in demand for therapy appointments since the pandemic began, particularly with new referrals of first-time patients from other primary care physicians in the area, said Dr. Sam Elsanadi, Eisenhower Behavioral Health medical director.
Eisenhower Health was getting calls right and left at the start of the outbreak, Elsanadi said,and struggled to respond because the clinic was partially closeddue tostay-at-home orders. Eventually, the Rancho Mirage hospital expanded telemedicine options, whichmade it possible to accommodate the increase in appointment requests.
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The data tells us that people were experiencing high levels of anxiety and depression, said Dawn Brown, NAMI director of community engagement. They were reaching out for information around treatment and resources, but nearly all needed support, reassurance and encouragement.
For some, the experience of living through the current pandemic isstressful because it combines two difficult psychological states: high levels of uncertainty and not having control, said Kate Sweeny, a University of California-Riverside psychology professor who researches how periods of uncertainty can be damaging to well-being.
We have some control about our own risk of exposure to the virus, but we have no control over when the economy reopens or when we can go back to work, Sweeny said. It comes down to the fact that we just dont have control and we dont know what the future looks like.
"That is a very uncomfortable place to be on a deep fundamental level.
People are now experiencing chronic stress due the longevity ofthe pandemic thiscan result insickness and disrupted sleep.Individuals who had a history of anxiety and depression prior to the pandemic are more likely to have heightened reactions to these new chronic stressors than those who didn't grapple with mental health issues beforehand.
Additionally, sustained stress also is of particular concern for thosesuffering from systemic stressorspoverty, discrimination, lack of opportunitiesas they have fewer coping resources.
Our bodies response to stress gets spent out fairly quickly, Sweeny said. When the stress becomes chronic, it taxes our systems heavily and can create long-term disruption to our how system works in responding to stress."
Humans thrive on predictability, control and having a secure sense of safety, said Dr. Anita Chatigny, a psychologist atDesert Regional Medical Center in Palm Springs. When those are taken away, it jolts peoples sense of security, sending them into a hyper-vigilant search for it.
A lot of times when we dont have safety,"Chatigny said, "we lean in and explore the reasons we feel vulnerable.We are constantly ruminating about our vulnerability and constantly being reminded about the things we dont have control over.
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Common early indicators of depression are changes in sleep and/or appetite, Brown said.Anytime a persons daily life is being affected in a negative way, they should consider whats changed, Brown added. Additional signs of depression include persistent feelings of apathy, sadness, guiltand hopelessness that can lead to excessive crying, irritability or social isolation.
Anxiety can manifest as overreactive stress that is out of proportion to the issue, Brown said. This can result in restlessness, irritability, racing thoughts, excessive worry, fearand insomnia.
How can people copeas the pandemic continues?Experts recommend trying to reduce exposure to stressors. For example, setting a limit to the amount of negative news you consumeeach day by setting down your phone.Orusingthat energy to make a plan for how to address it.
If your stressor isfear of contracting COVID-19, you can make a mental checklist of the ways you've protected yourself, such as wearing face coverings in public and social distancing. If you haven't, you can start:Making a plan forprotecting yourself alsocan help alleviate anxious feelings.
Some distractions, however, do not effectively addressstressors, experts say.
People are typically bad at knowing the right kind of distractions, Sweeny said. People try to zone out, and that is not necessarily the best thing to do. Bingeing Netflix passes the time, but it is not captivating enough to take peoples minds off their most stressful worries.
Entering a blissful state of flow, Sweeny said, is a better alternative. Flow activities are ones that fully absorb the individual by doing something challenging where progress can be marked, such as a hard hike.
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Flow, mindfulness, seeking moments of awe, and thinking ahead to a positive future are all more productive coping strategies than just relaxing, Sweeny said, even though people might feel most drawn to plopping on the couch after a stressful experience.
People also should avoid self-medicating as a means of coping; substances like alcohol can trigger worse depression and anxiety, Elsanadi said.
People find it helpful to hear they arent alone, Sweeny said. If people are feeling weird or bad, there is a reason for that:This is a disruptive experience. It just feels bad to be uncertain and not around other people.
"Those feelings are totally reasonable and normal, and it is OK if you feel bad because it is a bad situation.
Tad Worku, an emergency room nurse at Loma Linda University Medical Center, recognized the fact that it can be helpful for people to know they aren't alone infeelingdepression and anxiety.
Worku, who previously worked a professional musician before turning to nursing, began writing and singing aboutthe profound impact ofhis experiences at work.Knowing he wasnt the only one at the hospital who mourned the loss of patients or grappled with complicated medical scenarios, the 33-year-old decided to start bringing his guitar to the hospital to help his co-workers cope with the trauma.
Tad Worku, previously a professional musician, now works at Loma Linda University Medical Center as an emergency medicine nurse. Palm Springs Desert Sun
The situations in the emergency room began impacting my mind, and my thought process led me back to music, said Worku, who has worked at Loma Linda for five years.
Then, the pandemic hit and the pressures on the emergency room increased.A new level of anxiety came fromcontinued unknowns, changing guidelines and a learning curve forunderstanding how the virus impacts peoples bodies.So, in mid-March,he and a few other colleagues launched a support group for nurses tocreate a safe space to talk about their experiences.
I was already reading lots of articles about the burden on health care providers, burn out rate, second victim syndrome and how we are not immune from it, Worku said. When COVID-19 hit in mid-March, you could almost notice it in the air in the health care setting. There was this additional pressure now that was impacting us.
"I wanted to create a platform to make sure we were taking care of ourselves as we took care of others.
Tad Worku in his music video "The Story."(Photo: Loma Linda University Medical Center)
Worku recallslistening to the screams of parents who lost a child, watching a drunk driver wake up only to realize they lost their best friend, and serving as bedside support while someone passed, all in the past five years.
Despite these trying and challenging situations, Worku tries to remain hopeful.
I have walked into countless situations that would emotionally challenge me and make me question a lot of things like hope, he said. But I didnt come into this environment to become jaded, and even though I am in an environment where I see some of the hardest things, I have to ask myself, how do I see the light past the darkness?
In his songs, he tries to answer his own lingering questions.
The lyrics to one of my songs say, I have seen life slowly fading away, but in everything I have seen, love remains, Worku said.
For many, the pandemictook away the opportunity for both group support and in-person counseling services. However,many providers have become more innovative in how they offer support to clients remotely through video chats. Telemedicine become more accessible after President Donald Trump approved Medicare to cover the services at the end of March.
In the past, telehealth has been available but not recognized as a mainstream approach to psychotherapy, said Chatigny, the Desert Regional psychologist. What they are finding now is that there are people in Northern California who can now treat someone in Southern California, so geographic barriers to care have lessened.
Additionally,Chatigny said individuals shouldn't confuse social distancing with social isolation, which can further bread feelings of depression. Individuals should also reach out to loved ones or others within their own support circle over the phone or through video chat as well.
If someone is experiencing suicidal thoughts, they should immediately call 9-1-1 or head to the nearest emergency room, Elsanadi said.An emergency room is fully equipped with doctors and social workers who are trained in this type of care.
Eisenhower Healthhas seen an increase inpatients experiencing suicidal thoughts, specifically inpatients who were already experiencing anxiety and depression prior to thepandemic.Elsanadisaid many of his patients said their feelings were triggered by concerns over their financial future.
People should pursue help and not hide (what they are feeling) or keep it inside, Elsanadi said. It might not go away on its own and it doesnt mean medication is the answer, but just talking with a counselor or psychologist could help, and with telemedicine now, people dont even have to leave their home now to do so.
Ifyou are experiencing symptoms of anxiety and/or depression that are persistent, becoming too much to bear, or impacting your ability to do common daily activities, Riverside County has a variety of resources for residents.
Riverside University Health System - Behavioral Health and the National Alliance of Mental Illness both provided The Desert Sun withlists of accessible resources for all.
Here's where to find help in the Coachella Valley:
Desert Sun reporter Nicole Hayden covers health in the Coachella Valley. She can be reached at Nicole.Hayden@desertsun.com or (760) 778-4623. Follow her on Twitter @Nicole_A_Hayden.
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