For the first time in my life, I’ve started seeing a therapist. My mental health had never seriously affected my day-to-day functioning before this year, even when it took a hit in 2019 after an immediate family member was diagnosed with late-stage cancer. But in 2020, the addition of COVID-19 means anxiety and hopelessness now take a starring role.
I, of course, am not alone. The pandemic’s psychological effects on the general public, essential workers and coronavirus survivors are similar to those of large-scale disasters, when depression, post-traumatic stress disorder and anxiety spike. This also happened a year after the 2003 SARS outbreak. Being quarantined contributes to adverse mental health outcomes.
Further, in the United States, the pandemic isn’t the sole contributor to the poor mental well-being of Americans. The country’s political turmoil has elicited distress in many marginalized groups. For the Black community, police brutality and the microscope on racism can negatively impact mental health.
Americans’ symptoms of deteriorating mental health haven’t improved from May to August 2020, according to a recent COVID Response Tracking Study poll from the National Opinion Research Center.
So, what will people’s mental health look like by the end of the year? What challenges will we face? Are there any positives? In honor of World Mental Health Day, we asked therapists to share their thoughts:
People will experience grief and loss in ways we haven’t had to contend with before.
Ever since our sense of normalcy has been upended by COVID-19, people have experienced astounding loss and grief ― even if they may not recognize it.
People are not only grieving loved ones who have died, but also the loss of jobs, special events, travel plans and routines. Sima Kulshreshtha, a mental health therapist in Seattle supporting Therapy Aid Coalition, said she anticipates grief will rise each time individuals encounter an aspect of their lives that cannot look as it did pre-pandemic.
Stress will rise as some follow restrictions and others don’t.
“By this point, people know what to do to be safe and are making decisions for themselves around risks that they’re willing to take,” Kulshreshtha said.
But seeing those who aren’t following proper health and safety guidelines can cause psychological harm. For example, observing family and friends acting in an unsafe manner can evoke particular stress if you are an essential worker doing all you can to protect your loved ones from the virus, Kulshreshtha said. There may be conflict about what is safe when it comes to social or family gatherings.
People could become even more burned out.
Ashley Ertel, a therapist at Talkspace, said she’s concerned about the well-being of health care workers, who may be burned out due to the demands of their jobs. Ertel said they are likely sacrificing downtime, relationships or other calming parts of their lives to fight the coronavirus.
Those with school-aged children also face an extra stressor. Christina Hong Huber, a postdoctoral psychology resident and therapist at Arlington/DC Behavior Therapy Institute, is concerned about the stress parents will carry from having to monitor their children’s virtual learning while working. Meanwhile, parents who had already been looking after their children full-time no longer have kid-free hours anymore.
Students may also face a unique emotional toll.
Akeera Peterkin, a licensed clinical social worker and owner of Amani Nia Therapeutic Services, worries about young adults’ lack of socialization from not being in school or on campus.
Socialization assists in identity growth and identity realization and is a way for young people to manage stress, Peterkin said. A lack of proper outlets or resources through school and being around peers may hurt their emotional growth.
“They might feel hopeless, helpless or overthink,” Peterkin said. “They might try to control every little thing. Some may not be as vulnerable with others ― not opening up or asking for help as much ― to try to create a sense of safety for themselves.”
Rates of depression may increase.
Experiencing ongoing, prolonged difficulties ― like what’s happening with the pandemic ― can increase a person’s risk of depression, according to research.
“Having interrupted routines, being stuck at home and having fewer distractions have led to increased attention to and rumination on negative thoughts and feelings,” Hong Huber said. “The sense of isolation can contribute to an increase in depressive and anxious symptoms, and the associated social withdrawal can maintain this distress.”
Anxiety will likely also increase.
Many people are feeling extreme anxiety due to this year’s unpredictability, fear of COVID, police brutality and social injustice, a lack of leadership and more. That’s likely to continue through the rest of 2020, Peterkin said.
Peterkin is particularly concerned about the last few months of 2020, as the holidays can bring additional anxiety around family gatherings and gift-giving, especially if people have lost their jobs.
“We also have a very big election year, so the holidays might bring up a lot of political discussions or separation from family members depending on political views,” Peterkin said.
Essential workers who aren’t in health care may also be anxious about their own well-being. Kulshreshtha said restaurant workers or retail employees might distrust their employers if they’re not taking COVID-19 as seriously as they did at the beginning of the pandemic.
Those working in health care face a different challenge. They may be overwhelmed as more people get sick in the winter thanks to the flu and other illnesses on top of COVID-19.
Finally, Kulshreshtha anticipates anxiety will increase if pandemic restrictions are eased ― whenever that may be ― as people worry about re-engaging in social situations that they have always found stressful, such as work meetings or being in public spaces, or getting back into a routine where there is a possibility of exposure.
The colder months could contribute to mental health struggles.
“For some, extreme weather can exacerbate mental health difficulties and contribute to a sense of gloominess,” Hong Huber said.
Each year, as the weather turns with the coming of fall and winter, at least 5% of Americans experience seasonal affective disorder and approximately 14% experience milder winter blues. A decrease in people socializing with others outdoors, which is one of the ways individuals are coping with the pandemic, may make this issue worse.
Some people may develop post-traumatic stress disorder.
Being surrounded by constant trauma places people at a higher risk for mental health troubles, Ertel said. “And for some people, that could develop into acute stress disorder or even PTSD,” she added.
This is especially true for those working in the medical field fighting COVID-19 and those in the Black community dealing with continued social injustice and police brutality. But it’s also a risk for many people just living through this pandemic. Peterkin added that when it comes to trauma, the system becomes overloaded with stressors, and that can become overwhelming.
“The body tends to respond in a hyper-vigilant way,” Peterkin said. “Either individuals will want to protect themselves and create a sense of safety and control, or they feel like they don’t have the ability to control or feel safe. It is those who tend toward the second response that often display symptoms of PTSD.”
These symptoms can include emotional numbness, persistent avoidance of reminders of the trauma, difficulty sleeping and concentrating and feeling jumpy and irritable.
The return of some certainty may help.
“Now that we’re realizing the vaccines won’t be ready until probably next year and the virus will be around at least until next year, there’s a little more certainty that allows us to feel a little bit more prepared for the second half of the year,” Hong Huber said.
Additionally, we know what to expect when it comes to possible lockdowns and what we need to do to stay as healthy as possible. That can make the pandemic feel a little more certain than it did when it started.
By the end of the year, Kulshreshtha also anticipates that people who may not have connected with others virtually at the beginning of the pandemic will come to rely on it more, which may also help improve some mental health outcomes.
More people will consider therapy to improve their well-being.
Throughout the year, “folks who are more financially and socially privileged have had more time, motivation and commitment to use this period to work on themselves, their families and partners,” Hong Huber said.
More individuals and couples have been attending therapy regularly to learn how to manage mental health issues, and that’s likely to continue. You’ll likely see less of a stigma — finally! — attached to seeking professional help.
Peterkin said resilience will also be key to positive mental health outcomes. Therapy and other professional resources can help with that.
Communities may become more connected.
Peterkin said there is one notable silver lining of 2020: It has taught people how to maintain connections with loved ones, have honest conversations about issues like systemic racism, and lend a helping hand to strangers.
“These can help us come to the end of 2020 as a stronger community, and that can help people feel more connected, although we are taught to socially distance,” she said. “This will be helpful when it comes to our mental health.”