MIAMI – As we conclude Mental Health Awareness month, many individuals feel hopeful at the same time they feel exhausted.
Many are reporting how difficult it is to even get out of bed and face the day, but they are reporting a loss of interest in plans, a sense of slowness, disrupted sleep patterns, and, perhaps most pervasively, a constant mental fog.
Image credit: Free-Photos from Pixabay
These symptoms have been reported among those who have had COVID-19 – a lingering collection of symptoms that have become known as “Long Covid.” However, the current exhaustion is being reported among individuals who never had COVID-19.
The fog is sufficiently prevalent that it is being talked about. It comes up in conversations in the workplace between friends and even among physicians, psychologists, nurses, and mental health providers. At the same time, it is often cast aside as a temporary condition and a little show of resilience will help us all power through.
That remedy is not working, and neither is downplaying of the condition. A colleague psychologist mentioned to me in a recent meeting, “We need to start by honoring that the exhaustion is real.”
Exhaustion is an actual condition, one that is not just simply feeling tired. Exhaustion challenges the limits of our mental and physical health. It is not a mental or emotional disorder either. It can have physical causes, but it also needs to be understood as a valid and real experience.
My colleague went on to add that “telling people they are just tired when they feel exhausted invalidates their experience and adds to the stress.”
Indeed, and the cause is likely to be stress. It is also a very normal reaction to an exceptionally abnormal year.
The American Psychological Association released a survey of Americans a few months ago where they reported that 76% of respondents characterized the coronavirus pandemic is a significant source of stress.
Long periods of stress also unmask other underlying mental health issues that were previously managed. A recent study by the Center for Diseases Control (CDC) showed that the pandemic exposed many of those mental health issues.
The CDC found that “During August 2020–February 2021, the percentage of adults with recent symptoms of an anxiety or a depressive disorder increased from 36.4% to 41.5%, and the percentage of those reporting an unmet mental health care need increased from 9.2% to 11.7%. Increases were largest among adults aged 18–29 years and those with less than a high school education.”
A separate study published by the Kaiser Family Foundation (KFF), a nonprofit organization focusing on national health issues, almost concurrently also noted that women and communities of color endured the most adverse mental health consequences of the pandemic.
The researchers wrote that “Research during the pandemic points to concerns around poor mental health and well-being for children and their parents, particularly mothers, as many are experiencing challenges with school closures and lack of childcare. Women with children are more likely to report symptoms of anxiety and/or depressive disorder than men with children (49% vs. 40%). In general, both prior to, and during, the pandemic, women have reported higher rates of anxiety and depression compared to men.”
The KFF report also noted that the “pandemic has disproportionately affected the health of communities of color. Non-Hispanic Black adults (48%) and Hispanic or Latino adults (46%) are more likely to report symptoms of anxiety and/or depressive disorder than Non-Hispanic White adults (41%). Historically, these communities of color have faced challenges accessing mental health care.”
Dr. Joshua Gordon, the Director of the National Institute of Mental Health (NIMH) noted that the scientific community has learned a great deal about mental health during the pandemic and added that there was good news in the early data.
He wrote, “Early in the pandemic, there were concerns that suicide rates would increase. So far, data from the CDC suggest that overall suicide death rates have remained steady or have even fallen during the pandemic.”
Gordon also added that the pandemic increased public awareness of mental health symptoms and services, including how to access crisis intervention services.
Research published this week in the Journal of the American Medical Association supported those findings.
“They went down, and they went down dramatically at the peak of the shelter in place period,” said Dr. Jeremy Samuel Faust, a co-author of the research letter and a physician in the Division of Health Policy and Public Health at Brigham and Women’s Hospital in Boston. “In April we had a 16% decrease of suicides, and that’s the time when most of the country was shut down,” he said.
The combination of findings also suggests that awareness of mental health increased during the pandemic, including how to recognize mental health issues and get help for them. They also suggest that a shared challenge and response – that is a shared purpose again the pandemic – may have also been protective.
However, emerging data now suggests that later in the pandemic the news may not be so great. Individuals suffering with schizophrenia, for example, have been nearly 10 times more likely to contract COVID-19, and almost 5 times more likely to die from it when compared with individuals who do not have a mental illness.
Gordon added that “deaths due to opioid overdose rose substantially in the context of the pandemic. These data remind us that we need to work hard to address long-standing disparities and ensure access to life-saving medical and psychiatric care is available for all Americans.”
But even with some of the pandemic’s direct effect abating in developed countries because of vaccination, the KFF study also noted lingering and broad-reaching effects that may last for some time.
For example, KFF noted that “any people across the country have experienced job or income loss, which has generally affected their mental health. Adults experiencing household job loss during the pandemic have consistently reported higher rates of symptoms of anxiety and/or depressive disorder compared to adults not experiencing household job loss (53% vs. 32%, respectively).”
KFF also noted the disproportionate effect the pandemic had on essential workers like health care providers, grocery store employees, and mail and package delivery personnel. The KFF analysis “found that essential workers face additional challenges, including difficulties affording basic necessities as a result of the pandemic.”
The research findings underscore the conversations happening from workplaces to dinner tables to covens. The pandemic is not over and its effects may carry on in various ways.
One grocery store worker in Miami who says she is Catholic but practices folk magic and goes by Luz said in Spanish, “The pandemic has told me most people see me as disposable.“
Gordon stated, “The mental health impacts of COVID-19 continue. From all that we know, it is clear these impacts will outlive the pandemic itself.”
A woman overheard me as I asked Luz a question and interrupted “not disposable – we’re expendable.” She asked her name be withheld, She said she worked in janitorial services for a local firm. She said, “I’m as fatigued as I am angry. I have to work because I need the money; and because I need the money, I was denied the choice to be safe. That hurt, that fear, that will never go away.”
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