Pandemic-related depression: Behavioral health experts available for interviews
Not-so unprecedented depression
COVID-19: Most of us haven’t experienced anything like this before and that is apparent in our collective reactions.
A survey study published in JAMA Network Open in September 2020 found that U.S. adults were reporting levels of depressive symptoms more than three times higher during the pandemic than before it took hold.
This tracks with historical pandemic behavior.
A study examining asylum hospitalizations in Norway from 1872 to 1929 just after the 1918 influenza pandemic found that the number of first-time hospitalized patients with mental disorders increased by an average annual factor of 7.2 in the 6 years following the pandemic.
What’s a normal reaction to a pandemic?
“A pandemic is a trauma, and there is no normal response to a trauma,” said Andrew Anson, MD, attending psychiatrist, Bridgeport Hospital, whose patient volume has grown this year and is seeing patients across a range of platforms, including virtual reality goggles.
Dr. Anson explains that our brains have a few pathways to cope with stress and that most people fall toward one end of the spectrum from dissociation to hypervigilance.
Dissociation: This is when the hippocampus, the emotional center of the brain, compartmentalizes traumatic memories. When it takes on too much people can become sleepy, unable to deal with emotions and unmotivated to participate in those Zoom happy hours. It could feel like a low-grade depression.
Hypervigilance: On the other end of the spectrum. The amygdala, the part of the brain that triages incoming information, may flag too many things as high importance, which can make someone jumpy or obsessive.
When all you want to do is sleep
If you are experiencing serious depression, please seek professional help. The National Suicide Prevention hotline number is: 800-273-8255.
There are mood-balancing steps people can take at home.
“Depending on where you fall on the spectrum, there are a few things you can do to help guide yourself back to middle ground,” said Dr. Anson.
Anson recommends people experiencing symptoms of dissociation find natural ways to restore dopamine such as coffee or caffeinated tea, exercise, reading or watching thrillers.
For people experiencing hypervigilance, Dr. Anson recommends massages, meditation, a pet and yoga.
In both cases, Dr. Anson recommends creating a routine for yourself and scheduling pressing tasks for when the presence of dopamine, a chemical that acts as a messenger between brain cells, is highest, usually early in the morning.
Dr. Anson also emphasizes that a healthy diet is essential for the body to create the neurotransmitters that can help restore mood.
Taking the wheel
“When someone is depressed they tend to focus on all the things that are not working,” said Charles Morgan, MD, chief of Psychiatry, Bridgeport Hospital. “Our job as mental health professionals is to remind people of when they have been through tough times and prevailed.”
Dr. Morgan uses the letters of COVID to give patients actionable ways they can strengthen their emotional reserves.
Create. “Channeling creativity facilitates positive neural connections. Use your cell phone to take pictures of things you pass by daily and crop them to see them differently.” Dr. Morgan himself has started singing lessons via Zoom.
Observe. Put your senses to work. “I grew wildflowers this year for the first time,” said Dr. Morgan. “The burst of yellow awoke my senses.”
Visualize. “Create images in your mind of having or doing whatever it is you want,” said Dr. Morgan. “I ask people with chronic illnesses to visualize themselves being disease free, but it could be anything. The goal is to see beyond your current circumstance.”
Individual. “Be you,” said Dr. Morgan. “Not anyone’s version of you. Take a break from whatever you are consumed with to sit with yourself without that element.”
Grab a buddy
Javier Alvarado, LCSW, director, Clinical Social Work, Yale New Haven Hospital, also served the U.S. Army and sees parallels between healthcare workers and soldiers.
“Just like soldiers, healthcare workers are on the front lines exposed to trauma and death with a lot of uncertainty. Both are expected to move forward and do their job,” said Alvarado. “The most important thing we teach soldiers for resilience is connection. We brought these lessons to Yale New Haven Health and they can apply to anyone going through a traumatic situation.”
“Pairing up with someone for regular check-ins around how they are eating, sleeping, handling work and family, protects us,” said Alvarado.
Alvarado practices this and checks in on his “buddies.”
Dr. Anson learned how to use TikTok and wrote a play for his nephews.
Dr. Morgan finds joy in seeing his patients in their 80s and 90s successfully navigating telehealth.
Which leads us to D.
Determination. “Be determined to get through this,” said Dr. Morgan. “Write down the challenges you face and your reasons for getting through this. Stick notes around your house with those reasons – it doesn’t have to be abstract.”
Dr. Morgan recommends giving back and modeling this determination for others.
“A phone call, a sign outside your home reminding people we are in this together. These things don’t cost much, but contribute to a sense of connection. No matter your circumstance, there is always something you can give.”
“To paraphrase the famous American psychoanalyst Eric Fromm, ‘it is possible for the individual to be sane even when society is sick.’ It's in these moments that he recommended things that allow us to work, build connection, be creative and find agency,” said Dr. Anson.