Coping with the other impact of Covid-19: mental health challenges

Mental breakdowns. Domestic violence. Substance abuse. Crippling depression and anxiety.

From a psychiatric standpoint our current challenges go far beyond coronavirus. Of course, Covid-19 is a big deal, but what will be left in its wake? We must also be focused on the pandemic’s mental health impact.

Research claims that so far, over half of U.S. adults have been affected psychologically because of this pandemic. Stress, anxiety and overall confusion are rampant through our communities as the virus continues to spread. How can we better understand this troubling consequence of Covid-19?

The source of our collective anxiety is actually trauma which we experience on a mass level. Similar feelings of helplessness and depression were prevalent after the Spanish Flu pandemic from 1918 to 1920. Many people died and lost loved ones while so many others survived but lost their livelihoods. The result was a mental health pandemic after the flu outbreak. Survivors of the disease itself suffered mental health issues, but it wasn’t only them. The entire population had become traumatized. Loss of focus, sleep problems, depression and anxiety symptoms were widespread. Aren’t there some striking parallels between then and now?

Trauma is devastating for those experiencing it; some people develop post-traumatic stress disorder or PTSD. Psychological damage from trauma can affect our lives and the lives around us, feeling like an insurmountable challenge.

The good news is that it’s quite possible to overcome trauma using what I like to call the “Three R’s.” It may sound a bit simplistic, but there is substance in these three ingredients.

The first and biggest “R” is “resilience.” Resilience is essentially “bouncing back” from challenges with a problem-solving attitude and a positive disposition. Cultivation of it is like a vaccine for your mental health in tough times. Some people have a natural capacity for it, and others may have to work at it, but I’m convinced everyone can create a pathway to resilience.

So how do we build this “resilience?” Through the other two “Rs” — “Routine” and “Relationships.”

A good routine can help anyone through a time like this. Many are stuck at home working (or not working), and the same goes with kids. Online learning requires discipline, setting aside time for work and study. It’s even true if you have to go back to the office or the kids are headed back to class. A routine of getting ready in the morning or washing your hands after coming home may keep you both safe and sane!

Daily structure fosters a sense of purpose which is always supportive of mental health. Using time management and a little creativity, this is a practice that can easily be done at home. As a routine crystallizes, we relax into new patterns. Familiarity, in this way, brings comfort.

Relationships are both an ingredient towards resilience and an end-goal in themselves. Being patient, kind and compassionate during a crisis can provide us with an emotional foundation. It has long been recognized in psychological circles that altruism feels good for the one giving.

Being at our best for loved ones and those around us builds a strong community of support. Humans need connection; kindness creates a better environment overall. This is particularly salient for parents, as children can be influenced by turbulence at home. And at the end of the day, aren’t relationships what our lives are made of? We flourish when we keep good relationships with our families, our friends, our partners, our peers and, of course, ourselves. The appreciation of these relationships can give us the strength to handle any crisis.

Remember, crises can end up bringing out the best in people. By managing a routine and caring for our relationships, we set the stage for personal resilience that can help us learn from our circumstances and become stronger. We know the tools for the job — don’t let these uncertain times set us off track!

Arthur Bregman, M.D. is a Coral Gables psychiatrist. As an early adopter of telemedicine, Dr. Bregman “sees” patients from South Florida and across the country. He served as clinical professor at The University of Miami Miller School of Medicine’s Department of Psychiatry for several years, training numerous psychiatric residents during that time. His expertise in child and adolescent psychiatry was instrumental when he served as Chief of Psychiatry for Nicklaus Children’s Hospital in Miami for more than a decade. Today, he and his practice of psychiatrists and therapists see many UM students who need mental health support during their college years (or beyond). Follow him on Facebook for his Sunday afternoon video discussion.