The pandemic and rolling lockdowns were hard on us all — and it brought the subject of mental health to the forefront. In today’s podcast, we examine mental and emotional wellness during COVID-19, how society is coping, and the long-term ramifications of these challenging times.
Dr. Ronald Pies: I think it’s important to focus on what you can control and not ruminate about what you cannot control and to take good care of yourself.
Jeffrey Freedman: Welcome to the RP HealthCast. Science. Innovation. Life. One story at a time. And I’m your host, Jeffrey Freedman.
It’s wonderful that mental health and mental wellness are topics that are now, openly discussed. I mean, just a couple of years ago, these topics were taboo. They were off the table, but the change actually began. There were several actors and artists that publicly talked about their struggles with addiction, with anxiety, depression, and suicidality. This started opening up public discourse about mental health.
Now, the full year of the pandemic and the rolling lockdowns were hard. They were hard on all of us. And it really brought the subject of mental wellness to center stage. I mean, for some of us, this pandemic led to isolation. For others, it was joblessness. And for many, there were issues surrounding childcare, adult care, and homeschooling. I mean, there are just so many challenges this year, that have severely affected the mental well-being of so many people around the country, and around the world.
So, here we are, one year after it all began. And in today’s podcast, we’ll discuss and explore where we are today with mental well-being, how society in general is coping and what are the long-term ramifications from the pandemic.
My guest today is Dr. Ronald Pies. Doctor Pies is the Editor-in-Chief Emeritus of Psychiatric Times. He’s also a Clinical Professor of Psychiatry at Tufts School of Medicine in Boston and he’s the Professor Emeritus of Psychiatry at SUNY, Upstate Medical School, as well as being a renowned psychiatric author.
Doctor Pies, thank you for joining us today.
Ronald: My pleasure. Thanks for inviting me, Jeff.
Jeffrey: Today, we’re going to be talking about mental health and wellness. This past year, has been difficult on all of us. But it’s been difficult in different ways for different people, and we all process these issues very, very differently. Now, we’re one year into the pandemic. Can you talk to us a little bit about how the pandemic affected our mental health and what are some statistics both here in the US and abroad?
Ronald: Well, first, thanks for inviting me to speak on this topic, Jeff. It’s an important one. And to answer your question, there’s good evidence that the pandemic has had adverse effects on mental health in many parts of the world. In addition, the pandemic has disrupted or even halted critical mental health services in something like 93% of countries worldwide. And unfortunately, at the same time, the demand for mental health services is increasing. So as far as the impact of the pandemic on mental health, let’s start with the United States.
Early on in the pandemic, the Center for Disease Control’s published a survey showing that in June of 2020, adults in the United States reported, and I’m quoting now, considerably elevated adverse mental health conditions associated with COVID-19, unquote. And using various screening instruments, the CDC survey found that almost 41% of respondents reported an adverse mental or behavioral health condition, including symptoms of anxiety disorder, depressive disorder, or trauma related symptoms, sometimes new or increased substance use, and thoughts of suicide. So that’s in the US.
As far as other countries, in the United Kingdom, a number of studies have found elevated rates of mood disturbance since the pandemic began. In one survey, 25% of the participants said that their anxiety and depression during lockdown had gotten significantly worse.
In Asia, there’s some evidence that maybe there are lower levels of distress in Asian countries. But in China, something like 35% of people were experiencing mental distress.
Jeffrey: All statistics considered. I mean, the pandemic brought about significant stressors. But let’s talk about the different age groups. So, different age groups have different issues and different problems; from children, to parents, to the elderly.
Ronald: Right. Well, there are actually some interesting age and gender findings, Jeff. For example, it’s a little counterintuitive, but most of the evidence suggests that the pandemic has affected older people’s mental health less severely compared with that of younger adults. But most of the data suggests that it’s the younger people who have suffered the most in this pandemic. Some people have speculated that as we age, we develop more resilience.
Just to touch on the age and gender issues. The Kaiser Family Foundation came out with a report in March of this year, finding that those hardest hit by the pandemic in terms of their mental health, have been younger people and women, including mothers with children under the age of 18 in their households, are among the most likely to report that stress and worry related to the coronavirus has had a negative impact on their mental health.
We also have data showing that among first-year college students, the prevalence of moderate to severe anxiety increased from 18% before the pandemic to about 25%, within four months after the pandemic began. And among these first-year college students, the prevalence of moderate to severe depression increased from about 21.5% to 31.7%.
So, we also have data from parents of teenage children. Researchers found that about 46% of parents of teens said that their child has been showing signs of a new or worsening mental health condition since the start of the pandemic, with teenage girls, more affected than teenage boys.
Jeffrey: Well, male, female, older, younger. I mean, it seems across the board, it’s pretty obvious that that these anxiety and stressors are there. So, what are some signs that people should watch out for to see if their mental health has become an issue? And when should they start seeking medical attention?
Ronald: Great question. Well certainly, anyone who’s experiencing symptoms of serious emotional or behavioral disturbances should seek professional evaluation, either by means of telemedicine, or in person, if possible, if it’s safe to do that. Some symptoms that I would worry about, would include feeling depressed nearly every day; the inability to carry out even simple activities of daily living like self-hygiene, showering, and so on; managing everyday chores; people who are experiencing consistently poor sleep, loss of appetite, significant weight loss, extreme or unrelenting anxiety, or panic attacks. All of these would be reason to seek professional evaluation and help.
Jeffrey: Yeah, and those are certainly the extremes before it gets that bad, right? If people are feeling anxious and stressed, before they go seek out medical attention, what can they do to self-correct without the medical intervention?
Ronald: There are a few things that are helpful. First of all, particularly for people who are kind of stuck at home, I would advise creating a schedule and a routine to structure their day. Don’t just stay in your pajamas or leggings all day.
I read an interesting quote from a young psychiatrist, actually third-year resident at UCLA, Dr. Anna Yap. Y-A-P. And she pointed out that as humans, we like to have something we’re moving toward and when we don’t even know when the endpoint of something is, which is true of the pandemic, how can we move toward that goal?
One way to counteract that feeling of just treading water, or killing time, is to change from your pajamas into clothes or moving from the bedroom to the living room to help you feel like you’re actually experiencing change during the day. These sound like very trivial minor things. But in my own experience, I think they can make a difference.
So my own recommendations for dealing with prolonged isolation and loneliness during the pandemic include first of all, exercise. Indoors or outdoors exercise is an excellent antidepressant. No side effects assuming that you’re in reasonably, good health.
And finally, finding ways of establishing some kind of community, whether that’s through Zoom sessions or phone calls or email. And of course, now as people are becoming fully vaccinated, it is becoming more feasible and safe for meeting with other vaccinated friends or family members. So that is, I think, a real positive that we’re seeing now, assuming we can keep these vaccination rates going.
Jeffrey: Now, has there been any other benefits for our well-being coming out of the pandemic or are we worse across the board?
Ronald: I would not say that we are all worse off in all respects. For example, there are people who clearly prefer working from home. It’s nice if you can do that, but of course, there are many people who cannot work from home.
There are also some interesting data from the UK and Portugal. Researchers there surveyed 385 caregivers, mostly mothers who had one or two children. And they found that as many as 48% of the respondents reported a renewed appreciation for their family during the pandemic. And specifically, the caregivers said that they were spending more time with their families and that this led to, as one participant put it, quote closer relationships and a better understanding of each other. So, that’s I think a plus for some people.
I’ll add that I’ve also seen some anecdotal reports suggesting that for some socially phobic or autistic individuals, the seclusion of the pandemic has actually provided kind of a safe haven in which they don’t have to face the social pressures they had to deal with before the pandemic. That may also be true for some kids who typically faced bullying or teasing in school prior to the pandemic. For some of them, the virtual schooling has actually provided a break from all that. So I wouldn’t say it’s entirely negative for everybody.
Jeffrey: Well, one year into this, we are starting to see the world opening up now with vaccines a little bit.
Jeffrey: For those people that have had this sense of anxiety or dread. And I don’t want to say the serious cases, where they needed the medical attention, but living through life. And their life has gotten kind of difficult. Now that we’re opening up, can they expect for that to slowly go away on its own? Is there a light at the end of the tunnel for them?
Ronald: If we look back a year and compare it to how things are looking now, it’s kind of a mixed picture. On the one hand, with the end of the pandemic and side as millions of Americans and people elsewhere are getting vaccinated, it looks like the mental health impact has leveled off. For example, the March 2021 Kaiser Family Foundation report found that about half of adults, about 47%, continue to report negative mental health impacts related to worry or stress about the pandemic. But that’s actually a little lower than the 53% who reported these negative effects in July of 2020. It’s not a big decrease from 53 to 47, but it looks like some of the adverse effects are leveling off, maybe as people become more hopeful about vaccinations, and so on.
On the other hand, there’s evidence that a lot of people are experiencing what’s being called pandemic fatigue, which is considered kind of a burnout syndrome. At this point, there are people who are just tired of being cooped up, tired of restrictions, tired of bands on indoor gatherings, tired of wearing masks, tired of physical distancing, and are basically fed up with the so-called, New Normal.
So it’s really a mixed picture. Generally, things seem better in terms of mental health, but there’s also a lot of feeling like when is this thing going to be over?
Jeffrey: Dr. Pies, thank you so much for your time today. This has been highly informative. We very much appreciate it.
Ronald: My pleasure. Thanks for inviting me, Jeff.
Jeffrey: RP HealthCast. Science. Innovation. Life. One story at a time.
Dr. Pies Bio and links to some of his articles:
Ronald W. Pies, MD, is Professor Emeritus of Psychiatry at SUNY Upstate Medical U. in Syracuse, NY, where he is also Lecturer on Bioethics & Humanities. Dr. Pies is also Clinical Professor of Psychiatry at Tufts. U. School of Medicine in Boston, and Editor-in-Chief Emeritus of Psychiatric Times. Dr. Pies is the author of several textbooks on psychiatry, as well as works of fiction and poetry.