Dr. Jessica Nouhavandi sat down with three therapists—Steven Wolhandler, Jason Fierstein, and Jamie Stacks—to get their tips and thoughts on mental health during the current COVID-19 crisis.
What types of self-care tips, lifestyle changes, or resources can people use to protect their mental health during these difficult times?
JASON FIERSTEIN: Try to connect with others in your life by calling someone you haven’t reached out to in a while or touch base. See how you might support someone else during these challenging times, which also will help you feel better. Keeping that sense of connection is important for good mental health, and to know you’re not alone in this.
JAMIE STACKS: Mental health is a struggle now more than ever for many. One of the tips that I give my clients is to try to keep their routine(s) and schedule as close to “normal” as possible. While a pandemic is a time that calls for self-compassion and kindness, sometimes that means taking care of ourselves physically as well as emotionally. That being said, we all have a cake and chips once in a while. Don’t beat yourself up.
STEVEN WOLHANDLER: Another useful thing is to take periodic breaks from the news, which can be very negative and depressing, and from social media which can often bring social pressure rather than social support. Try setting aside some time each day to be Offline instead. Use that time to cook, make art, meditate, walk, exercise, clean or do house projects, or just nap.
What type of mental health challenges are occurring as a result of COVID-19?
JAMIE: COVID-19 has turned our world upside down. Many are feeling more depressed due to isolation. Anxieties are running high. Many of us are in a constant state of fight, flight, or freeze due to the fear and uncertainty of what our life may look like in the future. Essentially as individuals and a collective, we are experiencing trauma and grief.
STEVEN: Loneliness, anxiety over the physical health of yourself and your loved ones, and stress-related to financial uncertainty seem to be three common challenges. On an existential or spiritual level, the profound disruption of life as we have known it can cause some people to question their values and the meaning of the lives they’ve led prior to COVID-19. That can be challenging, but also can open opportunities for positive reassessment and change. For example, being cut off from our shopping or eating out routines can feel like a loss, but it also can be an opportunity to examine the true value of these things. In a time of loss, consider whether less is more.
JASON: People are also irritable and sometimes quick to trigger anger when out dealing with others, dealing with new rules and regulations concerning how society works now, or because they’ve been in lockdown with their family members for such a long period of time. Marital issues, and divorce, are also becoming more common, as is alcohol and marijuana abuse and dependence.
How are these challenges different for individuals? For couples? For families?
JASON: For individuals, it’s tougher because of the loneliness and lack of human contact. I think basic human contact goes a long way for positive mental health, and with long stretches of time without that, depression and hopelessness can arise. For families, the challenge becomes balancing work, raising kids, and giving to a marriage and marriage partner – under one roof all day, every day. Married partners don’t feel like they can attend to their marriage partner, let alone to themselves, so problems can build up in this way. Self-care can become a premium, which erodes good mental health and leaves us susceptible to other problems.
STEVEN: For everyone, formerly small nuisances become large irritants. If you’ve been short-tempered, grumpy or bitchy, acknowledge it and apologize–then leave it in the past. And respect other people’s need for solitude and connection, which can be more extreme now.
JAMIE: Many couples are finding that being around each other constantly is a challenge. When there is not the “escape” of daily work and life and you are in the house for months at a time with your partner, it can be tense. We are restless and anxious anyway and in this place can be snappy with our loved ones. Often that loved one is our partner. There is a safety in taking your frustrations out on your partner. They love you and you can predict their response.
What (if any) are going to be the long-lasting mental health effects of COVID-19 on individuals even once the pandemic is over?
JAMIE: I suspect we will have a great deal of post-traumatic stress both from the frontline workers and first responders, as well as those who are experiencing this pandemic. Life is not going to look the same. While the only constant is change, we didn’t always ask for or want the change. Adapting to a new way of being is going to include a process of grieving and processing trauma. This will be an individual and collective process.
STEVEN: Many will have long-lasting anxiety about recovering jobs and housing and economic security. Anxiety is often connected to depression, with depression being the de-energized expression of inner insecurity and anxiety being the energized expression of inner insecurity. COVID-19 has brought unprecedented levels of insecurity to our lives.
JASON: I think that long-lasting mental health effects of COVID-19 will be a prolonged sense of disorientation, anxiety issues or disorders, and residual fear of this happening again (and of getting sick). For some, post-traumatic stress disorder (PTSD), increased depression rates and suicide (if it goes on a lot longer), and increased divorce rates (especially exacerbated by the shutdown and economic effects) will also happen.
What are some specific pieces of advice you are giving your patients currently?
JASON: Feel your feelings, even if you don’t want them or if they don’t make sense to you. The quicker you can identify and feel your feelings, the more quickly they can pass. Stay present to those experiences, as they will change many times throughout this process.
STEVEN: Practice gratitude – focus on the many things that you have to be grateful for, and there are always plenty of things to be grateful for, even when there are also many things for which you are not grateful. Look for humor and playfulness in all moments.
JAMIE: Don’t forget self-care. In stressful times we can forget even the most basic self-care, such as eating and sleeping. Make sure you check in with yourself and see that you are doing these things.
How do you think therapy can be especially helpful during COVID-19?
JAMIE: Therapy can be a constant. You can depend on that day/time to know you will get that connection in a time where not much is reliable or known.
STEVEN: Therapy (these days via video) can help folks feel more connected and can provide empathy and comfort. Being heard by anyone is an essential aspect of breaking out of isolation, and good therapists are trained to be good listeners. Therapy can offer insight and stability for specific issues in your life that may feel more intense with the changes COVID-19 has brought.
JASON: In a deeper way, COVID-19 may have exposed historical or early childhood experiences that people have that now need attention. They’re issues that people may not have previously worked on and were not aware of until a crisis situation. Therapy is a great way to address those things now.
Millions have lost their jobs and health insurance during this time. How do you think that has affected mental health access?
JASON: Mental health access is still limited in a number of ways, especially in some states. Unfortunately, losing one’s job and health insurance may make it harder to find the proper mental health care for people, but it is still out there. Low cost or affordable counseling options may be available through community mental health centers or over a crisis or chat line.
STEVEN: In a time of greater need, many people in the United States may find themselves cut off from access to a therapist because their health insurance was provided by jobs that have disappeared.
JAMIE: Sadly this will make it more difficult for those who need it to access therapy and mental health services. On the upside, I have seen more clinicians than ever offering pro bono or a sliding scale to meet the needs of those who have lost jobs and insurance.
Are there any other tips you have for people who can’t currently afford mental health services?
JAMIE: Search for those who are offering pro bono sessions. Follow the pages of therapy practices on social media or sign up for their blog updates, those are often filled with tips on coping and taking care of your mental health.
STEVEN: Purge toxic people from your life. If you’ve had trouble setting boundaries with a toxic or intrusive person, staying at home because of COVID-19 can provide you with a good excuse for limiting your contact. That could be something to be grateful for.
JASON: I would say that a lot of good mental health can be done at home, or by oneself. Professional counseling is not a substitute for those things, but I think there are plenty of great online resources, from YouTube, to phone apps, to good books on Amazon or at your online public library, that can address every issue you might be dealing with. If you think you might need medication for your mental health issue, contact your primary care provider, nurse practitioner, or psychiatrist to consult about getting a prescription to help you.
If you are taking mental health medications (or any other generic prescription medications), check out www.honeybeehealth.com. We offer affordable prices without insurance or coupons needed, so we can help if you’ve lost your employer-provided health insurance.
Steven Wolhandler, JD, MA, LPC is a psychotherapist, mediator, arbitrator, custody evaluator, national consultant and retired attorney. He specializes in helping clients deal with seriously difficult situations and people, with penetrating insight, effective solutions, warmth and humor. He lives in Colorado, consults with people nationwide and can be reached through www.emotionalpredators.com and www.creativeresolutions.org. He is the author of Protecting Yourself from Emotional Predators.
Jason Fierstein, MA, LPC, is a counselor and psychotherapist based in Phoenix, Arizona. His practice, Phoenix Men’s Counseling, works with men and couples to achieve positive mental health, happy relationships and marriages, and good work-life balance. He has been helping men for over 20 years, and truly loves the work he does, and appreciates his clients that take the risk to do counseling to better themselves.
Jamie Stacks’s life work is to help people who desire a more authentic and improved quality of life. They are a Licensed Professional Counselor and have been practicing since 1998. They practice psychotherapy with adults, individually or with families/partners. The focus of their practice is helping people to recover from anxiety and anxiety attacks, addictions of all kinds including alcohol counseling and other substance abuse, trauma, helping you identify the symptoms of PTSD and co- dependency issues. Grief is another area that they have a great deal of experience in both personally and professionally.