During the past year, the coronavirus pandemic, and the parallel economic recession caused by the pandemic, has resulted in a steep increase in mental illness across the country. “There has been an increase in both the rate and severity of depression and anxiety nationwide, as well as increased rates of suicide and violence,” says Barb Johnson-Giese, a Licensed Clinical Social Worker and Behavioral Health Coordinator at Door County Medical Center. In fact, the Kaiser Family Foundation reports the average share of American adults reporting symptoms of anxiety disorder and/or depressive disorder has risen from 11% in January 2019 to 41% in January 2021.

Living through uncertain times

If there is one word that could describe the past year it might be “uncertain,” and not knowing what will happen from one day to the next is likely to increase anyone’s level of stress and anxiety. “Human beings crave information about the future in the same way we crave food, sex and other primary rewards,” writes sociologist and author Christine Carter, “[and] our brains perceive ambiguity as a threat.” 

In a normal year, the fear of dying or becoming severely ill, social isolation, the loss of income, and significant changes in daily routines—all things that increase uncertainty—would likely result in anxiety, sadness, grief and stress in most people. Throughout 2020 and into 2021, the effect has been magnified, spread across the globe, and perhaps more importantly, prolonged.

“Sadness, grief and stress are all natural responses to the pandemic,” notes Johnson-Giese. “However,” she adds, “when people are exposed to situations that are uncertain, that are perceived to be harmful or a threat to survival, their bodies will release the hormone cortisol, which kicks the fight or flight response in gear. In short-term situations—such as a deer running in front of your car—this response is very effective. But, in long-term situations—like the coronavirus pandemic—the continuous release of cortisol can take a negative toll on their emotional and physical health.”

The effects of prolonged stress and anxiety

The American Psychological Association reports that prolonged stress “affects all systems of the body including muscles, respiratory, cardiovascular, endocrine, gastrointestinal, nervous and reproductive systems.” Indeed, the side effects of prolonged stress, and the continuous release of cortisol, include:

• Fatigue
• Irritability
• Headaches
• Intestinal problems
• Anxiety and/or depression
• Weight gain
• Increased blood pressure
• Low libido, erectile dysfunction or problems with menstrual periods
• Poor sleep

That’s quite a list! But, chances are it is likely that many of us have been feeling one or more of these symptoms during the past year.

Nevertheless, it’s important not to beat yourself up if you have been experiencing any of these symptoms. As Johnson-Giese notes, these are natural responses to situations that are perceived as harmful or threatening. 

Coping techniques—supporting your emotional and mental wellbeing

What you can do is learn about, and put into practice, techniques that can help you deal with the reality of the present moment and trauma of the past year. And, while there are many ways to cope with the present reality that we find ourselves in, several, research-based techniques continue to come to fore—daily techniques that can help stabilize mood, lower cortisol levels, and improve your overall emotional and physical wellbeing.

Reduce screen time: In general, too much screen time is already associated with negative physical health outcomes. Throughout the course of the last year, we’ve discovered that continuously checking the news—about the state of the pandemic or the economy—can result in negative mental health outcomes as well. Society has even coined a term for it: “doomscrolling,” or the act of consuming large quantities of negative online news at once. Too much online news can result in feelings of helplessness, anxiety and stress. Mental health experts suggest limiting news consumption to twice a day: once in the morning and once in the evening. And definitely try to avoid reading about COVID-19 before you go to bed.  

Practice acceptance: As previously mentioned, feelings of uncertainty can lead to anxiety and stress. One technique to help alleviate the stress of uncertainty is to practice acceptance—that is, accept that we cannot control every aspect of pandemic life. Instead, focus on what aspects of the pandemic you can control—for example, being kind to others, wearing a mask, reducing exposure to the news, and practicing social distancing. 

Following established daily routines: For many, the coronavirus pandemic has upended their daily routines. However, daily routines help keep us grounded, and following the established routines of our pre-pandemic lives—even to a small degree—can help you feel in control. Small actions, like making your bed and getting dressed, even if it’s not required, can make a big difference.

Actively check in on your own mental health: At any given time, we may be startlingly unaware of our own emotions. Mindfulness, a practice that emphasizes focusing our awareness on the present moment, can help us become more aware of our own feelings at any given time and help us stop negative thoughts and emotions before we become overwhelmed. Additionally, a large part of the Mindfulness practice is meditation. Learning to meditate, for even a few minutes a day, has been shown to decrease levels of the stress hormone cortisol, and if sitting quietly doesn’t work for you, Johnson-Giese notes, “Engaging in rhythmic physical activities, such as dancing, walking, running or biking, can reduce stress in a manner similar to meditation.” 

Do something you enjoy: Participating in activities or hobbies that help you relax and unwind in a healthy way—for example, cooking, hiking, reading, or playing an instrument—can be like a mini-emotional vacation, allowing you to focus on something other than the pandemic. 

Reduce social isolation: One negative consequence of the coronavirus pandemic has come from one of our most powerful tools for fighting the disease—social distancing increases social isolation. And yet, today we have more tools to combat social isolation at our disposal than ever before. Keep in touch with friends through technology—use Facebook to check in with friends or set up a Zoom visit. Send people emails, or even a handwritten note. Visit with people in safe, socially distanced settings—for example, try masking up and going for a hike with a close friend.

Coping techniques—supporting your physical wellbeing

By now, it is pretty well established that your physical health is directly connected to your mental health. In fact, recent research has shown that bacteria in the gut produce around 95% of the body’s supply of serotonin, a neurotransmitter that relays signals from one area of the brain to the other and directly influences mood. So, taking care of your physical health will help support your mental health—our heads are connected to our bodies after all.

Eat well: As mentioned above, brain health is directly connected to gut health, so what we eat effects how we feel. However, stress tends to make us crave comfort foods, foods that are high in sugars and carbohydrates. Somewhat ironically, the same type of food—that is, “junk food”—is linked to an increased risk of anxiety and depression. Conversely, studies show that low-sugar/low-carbohydrate diets, like the Mediterranean diet, decrease anxiety and stress. The next time you’re at the grocery store, focus on buying fresh fruits, vegetables, and whole foods so that when you have a craving, you can reach for something that will benefit not only your body, but also your mind.

Keep physically active: Being physically active while remaining home can be challenging, but maintaining physical activity is important not only for your physical health, but also for your mental health—it can reduce stress and anxiety and even improve your mood, indeed, numerous studies show that vigorous and regular exercise “can treat mild to moderate depression as effectively as antidepressant medication.” However, you don’t need to run 10 miles a day to reap the benefits of staying physically active. Here are some tips for staying active while at home:

• Catch up on household chores—cleaning the house, organizing your closet or vacuuming are all great ways to increase physical activity levels
• Work outside—mowing the lawn and weeding the garden count too
• Take a walk—breaking up your day with a short walk is an excellent way to reduce stress and increase your daily activity level
• Aim for at least 20 minutes of activity a day—to get the most out of an active lifestyle, it is important to be physically active on a regular basis.

Get plenty of sleep: While getting a good night’s sleep is important for a number of reasons, one of the primary reasons has to do with mental health—it is estimated that 90% of people with depression suffer from sleep disorders. Setting up a regular sleep schedule is an important part of getting a good night’s sleep: 

• Go to bed and get out of bed at the same time every day—your body’s internal clock will get used to the schedule and falling asleep and waking up will become easier
• Use alcohol in moderation, and try not to consume caffeine in the afternoon and evening—both interfere with sleep 
• Again, cut back on screen time—and, as previously mentioned, avoid reading the news before bedtime. It can increase anxiety levels and make falling asleep harder.

Focus on what you can change—and start small

“All of these techniques are within the individual person's control,” says Johnson-Giese, adding, “however, it is important to identify what you have control over and focus on those techniques that bring you a healthy sense of comfort or accomplishment.” 

Additionally, Johnson-Giese suggests starting small, “Making changes sound like an easy thing to do, but change, even for our betterment, can be difficult because we like stability and structure. Trying to fit something new into our daily routine upsets that structure, and we tend to revert back to what we know best, even if it's to our detriment. So, start small and set realistic goals that you can be successful with, and choose something you enjoy—you will be more likely to stick with it over time.”

Warning signs of mental illness

Mental illness is not a “one size fits all” type of disease, and each individual will present with different symptoms. Nevertheless, there are common warning signs that someone is experiencing a mental illness, which include:

• Feeling sad or withdrawn for more than two weeks
• Out-of-control or risk taking behavior
• Marked weight gain or loss
• Extreme changes in mood
• Difficulty concentrating
• Continuous worries and fears that inhibit daily activities
• Thoughts of suicide or harming others.

If you are, or anyone you know is, experiencing any of the symptoms above, there is help. The National Suicide Prevention Lifeline is available 24/7 at 1-800-273-8255, or text “HOPELINE” to 741741, to connect to a trained crisis counselor via text. Additional sources of information include your own Employee Assistance Program, accessed through your employer, or the Community Resources tab on the Door County Library website. If you are having thoughts of suicide or harming others, call 9-1-1 or go to the nearest emergency room to avoid a preventable tragedy.