This list was compiled by child counselor Mariah Goodwin, MA,LPC.

Americans are reporting high levels of emotional distress from the coronavirus pandemic -- levels that some experts warn may lead to a national mental health crisis.

“Our society is definitely in a collective state of trauma,” said Jonathan Porteus, PhD, a licensed clinical psychologist who oversees the crisis and suicide hotline in Sacramento, CA. Unlike posttraumatic stress disorder, which surfaces after a trauma has ended, the country is only starting to grapple with the pandemic’s psychological fallout, he said.

“We do see an emerging potential crisis,” said Karestan Koenen, PhD, a professor of psychiatric epidemiology at Harvard’s T.H. Chan School of Public Health, during an online forum this week.

Another recent report, released Friday from the Well Being Trust, said the pandemic could lead to 75,000 additional “deaths of despair” from drug and alcohol misuse and suicide due to unemployment, social isolation, and fears about the virus.
A recent poll of more than 3,100 WebMD readers found that 26% said they felt a sense of trauma from COVID-19.

Koenen, who has studied other major disasters, sees problematic differences this time, including how long-lasting the pandemic may become and how it has affected the whole world.

“We know that social support is so important to buffer the effects of disasters, to help pull people out of disasters, and here, we see that because of physical distancing … we’re sort of robbed of some of that social support, so that’s extra-challenging.

“In terms of this specific situation, we’re really treading new ground.”

Mental Health’s First Responders
At the nation’s crisis and suicide hotlines, counselors are seeing the first waves of emotional distress. Callers have flooded the phone lines to talk about health fears, job losses, relationship strains, and lonely days spent in isolation.

Calls to the Sacramento crisis line increased 40% from February to March, according to Porteus, the CEO of WellSpace Health, which operates the hotline. In a year-to-year comparison, April’s call volume was 58% greater than in April 2019, he said.

Lauren Ochs, MA, a counselor who takes crisis calls in St. Louis, MO, has also talked to many more people since the pandemic started, averaging 25-35 calls during her 8-hour shifts, she said. “About 80% to 85% at least mention COVID. That might not be their primary problem, but some way, somehow, they’re affected by it.”

Calls also have risen significantly at the San Diego Access and Crisis Line in California, said Program Manager Heather Aston.

“We’ve seen an increase in more anxiety-driven calls,” Aston said. Some people are worried about COVID-like symptoms. “They want to know where can they go to get safely tested.” Others are concerned about family members. One woman called for advice on how to help a sister who had stopped eating and drinking and was having paranoid thoughts about COVID-19, Aston said.

Long-Term Effects
In a recent opinion piece published in the Journal of the American Medical Association, Sandro Galea, MD, MPH, DrPH, a professor at the Boston University School of Public Health, warned of an upcoming wave of mental disorders because of coronavirus.
He noted that “large-scale disasters, whether traumatic (the World Trade Center attacks or mass shootings), natural (hurricanes), or environmental (Deepwater Horizon oil spill), are almost always accompanied by increases in depression, posttraumatic stress disorder (PTSD), substance use disorder, a broad range of other mental and behavioral disorders, domestic violence, and child abuse."

The COVID-19 pandemic would likely produce a similar “overflow of mental illness,” he said.
He cited examples:

• 5% of people affected by Hurricane Ike in 2008 met the criteria for major depressive disorder in the month after the hurricane.
• 1 in 10 adults in New York City showed signs of major depressive disorder in the month following the 9/11 attacks.
• Nearly 25% of New Yorkers reported using more alcohol after the attacks.
• Communities affected by the Deepwater Horizon oil spill showed signs of depression and anxiety.
• The earlier SARS epidemic was linked with increases in PTSD, stress, and psychological distress in patients and health care workers.

The mental health effects can happen immediately and last over time, he wrote.

The pandemic also comes at a time when people already struggled to get mental health care, often due to cost, lack of access, and a shortage of providers. As people who had been getting help before stay-at-home orders found their care interrupted, some providers have begun to offer telehealth services.

Charles Jones, the CEO of MDLive, a large telehealth provider, told MedCity News that his company has seen increased demand for behavioral health services from patients who are stressed out about health or work issues. Cigna, one of the largest providers of mental health services, launched a toll-free, 24-hour help line for the public to speak to behavioral health specialists.

Profound Effects
From isolation to anxiety to excess drinking, coronavirus has touched almost every area of life, said Lan Nguyen, a suicide and crisis services program manager for the hotline in Santa Clara County in Northern California.

For many callers, community shutdowns have bred a deep sense of isolation, he said. “People complain that they are stuck in the house all day. They don’t know what to do.”

On the home front, relationships can be strained, Porteus said. “Families are kind of a tinderbox, especially in confined areas.” Children may now face a greater risk of abuse, especially since they can no longer find respite at school. “There are a lot of family dynamics that are not healthy, and now kids have to be in them full-time,” he said.

The same goes for victims of domestic violence, according to Porteus. “People can’t get out of their homes, so they’re more enmeshed with the perpetrators than ever before.”

The St. Louis hotline has heard from many struggling health care workers and others, Ochs said. “I recently talked with an eighth-grade teacher who was in a lot of emotional distress about the school year ending early,” Ochs said. “I don’t think any teacher was really prepared for the school year to just stop.” Not only was he grieving the abrupt loss of his students, but he had little chance to say good-bye. “He was a teacher in a high-poverty area, so it’s hard to reach out to [his students]. It’s hard to Zoom with them, it’s hard to make contact with them.”

Those who have lost jobs or been furloughed have called about financial worries, according to Nguyen.

Besides the financial impact, losing a job can be emotionally devastating, Porteus said. “Our identity is really hit and sometimes, it feels catastrophic. Many of the people who are calling don’t know who they’ve become. They’ve lost what they feel is everything, and they’ve also lost their social context.”

Recently, the San Diego hotline helped one older man who had called in about losing his job as a chef, Aston said. “He had roughly $20 in his checking account and he was suicidal.”

Intense stressors like job loss and fears for one’s life and health can contribute to substance abuse. The Sacramento hotline also has gotten more calls from people struggling with alcohol or substance problems, Porteus said. Overall, alcohol sales have gone up nationwide, and now, some restaurants will deliver alcohol with takeout food orders.
“One thing [counselors] are noticing, especially with older adults, is ‘Yeah, I’m drinking. Why not? I’m not going anywhere. I don’t have to drive. I don’t have all the normal constraints while I’m around people,’” Porteus said.

Future Efforts
At a time when coronavirus efforts have battered many state budgets, it could be difficult to fund future mental health services. But some experts are looking ahead.
In his JAMA article, Galea wrote: “Scaling up treatment in the midst of crisis will take creative thinking.” He suggested training lay people to provide psychological first aid, as well as “helping teach the lay public to check in with one another and provide support. Even small signs that someone cares could make a difference in the early stages of social isolation.”
He also advocated for more telemedicine mental health visits.
In its report, the Well Being Trust urged policy makers to consider three areas to combat mental health issues:

• Addressing unemployment
• Making it easier to get mental health care
• Integrating mental health care with primary care

“If the country continues to ignore the collateral damage -- specifically our nation’s mental health -- we will not come out of this stronger,” said Benjamin F. Miller, PsyD, chief strategy officer at Well Being Trust.

Finding Resilience
Even if an epidemic of mental illness is looming, counselors say that people are resilient and can strive to protect their emotional well-being.
Experts offered these tips:

• Try to eat and sleep well.
• Try to stay socially connected, even if you can’t see others in person.
• Limit news and social media.

Developing one’s own psychological tools helps, too. Given “the state of ambiguity and helplessness and fear,” Porteus said, “the best thing we can do is figure out how to tolerate the distress.”

When people are in crisis, he said, it’s helpful to go online to learn about “distress tolerance” skills, which involve accepting that some problems are beyond one’s control. Instead of becoming mired in feelings of unfairness and anger, people can learn healthier ways of thinking and coping when they can’t escape painful situations.
For those who have lost jobs, he suggests looking up interest inventories -- questionnaires that ask you to rate your enjoyment and interest in a wide variety of activities -- to explore career options. “You can figure out the kinds of things that you’re good at and start getting a sense of what your next steps might be."
Taking constructive steps can help to counteract a downward spiral, he said.
“People look at the pandemic and they tend to be drawn to the negative. If we can help shift people to look at the positive, it really helps because we know that neurons that fire together wire together,” Aston said. “We’re going to be able to see the positive more quickly.”


Shared from WebMD

Katherine Kam wrote this story while participating in the USC Center for Health Journalism‘s 2020 California Fellowship.
WebMD Health News Reviewed by Michael W. Smith, MD on May 08, 2020

Coping with Covid is a new group at Compass Point for Individuals trying to figure out life during the ongoing Pandemic. Please join us as we find meaning, purpose and life satisfaction in this 'new normal.'

This group may be a fit for you if -
- You live in Ohio
- You have a smart phone, tablet or computer with internet connection
- The pandemic has affected your day-to-day life
-Changes have caused you stress, anxiety, etc.

This group will cover different mental health topics including yips, tricks and resources we can use to build awareness, motivation and coping skills.

To schedule, click here to register online or call our front office at 888-830-0347

Millions of people in the U.S. are affected by mental illness each year. It’s important to measure how common mental illness is, so we can understand its physical, social and financial impact — and so we can show that no one is alone. These numbers are also powerful tools for raising public awareness, stigma-busting and advocating for better health care.

The information on these infographics and this page comes from studies conducted by organizations like Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Disease Control and Prevention (CDC) and the U.S. Department of Justice. The terminology used reflects what is used in original studies. Terms like “serious mental illness,” “mental illness” or “mental health disorders” may all seem like they’re referring to the same thing, but in fact refer to specific diagnostic groups for that particular study.

You Are Not Alone

• 19.1% of U.S. adults experienced mental illness in 2018 (47.6 million people). This represents 1 in 5 adults.
• 4.6% of U.S. adults experienced serious mental illness in 2018 (11.4 million people). This represents 1 in 25 adults.
• 16.5% of U.S. youth aged 6-17 experienced a mental health disorder in 2016 (7.7 million people)
• 3.7% of U.S. adults experienced a co-occurring substance use disorder and mental illness in 2018 (9.2 million people)


• Annual prevalence of mental illness among U.S. adults, by demographic group:
  • Non-Hispanic Asian: 14.7%
  • Non-Hispanic white: 20.4%
  • Non-Hispanic black or African-American: 16.2%
  • Non-Hispanic American Indian or Alaska Native: 22.1%
  • Non-Hispanic mixed/multiracial: 26.8%
  • Hispanic or Latino: 16.9%
  • Lesbian, Gay or Bisexual: 37.4%


• Annual prevalence among U.S. adults, by condition:
  • Major Depressive Episode: 7.2% (17.7 million people)
  • Schizophrenia: <1% (estimated 1.5 million people)
  • Bipolar Disorder: 2.8% (estimated 7 million people)
  • Anxiety Disorders: 19.1% (estimated 48 million people)
  • Posttraumatic Stress Disorder: 3.6% (estimated 9 million people)
  • Obsessive Compulsive Disorder: 1.2% (estimated 3 million people)
  • Borderline Personality Disorder: 1.4% (estimated 3.5 million people)

Mental Health Care Matters

• 43.3% of U.S. adults with mental illness received treatment in 2018  
• 64.1% of U.S. adults with serious mental illness received treatment in 2018  
• 50.6% of U.S. youth aged 6-17 with a mental health disorder received treatment in 2016  
• The average delay between onset of mental illness symptoms and treatment is 11 years
• Annual treatment rates among U.S. adults with any mental illness, by demographic group:
  • Male: 34.9%
  • Female: 48.6%
  • Lesbian, Gay or Bisexual: 48.5%
  • Non-Hispanic Asian: 24.9%
  • Non-Hispanic white: 49.1%
  • Non-Hispanic black or African-American: 30.6%
  • Non-Hispanic mixed/multiracial: 31.8%
  • Hispanic or Latino: 32.9%
• 11.3% of U.S. adults with mental illness had no insurance coverage in 2018
• 13.4% of U.S. adults with serious mental illness had no insurance coverage in 2018
• 60% of U.S. counties do not have a single practicing psychiatrist

Provided by NAMI

With all of the new stressors impacting each of us during this time, we now more than ever need to take proactive steps to be mindful and find joy in our days. Although we cannot simply wish the pandemic away, we can add a few simple activities to help us cope with our ever-evolving reality.

Below we are sharing a list of what some of our providers here at Compass Point are doing while working from home proving tele-therapy, a list of what our clinicians have recommended to their clients as well as a general list inspired by Marsha Linehan, professor of psychology at the University of Washington, and the creator of Dialectical Behavioral Therapy (DBT), of activities that can be accomplished in limited time, within ones own home. Many of the items are also friendly for families with young children.

A lot of our clients familiar with DBT will know that our groups use lists like this to help participants identify activities they can use to boost their mood and cope with challenges. While many of us need this in the best of times, most of us need to find what works and how to find balance again in the wake of COVID-19.

Our team at Compass Point have been working remotely from home offering tele-therapy and practicing social distancing for over a month now. I asked them to share the activities and behaviors that have been helping them.

Marcy Rodgers

Since sessions have still been taking place via tele-therapy, clinicians have given quite a few activities they have been recommending to clients to de-stress. I asked them to share a few with us.

The below list is inspired by Marsha Linehans list of distracting, pleasurable activities

Joel:
Monday Morning April 13th, doing our best to be at arms length and beyond to stay healthy and give you the best information we can find.  I am working on getting Dr.Amy Acton, Local area Hospitals and other medical professionals to here how it is here.

Dr. Charles Roberts joins us right now. Dr.Roberts is a mental health expert. Dr, what we know is that anytime things change for people, like that book "who moved my cheese" and all that. Thats hard for some people. Isn't it? its like "my daily routine is upset, so I am not very happy."

Dr. Roberts:
That is so true. Good morning, Joel . Good to be with you.

Joel:
When you talk about those kinds of things, what are best practices? What can I do to impact my mental state, my physical state, and make things easier for me moving forward?

Dr.Roberts -
Well, you started off talking about routine and I think you are right on it with that. Our brains use routines to streamline information. We are constantly filtering out what is important or not important and routines really help us do that. Like were going to listen to one radio station at a time, so when we have all kinds of upset in routines like what we have right now. Its like listening to multiple radio stations all at one time, not super effective and overloading.  That is excatly what is going on.

Joel:
Thats the thing though. People are so hungry for information about the Cornonavirus, its spread, its impact, if I do get this will there be people available to take care of me? Those kinds of things, how do you step away from that kind of information when that is all that people seem to care about right now?

Dr. Roberts - Well, you kind of have to force yourself to do it. Part of it really is setting a routine. Setting a time to check in with the outside world. A time to check the news, a time to do all that. People joke about "wine with Dewine" here in Ohio, but I think that gives people a time to sit down do that and then say okay, now the rest of the day I am going to do things that I need to do, focus on things close to home, that I can control.

Joel:
Right. Is it just the nature of being productive? Like, hey, I cant go to work, I am not doing what I normally do, so I am going to identify things around the house and get those done so I have a sense of accomplishment?

Dr. Roberts:
Accomplishments part of it, but part of it is just staying busy and keeping your mind occupied. Practice being mindful. At any one thing at any point on time.

Joel:
There is the whole "alone together" thing too. I get the concept of it, but I am missing being around people. Usually by 8/8:30 this place is vibrant. I mean, 70/80/90 employees. Communication people we tend to be kind of loud. Were mixing it up and were having fun. This morning there's like 8 people here. I am going home after work.  I love my wife, I love my son, but I don't have any contact with buddies or going out to dinner, being in crowds. How can you handle that loneliness?

Dr.Roberts:
Well, Joel. you're even one of the lucky ones. Cause you're getting out and seeing 8 people each day. That's pretty good. Our brains are required to have new experiences. Were not meant to be isolated, even isolated alone with the same people, its isolated. No new experiences, no new information, no new jokes. You know, its like sitting with the same people all the time, intellectual inbreeding. So reaching out and face timing and using some of this technology that we have. Its really, really interesting it can help a lot.

Joel:
Its funny, yesterday, my wife was cooking for Easter and my folks live about 20 miles from us so I texted them that we were going to bring a little care package. We did that and we sat outside and talked, even though it wasnt particularly warm, but they're both in their 80s so were very concerned about spreading anything. We may not be showing symptoms, we could have it and we dont want them to get it. So is that even relatively in the realm of okay? We sat the chairs 10 feet apart just so we can kid of see each other, or do you recommend the face time and the electronic things like that? Is that a better way to handle it.

Dr. Roberts:
I am always a fan of getting as much personal contact as possible. As long as that can be done safetly, following the CDCs social distancing guidelines right now, I think thats great. Human contact is important.

Joel:
No doubt. I wonder too, people who are depressed or have anxiety, theyre looking back theyre looking ahead. A lot of people right now, they're looking ahead and wondering, Is it going to get to May first and is it going to be May 15th or wait till June. Once I get back, what am I going back to? So what can I do to answer those questions so I am not as anxious about whats to come?

Dr.Roberts:
I think you mentioned that people with anxiety look forward a lot about what is to come and there is a lot that we do not know. There is a lot that we do know though. Our families will still be our families (as long as we dont run them out of the house while social distancing) you know, were still going to have some semblance of American life. Some things will transition, but that's looking forward. If you keep yourself grounded in the present, this moment now, I mean look how different our lives are now. It wont be this different. It will be more like what it used to be. So the big thing has already happened.

Joel:
Thats a good point. This is as low as it gets and we should be on the upward swing. So, you know, that should buoy your spirits a little bit. I am curious too. I dont know there will be necessarily a social war or civil war over it, but there are going to be people who are released to work first. Whatever essential worker means, there will some companies will say you're good to go or there will be testing that is released and some people will be able to get a hold of it quicker and theyll be cleared to work. How do I fight that feeling. How do I fight the jealous or upset feelings that someone else gets to get back to their life quicker than I do? 

Dr.Roberts:
I think its more of a mindset framing for ourselves. Were all part of a team here. If you look at our economy its so connected. All the different business, the people who are repairing things they have to go to the part store, the transportation has to be there. All that is still going to happen, that needs to happen. So its all going to get turned on, just we don't know in what order.

Joel:
Fascinating. Thats the thing, a lot of times when you're just a cog in the wheel and your doing what you do everyday you dont really have to consider that. Dr. That was a lot great information and things for people to think about and hopefully work through so when we do get the green light we can get back to it and everyone will be happy and healthy moving forward.

“Teletherapy is the online delivery of speech, occupational, and mental health therapy services via high-resolution, live video conferencing.”

Teletherapy, also known as online therapy, e-therapy, or video therapy, is therapy delivered through a virtual platform via a computer. If you’ve ever used FaceTime or Skype, it’s essentially the same thing – except secure and with a qualified therapist or counselor at the other end. Tele- Therapy is considered a highly effective method for therapy delivery.

Why should you consider Tele-Therapy?

As boredom sets in during this COVID-19 crisis, I have noticed the increased need for structure and a schedule.  So, the age-old question becomes even more pertinent: where do I begin?

I really can’t begin to label or quantify the value of good self-care.  Humans are equipped with amazing capabilities to self-regulate…if only we had the energy and desire to use them! In DBT, there is a skill (acronym) called the PLEASE skill, and I believe it is the answer to the question posed above.

I am going to focus on three components of PLEASE: Sleeping, Eating, and Exercising.

Sleep. Just do it, stop fighting it…put your Smartphone away and close your eyes.  Did you know that your brain cannot convert anything into memory until you are asleep? The Disney Pixar movie Inside Out had a lot of great content that helps drive this point home (it was quite factually accurate!).  In the movie, the main character Riley didn’t have her memory balls moved from short-term memory into her long-term memory until she slept! Our bodies are not machines; on a cellular level your body needs sleep to repair itself. Sleep allows time for the immune system to do its job and ward off viruses and bacterial infections.  During this time of illness-anxiety, sleep is a kind gesture you can do for yourself to maximize the immunity in your own body! Sleep will also help you reduce your overall stress level. So next time you want to watch the next episode on Netflix, play the next level on a game, or return one more e-mail, ask yourself what you need more: your health and sanity or screen time…

Eat. A balanced diet helps alleviate mood swings.  We (generalizing for Americans) live on a cycle of sugar highs and sugar lows. We have a habit of eating low quality breakfast (…if we eat any breakfast at all…) which floods the brain with chemicals and overwhelms our neuro-functioning; this results in you feeling hyper, a spike of motivation, and a burst of energy (yay!).  As a result of this flooding however; our bodies secrete insulin to suck up all the sugar like a vacuum leaving us feeling lethargic and moody (not so yay…).  This cycle repeats itself after lunch and dinner as well. Think about it…when do you reach for the candy bar? 10am, 2pm, 9pm…a few hours after each meal! Eating a balanced diet of carbohydrates, proteins, and fats ensures that our food (including a healthy amount of sugar) gets broken down over time and reduces that roller coaster of moodiness. While in quarantine, I want you to focus on mindful eating and try to keep it balanced and healthy!

Exercise.  I feel like this is a mute point in some ways. My goal is not to be preachy; it is to motivate you into action. The science behind working out is limitless and boils down to this: if you move your body your mind will feel better.  Physical exercise can helps your brain secret endorphins, adrenaline, and dopamine…all of which alleviate depressive symptoms.  Consider for a moment the cost of getting those chemicals elsewhere: prescription drugs, theme parks, extramarital affairs… Are those effective or realistic on a regular basis? Exercise also builds mastery. If you become fluent and experienced in a form of movement (yoga, running, lifting weights) it will build your confidence and overall satisfaction in life.  What can you do from home? I have seen a wide variety of online videos being posted on Facebook from different organizations, there are a seemingly limitless supply on YouTube, or you could go for a walk around your neighborhood.

For the full PLEASE skill, please refer to this graphic: