Pandemic having a profound impact on mental health

A couple of weeks ago, Jessica L. Griffin, her three children and her fiance, camped out in their backyard in Paxton.

The 24-hour experience - complete with dinner and roasted s’mores, and breakfast all cooked over a fire pit - was a time for memorable family bonding and fun. But it was also for medicinal purposes, to combat the adverse psychological effects of social distancing and home confinement during the pandemic.

“The idea is to create more positive memories so they don’t look back on this time and just remember the fear and anxiety we all have right now,” said Griffin, an associate professor of psychiatry and pediatrics at UMass Medical School in Worcester.

Everyone is experiencing some level of stress during the unprecedented, unpredictable pandemic. According to a recent national poll by the American Psychiatric Association, more than a third of Americans say the coronavirus is having a serious impact on their mental health.

Nearly 60% say it is having a serious impact on their day-to-day lives. And 62% are anxious about the possibility of family and loved ones getting COVID-19.

The feelings are normal, but if not buffered, all the stress can become toxic to one's mental health. One way to counter the anxiety is with supportive relationships, while some may also need to seek out professional help. May is National Mental Health Awareness Month.

“Right now, we are having to protect our physical health at the expense of our emotional health,” Griffin said. “We are likely to see an increase in depression, anxiety and substance abuse among our population.”

The major fear that Griffin and other mental health providers have is that once clinics reopen, they will see a surge in mental health cases and referrals for children who are abused or exposed to domestic abuse in the home. Child abuse rates have plummeted during the pandemic, she said, but that’s likely because children are not around teachers or others who might notice the abuse and report it.

“That is something we’re quite worried about,” said Griffin, who is executive director of the Child Trauma Training Center at UMass Medical School. “We know historically when unemployment rates go up, child abuse and domestic violence go up.”

Referrals to and from the CTTC have decreased, but requests from professionals on how to provide trauma therapy remotely have exponentially increased. Griffin and other trainers are working to equip clinicians and professionals with teaching skills and strategies to help children and parents increase their resilience.

Some mental health providers can deliver services remotely via telehealth programs; a list is available from LINK-KID (1-855-LINK-KID), a centralized referral system set up by UMass Medical School.

Children who have preexisting mental, physical or developmental problems, or have parents who are struggling with these problems as well as substance abuse or economic instability, are more likely to experience even more destabilization during the pandemic. But generally, the effects of the pandemic on most children depend on how caregivers and parents are responding.

“Kids are resilient. People in general are. The way in which children are going to bounce back from this is by how adults around them are responding. The better off the parents are doing, the better off their children will be,” Griffin said. It’s important for parents or caregivers to control media exposure, and maintain some sort of normalcy by setting up routines like eating meals or going on walks together. Adults also have to take care of themselves with a good diet, proper sleep and exercise so that they are able to care for their children.

Abbie E. Goldberg, a psychology professor at Clark University, recently expanded her ongoing 15-year-old study on adoptive families to include a survey about their experiences during the pandemic. Sixty of the 100 families in the original study participated in the survey. The majority of the adopted children, ages 11 to 14, are multiracial and many have learning or developmental disabilities.

The most common challenge is remote learning, Goldberg said. If a child was getting special education services at school, it's a challenge for parents to get them to participate in remote learning, much less to get tutoring. It’s even harder to get many of them to exercise. Aerobic activity, she pointed out, boosts self image, improves mood, and relieves anxiety and stress. It can also improve sleep and energy.

On the other hand, some parents say their children are incredibly self-directed and are doing well with online schooling. For children who are introverted or have problems with socialization, remote learning seems to be less stressful than going to school.

Goldberg said many of the parents in the study are letting their children play a role in what they are learning. Some are letting their children come up with their own topics for research projects. They are also doing things that invite learning “naturally.” For example, several families are now raising chickens. This serves as an opportunity to learn about the environment, agriculture, and caring for animals. One parent described how her daughter has been working for weeks on creating a board game.

“The creativity and innovation of these families is pretty remarkable,” Goldberg said. "Even though like most of us they are stressed and worried about health and money, they are doing things to take advantage of this situation. They’re taking on new hobbies and doing more things as a family.”

Sarah and Michael Dudek, young professionals who are able to work remotely from their Paxton home, are fortunate to have help from Sarah's mother to care for their 2-year-old son, Theo, a couple of days a week. But they too have faced some challenges.

Sarah, 36, is a licensed clinical social worker, and Michael, 40, is the principal at Blackstone-Millville Regional High School. It took the busy couple a while to figure out how to get their work done and provide the attention that Theo needs.

The halting of play dates and other social events resulted in some regressions for the toddler, including going from using a pacifier only at bedtime to wanting it throughout the day. He would also knock on the door to the basement, confused that one of his parents was on the other side trying to work. The couple was finally able to figure out a workable routine, including prioritizing virtual meetings and other work the night before. They now have a smooth routine for each to get their job done and have more family time.

“At first, I was really tough on myself if the day didn’t go as I thought it should," Sarah said. "Now, I’m realizing that work is always going to be there, and I will always have time the next day.”

The fact that families are together is creating opportunities to forge and strengthen connections with each other. But that togetherness becomes challenging, in that families have been forced to figure out and balance their new routines at home together all the time.

The first step is recognizing that there’s no definition of the perfect or right way to do this, advised Beth Greenberg, associate professor of psychology and mental health counseling at Becker College, where she is also program coordinator of the master of arts program in mental health counseling. We’re all learning at the same time in this new normal, she said, and it’s a matter of figuring out what works for the family as a whole and what works for individual family members.

“I think it’s a lot of juggling,” Greenberg said. “Initially there was chaos and uncertainty of how long (the pandemic) was going to last. Now we’re seven to eight weeks into the stay-at-home order. My observation is families are beginning to figure it out.”

She said creating routines in our lives will balance against all the things that feel unpredictable and beyond our control. Anxiety is almost always future-oriented and focused on not having control and having a sense of helplessness. We worry about what might happen. She said people should accept the things we can’t control and focus our thoughts and energy on what we can control.

A good way to learn to do that is through mindfulness - the practice of maintaining moment-to-moment awareness of our thoughts and feelings rather than focusing on the past or what could happen in the future. The therapeutic technique provides mental and physical benefits for adults and children.

Griffin and Jessica Dym Bartlett and Dana Thomson, colleagues who work at Child Trends, a national children's research firm based in Bethesda, Maryland, recently published a tip sheet on protecting the psychological health of youths during the pandemic. It outlines things parents can do, emphasizing three R’s: reassurance, routine and regulation.

The first is reassurance that children are safe and loved. The second is establishing a routine that is predictable, which can be calming for children and adults. Regulation means working on skills like exercise, deep breathing, meditation, listening to music, or walking that can help calm down the hyperarousal that the body experiences under stress.

Another way to improve regulation skills is to give children the vocabulary to describe how they’re feeling (for example, sad, worried, confused) and to support them in expressing their feelings by talking about how they feel and acknowledging that all of these feelings are normal.

Gratitude is also a helpful strategy to increase resilience. Griffin suggested each family member write three things they are grateful for on a piece of paper and put the slips of paper into a jar. At the end of the week everybody reads the statements. Pointing out the heroes like first responders and positive stories of ways people are helping one another is also calming and encouraging.

As an example, Griffin said, people and businesses in her hometown of Paxton are putting hearts in their windows, front yards and on mailboxes. It’s a way to spread the message that we are all in this together.

“Kids are inherently altruistic. They want to give back to other people. The more you can tap into that the better,” she said.

Teens and young adults are probably better equipped to endure social distancing and home confinement by maintaining connections through social media. However, they, like the rest of us, still miss in-person contact with peers.

“What I’m hearing is that for our teens and young adults, they are looking ahead and recognizing that at some point, they will reconnect with their peers. I think that’s helpful," Greenberg said. "It’s helpful to be hopeful."

The city of Worcester: https://www.facebook.com/WorcesterMassachusettsOfficial/

COVID-19 web page: http://www.worcesterma.gov/coronavirus/assistance

The Family Resource Center, at 508-796-1411, for people who don’t have their own physician for referrals for help.

State resources:

https://mass211.org/

https://www.mass.gov/info-details/managing-isolation-and-loneliness-during-covid-19

https://www.mass.gov/info-details/covid-19-updates-and-information

Federal resources:

https://www.samhsa.gov/find-help/disaster-distress-helpline

The U.S. Department of Health & Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) has a 24/7, 365-day multilingual and confidential crisis counseling and support hotline for people who are experiencing emotional distress related to a natural or human-caused disasters. Call (800) 985-5990 or text TalkWithUs to 66746 to connect with a trained crisis counselor.

Resources for assistance related to COVID-19