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Mental health concerns rise as COVID fatigue deepens

UMass Medical School behavioral health experts offer tips for coping with stress of pandemic

By Susan E.W. Spencer

UMass Medical School Communications

December 10, 2020

If you’ve been feeling depressed, worried or lonely; you have a hard time getting motivated; or you feel more tired during pandemic life, you’re not alone. COVID fatigue is real and is affecting mental health, said UMass Medical School behavioral health specialists.

UMMS Employee Assistance Program Director Valerie Wedge, LICSW, CEAP, said people have been seeking help for anxiety, including fear, uncertainty and work-life integration; depression, including loneliness, isolation and thoughts of self-harm; relationship issues; work-related concerns surrounding working remotely, perceived unrealistic expectations and work overload; and worrying about one’s own or others’ physical health. UMMS EAP contacts grew to 22 percent of the organization’s employees between March and November 2020, from a typical rate of around 5 percent, Wedge said. She attributed much of the growth to COVID-19 outreach work.

Illustration for Strategies to regain equilibrium vary from person to person, Runyan said, but movement of any kind, whether exercising or just going for a walk, is a “high-yield intervention” for calming the nervous system.Christine Runyan, PhD, professor of family medicine & community health, house officer counselor in graduate medical education and co-founder of Tend Health, which provides mental health consultation and support to health care providers, said normally 8 to 11 percent of people will mention these types of mental health symptoms in broad-based screenings. Now it’s 30 to 34 percent.

“I have come to conceptualize a lot of what is happening in COVID as a disruption in our nervous system,” Dr. Runyan said. “The mind-body connection is actually quite sensitive to both what is real and what is imagined. So much of 2020 has been filled with uncertainty, and our brains do not like uncertainty.”

For health care workers, there is the constant invisible threat of potential exposure. And they encounter what Runyan termed moral distress by constantly facing situations that challenge competing values, such as caring for people who are sick with a serious infectious disease while not wanting to risk exposure to their families.

“We respond in pretty predictable ways as human beings and these are not always helpful ways,” Runyan said.

Illustration for practicing gratitude and savoring the good in life, while dialing down negative inputs such as “doom scrolling” the news, can help rewire the mind to incline more toward the positive.Worrying, for example, can make people feel like they’re doing something and have some control. Some people get headaches, backaches or gastrointestinal symptoms. Some people cope with that nervous system activation by “contracting,” she explained. They pull into themselves, maybe increase nightly drinking. “And that can result in a downward spiral mode of motivation, energy and ultimately you’re creating the conditions within the nervous system that are very ripe for depression.”

Other stresses stem from simultaneously trying to do one’s job while managing children’s schooling or caring for family.

Working from home and social distancing can also lead to a sense of loss of the things that normally buoy people, such as social connection, purpose and sense of identity with a larger goal, said Runyan.

There’s a good reason you may feel tired these days, too. “Even if you’re not doing as much as you would normally do, your body’s need for sleep actually may be a little bit greater,” Runyan said. “You’re carrying around this anxiety about the state of your own health and your family’s health and the health of your community, which actually requires a lot more energy in our bodies.”

Strategies to regain equilibrium vary from person to person, Runyan said, but movement of any kind, whether exercising or just going for a walk, is a “high-yield intervention” for calming the nervous system.

Illustration for adapting your space with music or scent, which bypasses the cognitive processing part of the brain to signal a more primitive part in a calming way.

For people working at home, she suggested adapting your space with music or scent, which bypasses the cognitive processing part of the brain to signal a more primitive part in a calming way.

Runyan added, “Try as best you can to set aside a place in your home that is designated for work, because our brains are pattern-making machines and our brains will associate work and whatever level of stress that might entail with particular locations in our house.”

Practicing gratitude and savoring the good in life, while dialing down negative inputs such as “doom scrolling” the news, can help rewire the mind to incline more toward the positive.

Wedge said that the pandemic has exacerbated or complicated mental health issues for those who were already struggling. A Zoom therapy session isn’t always the same as in-person contact, and EAP staff have been working extra hard to find therapists who will see clients in person.

Illustration for If you’re prone to depression or anxiety, seek help sooner than later.If you’re prone to depression or anxiety, seek help sooner than later,” Wedge said. “Some of this is situational. Some of this will become more chronic than acute. If you’re feeling desperate, you feel like you just can’t get out of bed, you feel unmotivated, you lack energy or you’re crying all the time, or you see increased drug or alcohol use—it’s time to seek help.”

Despite the difficult time many people are having, Wedge and Runyan said that there will be a silver lining. Telehealth has improved rapidly. People are reconnecting with their family. Mental health for health care workers has received needed attention. We’ve slowed down.

“I think being sensitive and opening up our hearts with compassion and kindness is really what we’re called to do right now,” said Wedge. “That may seem a little soft, but I think we need to be soft right now.”

Click below to hear Runyan discuss COVID fatigue in a Voices of UMassMed podcast.