Days and weeks have turned into months since Gov. Andrew Cuomo declared a statewide emergency on March 17, as the coronavirus pandemic gained momentum, closing schools and shutting nonessential businesses. Now, as families in Seaford and Wantagh prepare to send their children back to classrooms and as parents slowly return to work, the effects of Covid-19-related stress on mental health have become a greater concern.
The combination of uncertainty, financial catastrophe brought on by business closures and massive unemployment, bereavement, and the unknown duration of the crisis is now taking a toll in anxiety, depression and stress in many people, and, experts say, needs to be addressed with healthy habits.
Professionals from backgrounds as diverse as education, family therapy, social work and substance abuse counseling have found that mental health issues across the board — domestic violence, drug and alcohol addiction (including increases in day drinking), depression, sexual abuse and anxiety — have risen dramatically during the pandemic, although it is still too soon to give definitive data.
From the outset, sheltering in place and social distancing changed the therapeutic relationship in challenging ways, according to Taryn Katujian, the community education manager at VIBS, a Suffolk-based organization that addresses a wide range of family mental health issues.
Speaking in a webinar sponsored by Seaford Democratic State Sen. John Brooks on Aug 6, Katujian said that telecounseling adds a barrier between counselor and client, making it difficult to assess potential problems for those whose jobs require them to report suspected abuse or signs of mental health issues, like teachers, coaches and clergy.
For example, “symptoms of depression or anxiety might include lack of attention to personal hygiene, a change in affect or energy level, or declining performance in school or at work,” Katujian said. Such symptoms are harder to assess via Zoom or telephone, and may go undiagnosed for longer periods than in face-to-face settings.
“Our ability to conduct proper assessments may have declined by as much as 50 percent,” she said.
Videoconferencing and social media platforms are imperfect as replacements for personal contact, however familiar they may be to their users. For that reason, educators, while insisting that safety is the single most important consideration for their students, agree with Katujian that distance learning does not address their students’ needs for social-emotional learning as effectively as classroom instruction.
“It’s impossible to duplicate the benefits of the classroom as a collaborative learning environment online,” Seaford Superintendent Dr. Adele Pecora said shortly before Cuomo’s announcement last week that schools in New York state could open next month.
“Feelings of isolation or withdrawal, the lack of proximity, can become intolerable” in both school and therapeutic environments, Katujian said, even for those who have no prior history of depression or anxiety.
Eric Walsh, a physician and public health expert, who also took part in Brooks’s webinar, pointed to what he termed “proinflammatories” as contributors to many coronavirus deaths.
“Lack of good nutrition undermines the immune system,” Walsh said. As chief executive officer of www.slavefood.org, a whole-foods advocacy group, he came down hard on the side of fresh fruits and vegetables, legumes, nuts and seeds, while forcefully criticizing the typical American diet, with its heavy emphasis on meat, carbohydrates, high-sodium prepared foods and sugary soft drinks.
Walsh cited a lack of adequate sleep as another proinflammatory, undermining the immune system’s ability to fight off the Covid virus. “Many people fall asleep in front of their computers,” he said. “The blue light from the screen prevents the body from falling into the deep-[rapid eye movement] sleep necessary for the immune system to rejuvenate itself.”
Third on Walsh’s list of culprits was lack of exercise. “Even a 30 minute walk several times a week helps build up our immune system,” he said. “With nice weather, just taking a walk in the fresh air is something that’s available to anybody.”
Finally, for those with a spiritual focus, no matter what form that might take, regular contact with spiritual practices in the form of meditation, prayer or participation in group meetings was an area of emphasis.
“Science has done study after study showing how prayer and meditation strengthen the immune system,” Walsh said. “Twelve-step programs have emphasized the importance of a higher power for years, and two of the biggest takeaways from the those programs are the importance of spiritual practices for mental health and the importance of mutual support from people struggling with similar health issues.”
Members of such 12-step fellowships have adapted to the lack of face-to-face contact in many of the same ways that schools and therapists have used. Traditional meeting places and rules of social distancing have closed many traditional meeting places, giving way to Zoom, Skype and telephone meetings.
“Church basements and schools — that’s like the typical meeting place in most people’s minds,” one long-time member said. “Some groups are still meeting face to face in parking lots or parks, but none of my meetings are happening right now, and some of my friends have told me they like the way videoconferencing lets them go to more meetings.”
Instead, he attends meetings several times a week via Zoom. “I like the Zoom meetings better than telephone ones,” he said. “At least there, I can see people. But something is definitely lost.”
Substance abuse counseling has undergone some significant changes as well in the five months since the lockdown began, said Susan Klein, program director at Southeast Nassau Guidance Center in Seaford. “Most of our clients are mandated, and because live meetings aren’t going on, attendees aren’t required to get court cards any more [as proof of attendance].”
And Klein suggested other reasons why online therapy or meetings might sometimes be less effective. “People might be doing other things at the same time they’re participating in therapy sessions,” she said. “We don’t allow them to drive during their sessions” — something the 12-step member said he had seen a number of times — “but their attention might not be as focused as in regular group settings.”