As the weather warms and our days get longer, newness springs on the horizon. With the COVID-19 vaccine continuing to ramp up at UAB, there is a light at the end of the pandemic tunnel. But how do we reckon with the loss, grief, emotion, and turmoil of the last year that continues to linger?
Experts across the School of Medicine and the UAB Medicine Office of Wellness discuss mental health during the pandemic and give their best advice on maintaining mental and emotional well-being as we look toward the future.
Mental health services surge
The world has battled the COVID-19 pandemic for over a year, and by now most of us have been affected in some way. Consequently, the number of people in need of mental health services has surged.
Irena Bukelis, M.D., associate director of the General Psychiatry and Residency Program, suggests that social isolation, economic recession, job insecurity, financial problems, school closings, restrictions in community life, and the uncertain outlook on future plans are just a few reasons many have found their mental wellness declining.
The Centers of Disease Control and Prevention (CDC) published a report in August 2020 which concluded that in late June, 40% of adults in the U.S. have been struggling with mental health or substance abuse issues, and rates of depression and anxiety have risen since 2019.
Similarly, a study published in the Lancet Psychiatry in November 2020 showed that about one in five individuals who recovered from COVID-19 developed mental illness such as anxiety disorder or depression within three months of COVID diagnosis. While it is too early to know the long-term implications of the pandemic on mental health, Bukelis says she expects “to see people struggling with worsening mental health for a while.”
How to cope and find peace after loss
COVID-19 sprung unique challenges and emotional agony on many Americans due to COVID-related grief and visitor restriction policies. The UAB Center for Palliative and Supportive Care has been especially impacted by the COVID-19 pandemic, as many families are not able to be present and comfort their loved ones who are nearing end of life.
Rodney Tucker, M.D., director of the Center for Palliative and Supportive Care describes the already emotional process of admission and discharge as even more difficult without family members present. With the lack of human connection during this time, we have to explore other ways to find peace.
At the same time, Sylvia Huang, Ph.D., M.A., director of the Psychology and Counseling Program in the Center for Palliative and Supportive Care, describes the Meet My Loved One (MMLO)© program as a game changer for end of life patients during COVID-19. The center was the first in the U.S. to implement the program to honor seriously ill patients in UAB Hospital’s Palliative and Comfort Care Unit (PCCU).
The proactive approach of MMLO allows a bedside care team to serve as a patient’s “proxy family” when the family's presence is limited.
In addition to MMLO intervention, PCCU also offers on-site phone and video grief counseling, music therapy, social work, and pastoral care to help families process grief, engage in legacy interventions, and connect with local community grief support groups to provide peace and healing.
Practice self-care in the spring
With all that we’ve faced in the past year, self-care can sound like a daunting task. However, the term “self-care” is unique to everyone, and can include small changes such as taking a flight of stairs over the elevator, adding a green veggie at lunch, and remembering to take your medication. In fact, taking medications as prescribed is a substantial pillar of self-care.
Bukelis explains that, in a study conducted last year, almost half of the patients with psychiatric disorders who participated were non-adherent to their psychotropic medication. Perception of feeling stigmatized by families, neighbors, health professionals, and other community members played a large role in medication nonadherence.
But when adequately treated, medications for anxiety and depression can significantly improve ones’ wellbeing at every stage of life. Bukelis states that “it is important not to stop medication during the first few weeks after starting treatment because it has not had enough time yet to reach the maximum benefit. In fact, studies show that medication in combination with therapy can have the most lasting benefit.”
Moreover, walking for 10 to 15 minutes each day or beginning your morning with simple stretches can benefit both physical and emotional health.
Lean on others
We are not meant to deal with things alone.
Megan McMurray, Ph.D., clinical psychologist in the UAB Office of Wellness, says that leaning on others will hold us accountable with our own emotions, and will also remind us that we are not alone. In order to lean on others for support, it is important we identify safe people to talk to about our struggles.
McMurray advises thinking through the following items when you consider opening up to someone.
• Who in my social network is skillful at offering understanding without judgment?
• Who do I know is a great listener?
• How did I feel the last time I shared with this person?
Likewise, how do we create an environment where people feel safe to talk to us about their mental health? Normalizing the conversation is the secret ingredient in making those around us feel comfortable. McMurray recommends a few ways to help others feel safe:
• Check in with friends, coworkers, and loved ones. Ask open-ended questions about how they are doing.
• For those in leadership roles, create a culture where vulnerability is acceptable. Start the conversation by sharing life stressors and experiences as a leader. Normalize therapy appointments by expressing it as an acceptable reason to utilize employee or student sick leave.
Stay the course
As COVID-19 vaccinations ramp up across the country, there is new hope in our community, our state, and the nation.
As we navigate through remaining feelings of grief and continue to practice self-care, McMurray recommends that we accept difficult emotions as they come up, rather than fight them away.
“Fighting against our own feelings is a losing battle that causes undue suffering on top of the pain we are already experiencing. When we avoid our difficult emotions rather than accept them, we do not develop the emotional skills required to build resilience or learn to trust in our capacity to handle difficult experiences.”
It is important to remember there is no right or wrong way to feel. It’s natural to feel overwhelmed with the uncertainty that still looms, yet also acceptable to feel hopeful now that vaccines are available.
Reach out for help
If you are struggling with depression or thoughts of suicide, please reach out for help. Remember, you are not alone.
Visit the UAB Cares website for student and employee resources or reach out to UAB Psychiatry by calling 205-934-7008.
Call the National Suicide Prevention Lifeline 24/7 at 1-800-273-TALK (8255) or text the Crisis Text Line 24/7 (text HELLO to 741741).