As COVID-19 continues to ravage the country, killing more than 135,000 Americans to date, an impending mental health crisis is looming. For four months, responsible citizens hoping to mitigate the spread of coronavirus and protect their neighbors, families, and themselves have been sheltering-in-place, unable to be around people they do not live with. And now that the number of confirmed COVID-19 cases are increasing in 40 states, and at least 19 states have paused their re-opening efforts, there's no sign this unparalleled public health crisis is near its end. In all likelihood, parents will be asked to continue to work from home while caring for their children and facilitating their at-home e-learning in the fall (or will be faced with the impossible decision to send their children to school) and those who've gone months without human contact will continue to live in isolation.
The mental health ramifications of this ongoing pandemic cannot be understated. Studies have already shown that nearly 45% of Americans' mental health has suffered as a result of COVID-19, and parents in quarantine have reported experiencing depression, insomnia, anxiety, anger, emotional exhaustion, and PTSD-like symptoms.
But it is women whose mental health is being disproportionally impacted during this time, especially that of Black women and women of color. According to Axios the majority of essential workers are women. Additionally, as the New York Times reported, women are taking on most of the additional work at home, be it home schooling or keeping their homes tidy. So it makes sense that women are experiencing higher rates of mental health issues. A recent survey from Total Brain found that 83% of working women have experienced an increase in depressed moods, compared to just 36% of working men.
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Woman's Day spoke to two mental health experts to better understand why women's mental health is suffering during this time, and how women can protect their mental health now and always.
Why is mental health taking a hit during COVID-19?
Make no mistake: a mental health crisis existed long before COVID-19 came to the United States. A reported one in five Americans have a diagnosed mental health disorder, according to the Centers for Disease Control and Prevention, and due to limited access to health care, limited mental health care services, and prevailing stigma, many Americans with mental health issues cannot seek support and treatment. The ongoing global pandemic has just exacerbated these issues, especially for those who've been disproportionately impacted by COVID-19.
"I very much think mental health is not separate from physical health in any way," Dr. Jessi Gold, a psychiatrist and assistant professor for the Department of Psychiatry at Washington University in St. Louis, tells Woman's Day. "So if you think about COVID as a disease, and that people are struggling with a disease, anybody who is therefore infected with COVID is coping with something, and anything that comes with that is going to be a challenge. And anything that’s challenging it is going to effect our mental and spiritual bodies as well as our physical bodies."
But Gold says you don't have to have been infected with COVID-19 to have your mental health negatively impacted. Whether you're an essential worker potentially exposing yourself to the virus, someone sheltering-in-place for an extended period of time, or a parent tasked with additional responsibilities and no outside support, you stand to face the mental health ramifications of the pandemic, too.
"People are worried and worries can make you have mental health issues in their own way," Gold explains. "Basically we were told that the thing to do was to self-isolate, and in a lot of ways that lead to really huge lifestyle changes. And any sort of lifestyle change or any transition is always an additional struggle — big changes like marriage, divorce, anything like that is always associated with emotional challenges."
Why are Black and brown women disproportionately impacted?
Studies of COVID-19 numbers have shown that COVID-19 is devastating Black and brown communities at disproportional rates. According to federal data, Black and Latinx people are twice as likely to die from COVID-19 than white people. When combined with ongoing impact of systemic racism (higher maternal mortality rates, limited access to affordable child care and health care services, underfunded communities and education services) and the continued deaths of unarmed Black men and women at the hands of police — and in addition to a lack of mental health resources — and what can only be described as a "perfect storm" of mental health struggles and issues has emerged.
"Imagine how the pandemic has hurt all people — citizens and immigrants of all statuses — then multiply by it a factor of 2-3," Dr. Kali Cyrus, a practicing community psychiatrist, Assistant Professor at Johns Hopkins Medicine, and diversity and inclusion strategist, tells Woman's Day. "That fear, anxiety, and worry attached to knowing your future is bleak in that way and there is nothing you can do because the numbers don't really lie. That's how it impacts me. However, when I talk to my patients who are are more economically disadvantaged than I am, many of them were not working anyway or had family members who were already really sick — so its just a continuation of the same for them. In some ways, they're used to having to weather storms like this. In any case, you're either aware and holding the worry of when/how/if you will be impacted, or used to carrying the weight of this burden already that is either overwhelming or you're used to it."
How can women protect their mental health during this time?
First and foremost, if your mental health has declined to the point that you're unable to complete basic daily tasks, are cutting off communication from friends and family, are experiencing an increase in drug and alcohol use, and are unable to sleep or eat, you should contact a mental health care provider or a crisis hotline. The Substance Abuse and Mental Health Services Administration has a national helpline, which can be reached at 1-800-622-HELP. Many states, including Missouri and New York, are offering free mental health care services to hospital workers, teachers, social workers, and other essential workers. Project Parachute is also offering free therapy to essential workers, and there are a number of free or low-cost mental health care services available for Black women.
And if you do have access to mental health care, you should consider making recurring appointments with a mental health care provider and take advantage of any telehealth services they provide.
"Since March I've been doing entirely telehealth. There's definitely differences, don't get me wrong, but it is very similar to therapy," Gold says. "It might be a little funny at the beginning, but maybe not so much anymore because people are doing so much video chatting and video conferencing and video everything right now.. . It might not be what you want to do for your therapy forever, but it's much better than nothing. And as someone who both gets therapy and does therapy, I can say it's very effective."
What can women do if they don't have access to mental health care services?
If you don't have affordable access to mental health services, or simply want to protect and care for your mental health outside of telehealth therapy services, there are a number of relatively simple things you can do on a daily basis.
"Limit the news. At some point it impacts your subconscious in ways you're unaware of until it is too late," Cyrus says. Doing something for others who are not as privileged as you can also be mentally beneficial.
"Some people are feeling guilty and not sure what to do with their privilege. They can channel that into donating to local causes or other national movements but often people in your own counties need help, like food banks," Cyrus says. Additionally, she suggest you "think about changes you want to make if pandemic life changes — when you go back to work — like contemplate the ways in which you want to change your life to make a more positive impact on the spaces you occupy."
Gold also suggests that you incorporate the following into your pandemic routine as frequently and consistently as possible:
- Prioritize yourself: "It does not need to be for hours. It doesn't need to be every day," Gold says, noting it's hard to prioritize when you have competing interests. "Even something as small as taking a bath, or something. Just try to find something that's just for you and try to do that."
- Create boundaries: "Just because everybody is at home doesn't mean they get a say in your every second of every day," Gold says. "Just because you're the caregiver doesn't mean you have to be care-giving all the time."
- Prioritize sleep: "I do think that [sleep] is essential in being able to function from day to day," Gold explains.
- Move your body: "Finding ways to get up and move at all, exercise wise — even putting on a mask and walking around with your kids — is also a good way to get out some of the pent-up anxiety that you have going on," Gold says.
- Remember coping skills aren't one-size-fits-all: "Just because one person says something is helpful doesn't mean it's going to work for you," Gold explains. "And just because something worked one time doesn't mean it'll work all the time."
- Learn how to be comfortable with uncertainty: "Living a bit more a day at a time is helpful," Gold says. "It is, unfortunately, the way we are right now. And if you look too far into the future and hope we can plan everything out we'll just be disappointed."
What can Black and brown women, specifically, do to protect their mental health?
Since Black and brown women are being disproportionately impacted, and face additional barriers to mental health care, there are a number of things they can specifically do to protect their mental health and wellness and the pandemic continues.
"[If you can] limit interactions with white people, as well as other people if they trigger the following: irritability, anger, or annoyance," Cyrus says, noting that tolerance for people who trigger these emotions may be lower. "Right now it is thrown in our faces that there is racial discord and class struggle and relationships can trigger this stress as well. So when you're feeling this so intensely at moments, just realize its not because you're an angry, bad person, it's because there is additional pressure increasing the intensity of these feelings."
Cyrus also suggests that Black and brown women try to "get away," even if it's just for 30 minutes. "Some time away without dealing with others' expectations can do wonders. In that time, breathe, get a milkshake, do something that you know makes you happy."
Cyrus also suggests that Black and brown women find ways to treat themselves, and to do so as often as possible. "Call a friend and talk sh-t or vent, go have a drink if substance misuse is not an issue, go on a walk, watch stand up comedy, get takeout, get a night away," she explains. "Splurging on one of these things will recharge you longer than you think, if you can afford to do it."
Remember: It's never too late to get help.
"There's no wrong time to get help," Gold says. "We're in a culture that very much thinks you have to be in a crisis to seek care. That's not the right mentality. That's a dangerous mentality, actually, because by the time you're in a crisis a lot of the treatments we provide aren't as effective. For example, medications can take months or weeks at least to work. It would be a lot better if you get help earlier. So if you start to feel that maybe talking to someone outside your family will be helpful, reaching out will be worthwhile."