Doctor warns of negative effects of coronavirus lockdowns
In a letter to President Trump, more than 600 doctors call for an end to the ‘national shutdown’ aimed at slowing the spread of the coronavirus; Emergency medicine specialist Dr. Simone Gold weighs in.
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Editor's note: This story discusses suicide. If you or someone you know is having thoughts of suicide, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
It’s poised to be the next pandemic: a mental health crisis, induced not only by the trauma of the novel coronavirus but the ramifications of lengthy lockdowns, lost livelihoods and exacerbated stress, isolation and addiction.
The COVID-19 pandemic, which has shuttered much of the U.S. economy for more than two months, infected 1.6 million Americans and claimed the lives of at least 94,000, is what medical experts have defined as a “perfect storm” for an already in-motion mental health calamity.
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“Since the lockdown, the center has seen a rise in depression cases involving loneliness, hopelessness and suicidal ideation. Anxiety in cases of agoraphobia appears to be more present as well,” Laura Rhodes-Levin, a licensed professional counselor and founder of The Missing Peace Center for Anxiety, told Fox News. “Those struggling with obsessive-compulsive disorder and germaphobia are experiencing heightened senses of fear and discomfort. In this time of isolation, overeating is a severe concern, as well as alcohol consumption and drug use.”
According to a recent poll by the Kaiser Family Foundation, almost half of the U.S. population claims that the protracted crisis is hindering their mental health. Last month, a federal emergency hotline for those experiencing psychological affliction documented a 1,000 percent increase in calls compared to April 2019, and digital counseling service Talkspace claim their clientele has soared 65 percent since the early days on the public health crisis in February.
And with unemployment rates skyrocketing by the day, such grim statistics are expected only to rise at an alarming rate. Over the past nine weeks, jobless filings have reached 38.6 million, and U.S. Labor Department officials expect the number could hit 20 percent by the month’s end.
Lobsang Tseten meditates and practices breathing exercises alone to maintain social distancing at a playground in New York. (AP Photo/John Minchillo)
Dr. Meghan Marcum, chief psychologist at A Mission for Michael, a resource for intensive mental health treatment in Southern California, said that “there is a very fine line between taking the necessary measures to mitigate a highly infectious disease while being mindful of the negative effects it will have on mental health.”
With that comes steep concerns of escalating suicide numbers nationwide. Even before the coronavirus crisis, the issue was of growing concern. The National Center for Health Statistics recently reported that the suicide rate nationwide rose 35 percent between 1999 and 2018, but a clearer picture of the pandemic’s suicide ripple effect won’t be fully realized for several months, as medical professionals have to meticulously investigate each death to determine its cause.
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Dr. Roger McIntyre, a professor of Psychiatry and Pharmacology and the CEO of AltMed, observed that online pharmaceutical service Express Scripts has recently reported a 40 percent increase in a prescription of pills for anxiety, a 20 percent increase in prescriptions for depression pills and a 50 percent increase in sleeping pills.
“We have also seen an increase in the number of people who are reaching out to our depression center seeking care," he said. "There is no doubt we are going to see an increase in depression, post-traumatic stress, anxiety disorders, as well as suicide and, we're seeing all of that. What’s concerning is that many people, despite the increased need, do not have access to the care.”
The long-term effects of the pandemic, McIntyre surmised, will be influenced by the degree of economic recovery.
“The longer that there is unemployment, the longer there will be mental distress and increased risk of suicide,” he continued. “Suicide is highly linked to unemployment in financial insecurity: for every 1 percent increase in unemployment [there] will be a 1 percent increase in suicide. [According to] our recent publication in the journal World Psychiatry, we are projecting an increase of between 8,000 and 10,000 additional suicides in the United States as a consequence of the pandemic.”
Employees work to create to-go donation meals for a company called Collective Fare in the Brownsville neighborhood in the Brooklyn borough in New York City. (Stephanie Keith/Getty Images)
Red flags have also been raised with regard to addiction relapses, compounded by stay-home orders, loss of loved ones and financial collapse. This past March, the Substance Abuse and Mental Health Services Administration (SAMHSA) saw a 338 percent uptick in calls to their hotline compared to February.
“Mental health does not discriminate. With this pandemic happening and all diversities being affected, many people across all social classes will be impacted, the hardest hitting low income who cannot afford or find the proper help,” said Tim Ryan, recovery advocate for Rehab.com. “Many people left untreated—left in their own mental health world of hell, suicides are on the rise, people will be trying to self-medicate with drugs and/or alcohol, self-harm and loss of housing and total life skills. There will be more dysfunction in family homes.”
Adding to the anxiety this month has been the emanation of severe inflammatory illnesses in several minors. While children were initially thought to be relatively immune to the disease, strange occurrences have prompted doctors to believe otherwise.
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In addition, this takes a severe toll on those forced to care for their young and sustain jobs and livelihoods where possible.
“Anxiety, stress, obsessive thinking, paranoia, depression, and thoughts of suicide have greatly increased among individuals with and without previous mental health issues. People who normally don’t regularly drink alcohol have turned to drinking daily in order to numb the stress of multitasking,” said clinical psychologist, Shannon Kroner. “I have personally spoken to many mothers who have turned to day drinking in order to just get through a day of helping their kids with schoolwork, keeping the house clean, making sure everyone is fed, and trying to keep up with their jobs through teleconferences and zoom calls.”
Add in multiple children in different grades, or an infant, or a child with special needs, and the stress can be overwhelming to any parent, Kroner pointed out. Additionally, marriages are being strained due to sharing the same space 24 hours a day, seven days a week with a partner, especially if there are also children involved.
Jack Campise talks with his mother, Beverly Kearns, through her apartment window at the Kimberly Hall North nursing home in Windsor, Conn. (AP Photo/Chris Ehrmann)
The elderly, who are most at-risk of dying from coronavirus, have mostly been forced into debilitating isolation, and front-line medical workers, despite the outpouring of gratitude from communities for their tireless effort in combating coronavirus and saving lives, are also among those most at risk of severe mental health consequences. Exacerbating their tensions is the notion that frontline workers face losses and are not afforded the time off to mourn and recuperate.
A study published by the Journal of the American Medical Association regarding the mental health outcomes of health care workers attending to coronavirus patients in China highlighted that more than 70 percent reported psychological distress, 50 percent reported symptoms of depression and anxiety, and 34 percent experienced insomnia.
“I’ve been much more irritable and have had disrupted sleep. Many people at the hospital are stressed both with the COVID and the financial impacts on the hospital. Many nurses have been furloughed,” one Tennessee-based emergency room doctor, who requested his name not be published given hospital constraints in talking to the press, said. “General stress and anxiety are elevated in everyone.”
And that stress is leading to losses of life.
For one, Dr. Lorna M. Breen, a top emergency room physician treating coronavirus patients at Manhattan’s NewYork-Presbyterian Allen Hospital, died by suicide late last month. That same week, a Florida nurse, William Coddington, who was said to be grappling with isolation and trauma amid the coronavirus fight, was found dead in a hotel parking lot.
And the longer the crisis remains, the more challenging it will be for these pivotal professionals to sustain the long hours and concentration that is demanded from them.
Furthermore, law enforcement organizations are also speaking out with regard to the ongoing toll the virus is taking in their community. More than 51 police officers from 13 different states have succumbed to the novel pathogen, according to data compiled by Police One.
And while states are steadily starting to open their crippled economies once again as summer approaches, governments are scrambling to contend with the double-whammy of the growing mental health calamity.
A report published earlier this month by the United Nations underscored that “decades of neglect and underinvestment in addressing people’s mental health needs have been exposed by the COVID-19 pandemic,” and called on leaders to make stronger commitments “in the way they treat psychological illness, amid a potential global spike in suicides and drug abuse.”
Fragmented efforts are being made in hard-hit states such as New York, which has teamed up with the Department of Defense to train 1,000 counselors to better tend to combat-like stress while neighboring New Jersey has deployed a “Check You, Check Two” initiative, encouraging medical staff to attend to touch base with two colleagues daily, in addition to committing $2 million in federal grants to bolster its telehealth counseling services offered through Rutgers University’s Behavioral Health Care.
In this Friday, April 17, 2020 file photo, a patient is wheeled out of the Cobble Hill Health Center by emergency medical workers in the Brooklyn borough of New York. (AP Photo/John Minchillo)
Meanwhile, the federal mental health czar is calling for more money to broaden services to help Americans struggling, with Dr. Elinore McCance-Katz, assistant secretary at Department of Health and Human Services and head of the Substance Abuse and Mental Health Administration, signaling that deaths from alcohol, drug overdose and suicide could surpass 150,000 if not adequately addressed.
And many experts say there is much more that could – and should – be done.
“Houses of worship should be opened immediately. Why are liquor stores and marijuana dispensaries considered essential, yet churches, temples, and mosques are not? People under large amounts of stress need a place to go to feel safe,” Kroner advocated. “Speaking to a pastor, priest, rabbi, or imam is important to many religious individuals during uncertain times such as these. In order to slow the increase of mental health issues, our government should not make it a crime to pray or enjoy the outdoors.”
Masha Pearl, executive director to New York-based charity The Blue Card, which provides aid to trauma victims and holocaust survivors, emphasized that they have witnessed a sharp increase in alcohol consumption and substance abuse, which in turn is weakening immune systems and making one more susceptible to a severe case of the novel pathogen.
“Governments ought to create a mental health outreach plan that does not wait for an individual to call a hotline or send an email requesting help. It would be most effective for primary care physicians and mental health providers to proactively reach out to their patient list and check-in regarding mental health,” she asserted. “Mental health providers should not be compensated by the patient during this time but by the government.”
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But among the doom and gloom, medical professionals are also hoping Americans can manage to find some silver linings.
“Cure cannot be worse than a pandemic itself. People are touching their limits and are unable to handle current circumstances. It’s already been really long. There are many positives for mental health out of this crisis though,” conjectured Weronika Rogowska, Los Angeles-based psychologist and life coach. “There is an opportunity in every situation. Probably many inventions are already born. People had a lot of time to get creative. When everything comes back to normality, we all going to be determined and motivated.”
And Rhodes-Levin concurred.
“I am hoping for some positive long-term effect in which people have had time to reprioritize what is important to them, such as spending time with family and cherishing the smaller things that have been difficult to attain rather than taking these things for granted,” she added. “This is the largest crisis that this generation has seen since World War II. It will be interesting to see which practices bounce back to normal and what will be changed forever.”