After a Year-Plus of COVID-19, Therapists Share 10 Ways Our Mental Health Has Changed

A year into the COVID-19 pandemic, to say that our mental health has felt the impact is painfully obvious and a massive understatement. "What we have endured over the past year collectively due to a pandemic is extremely stress-inducing alone," said therapist Maddie Spear, LCSW. "Add to that other natural life stressors, such as job loss, family loss, loss of social life . . . how could we not all be mentally affected by this?"

Our mental health has also reflected the changes we've seen as the pandemic has gone on (and on, and on) and other issues (racial injustice, political unrest) have piled on top. "A year ago, 90 percent of my clients were suffering from anxiety," said psychotherapist Carrie Mead, "but today I am diagnosing a mix of anxiety, depression, and trauma." She added, "I believe the trauma from the political environment, the pandemic, lost economy, and overall fear of the future will be increasing as time goes on."

But before we get there, let's take this moment — roughly the one-year anniversary of what many of us experience as the "beginning" of the pandemic and its effect on our lives — to reflect on how our mental health has changed over the year and what, for those of us who are struggling, we can do about it. Ahead, mental health professionals share what they've seen from their patients and what we can do to cope and heal.

Isolation and Loneliness
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Isolation and Loneliness

A year into the pandemic, "people are more isolated and lonely than ever before," said therapist Kelly O'Sullivan, LCSW. It's no secret why. "As a part of human nature, we desire and long to be connected to other people, especially those that we love," said Oddesty K. Langham, LPC, a therapist in Alabama. The pandemic has forced many of us to stay away from our friends and family, leading to feelings of isolation, loneliness, and even abandonment.

What to do: There's no perfect fix, but addiction psychiatry specialist Shahla Modir, MD, the chief medical officer at All Points North Lodge, recommended a simple phone call with friends and family. "If you are experiencing symptoms of anxiety, depression, and isolation, a phone call with family or friends for 10 minutes a day can help greatly alleviate some of these feelings," she told POPSUGAR. Plan low-key social engagements, like Zoom calls, outdoor picnics, or bike rides. "It's vitally important to maintain social connection during stressful times," she said.

Increased Depression and Anxiety
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Increased Depression and Anxiety

No surprise that many of the experts we spoke to reported seeing more patients develop symptoms of depression and anxiety since the beginning of the COVID-19 pandemic. "Many of us are experiencing a great deal of anxiety right now," said Jenna Carl, PhD, a clinical psychologist and vice president of development and medical affairs at Big Health. "We tend to feel better when the future is somewhat predictable," she explained, "and the pandemic has shaken our sense of control and certainty, creating a perfect storm for anxiety." It's normal to feel all over the place right now, added Tanya Jones-Awolusi, LCSW, of Butterfly Effect Counseling and Consulting. "Anxiety, depression, panic, grief, trauma, and anger pop up day to day and session to session," she said of her experience with clients during the pandemic.

What to do: "Self-compassion is one of my top tips for coping during this time," said Rachel Potter, LCSW, of Strive Behavioral Counseling and Well-being. "Being gentle with yourself and recognizing that you are doing the best you can in a unique and challenging circumstance." Jones-Awolusi added that a support system is key: "A person to check in with, a friend to talk to, a pastor to confide in, or a neighbor to share a smile with." Making an appointment with a mental health professional may also be helpful; they can recommend specific coping techniques or talk to you about medication options.

Lack of Control
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Lack of Control

When will the pandemic end? When will life get back to normal? The up-in-the-air answers to these questions result in a "large, looming uncertainty" that hangs over our lives, said Holly Schiff, PsyD, a clinical psychologist at Jewish Family Services of Greenwich. According to Mary Joye, LHMC, a licensed mental health counselor in Florida, that lack of control can manifest as anger and fear aggression, causing people to lash out and further degrade family relationships.

What to do: Dr. Schiff recommended establishing a routine. "Especially during this time of uncertainty and stress, it is this consistency and predictability that will help maintain a sense of normalcy," she explained. "There is some reassurance in knowing what's going to happen and when, not to mention that routines promote positive physical and mental health." Schedule in exercise, regular meals, and healthy amounts of sleep, she said. "When faced with events that are scary and largely out of our control, it's important to realize what you can control."

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While many of us may still be experiencing anxiety, depression, and fear, you might also feel a shift toward grief, anger, and discontentment, said Mead. "Whereas a year ago, my clients were fearful and uncertain about the virus, employment, and schooling of their children, my clients now feel a sense of grief over what has been lost," she said, be that a loved one who has died, a major life event that's been missed, or money or opportunities that have vanished with the economic downturn. "I am noting that anxiety has turned more to sadness, hopelessness and anger," she said.

Adding to the struggle is the fact that, for many of us, the locked-down lifestyle is still in place. That makes it difficult "for some people to move past their grief, when nothing much changed in life from day to day," said Jeremy Enzor, PhD, LCMHC, a clinical instructor for the psychiatric and mental health nurse practitioner program at Walden University.

What to do: People experience grief in different ways, but one thing to remember is that suppressing your emotions won't help, said Kahina A. Louis, PsyD, a licensed psychologist and CEO and founder of Strengths and Solutions, in a previous interview with POPSUGAR. Instead, start by acknowledging your feelings and validating them. "Beating yourself up for feeling sad when 'it could be much worse' only worsens the experience by now introducing feelings of guilt or shame," Dr. Louis said. Therapy and meditation can also help.

If you've lost a loved one, know that it will take time to get to a place where you can come to acceptance. The process might not be linear, so be as patient with yourself as you can. Sometimes talking about the death of your loved one with friends or family can help, as well as sharing stories about them, spending time with other people who knew them, or even listening to their favorite music. Remember and celebrate your loved one as you feel able.

Blurred Boundaries With Family and Work
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Blurred Boundaries With Family and Work

Boundaries between work and personal life have thinned and, in some cases, disappeared altogether over the past year. With working and schooling from home becoming a new norm, meetings and calls are scheduled at all hours and there's nothing to stop you from logging on late at night or early in the morning.

And it's not just about work, said Virginia Williamson, LMFT, co-owner of Collaborative Counseling Group. "Couples and families that had found ways of managing discord or dissatisfaction" through separate activities or outside resources have been "cut off" from many of these boundaries. "Even those couples and families that tend to experience low levels of distress are having difficulties crop up because everyone has been in each other's physical and emotional space for so long," she said.

What to do: When it comes to work, "it is important to know when to close the laptop," Dr. Schiff said. (Easier said than done.) "I have been doing a lot of work with my clients on setting boundaries at work, assertive communication, and the need for self-care," O'Sullivan said. Have a conversation with your manager, if necessary, to set concrete work or school hours and stick to them. Try turning off your laptop or your work notifications when you're off. Take time off, if you can, to help avoid burnout.

If your boundaries with friends, family, or roommates are fading, have a conversation with them about your needs. Take a walk if you need a break, and don't be afraid to speak up if you need time for yourself. "Talk about how you're feeling," Williamson added, and don't let the frustration build up inside before you speak up.

Feelings of Disconnection
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Feelings of Disconnection

One of the biggest mental health impacts of a year of COVID-19 has been disconnection, said Billy Roberts, LISW, a psychotherapist in Ohio. He described it as "feeling lost regarding relationships, but also meaning and purpose."

What to do: "Find ways to connect," Roberts said, both with others (again, think Zoom or safe activities) and with yourself, your values, and your goals. Roberts recommended experimenting with new hobbies and identifying attainable, "future-focused" goals that you can work towards and that help you feel like you're moving forward. For example, start a project you've been setting aside for a while. Work on your cooking skills with the aim of preparing a fancy dinner for yourself soon. Try a form of exercise you thought you'd never like. Sign up for an online course or try a new workout plan. Identify a goal you've always thought was aspirational and dedicate yourself to it.

Loss of Coping Mechanisms
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Loss of Coping Mechanisms

Dealing with anxiety or depression during the pandemic has been even harder than usual given how many of us have lost access to usual coping mechanisms. It's essentially "taken away opportunities to deal with stressors," said James Marrugo, LPCC, of Morning Coffee Counseling. For example, lack of or lowered income can make it harder to engage in self-care; lack of physical touch means you can't hug your friends and family; and pandemic restrictions have cut down on hobbies you can do outside of the house. Losing our normal coping mechanisms can also lead us towards others, like alcohol, that are less effective and potentially more damaging in the long term.

What to do: "People can remain resilient by being as flexible as possible and finding joy in new areas of their lives," Marrugo said, such as connecting with loved ones and community- or faith-based organizations, spending time outside the house as safely as possible, avoiding alcohol, tobacco, and substance use, and exercising. Social media can also be used as a less effective stand-in for a coping mechanism so make sure to give yourself daily breaks from it and the news cycle. "Consuming the news constantly can create more anxiety," said psychiatrist Bryan Bruno, MD, medical director at Mid City TMS. Try limiting the number of times you check the news and social media, dropping from five times a day to three, or from three to two. "You'll still know what is going on but you'll also give yourself a much-needed break."

Post-Traumatic Stress Disorder
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Post-Traumatic Stress Disorder

"When the pandemic ends, there is a possibility that people may have PTSD, specifically healthcare workers who have been on the frontline the entire time," said Dr. Bruno. "Right now everyone is focused on getting through the day; it's when we have a moment to stop and reflect that PTSD symptoms may begin."

Joye noted that PTSD may not be limited to frontline workers, either; you can also get PTSD by witnessing a traumatic event, such as watching people die on TV or in your family, she said. "I see many clients who have had PTSD traits," she said, including irritability, feelings of detachment, and panic attacks.

What to do: While some cases of PTSD won't be felt until after the pandemic, Dr. Bruno recommended a few ways to manage high levels of stress right now, such as taking a break from the news ("consuming the news constantly can create more anxiety," he said), getting outside, and connecting with family and friends. If you're dealing with PTSD symptoms now, it's important to seek treatment from a doctor or mental health professional; PTSD-specific treatments like Trauma-Focused Cognitive Behavioral Therapy and Eye Movement Desensitization and Reprocessing can help you cope with and manage thoughts and traumatic memories.

Chronic Stress
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Chronic Stress

"This pandemic has caused many to operate in fight-or-flight response," also known as our physiological response to dangerous or threatening situations, said Langham. "This survival mode type of response puts an added strain on our bodies and, when activated for a prolonged period of time, can impact our daily functioning." Prolonged stress, she said, can and does affect our mental and physical health, and many of us have been feeling that for a year or more. Langham anticipated that the chronic stress would contribute to more people needing mental health treatment. "For individuals who already struggled with anxiety, social anxiety and/or isolation, reentry into normal (or new normal) activity may present a challenge," she added.

What to do: Negative thinking can fuel chronic stress, so try to foster positivity in your every day life, said Ken Yeager, PhD, the director of the Stress, Trauma, and Resilience (STAR) Program at the Ohio State University Wexner Medical Center. In a previous interview, he recommended identifying three positive things in your life every day and noting the "why, how, and who" associated with those good things.

"Self-care is also important," he added. "Set aside time to disconnect, take a walk, be with yourself, and hear yourself," including daily time without any technology (music included).

Increased Awareness of Mental Health Issues and Disparities
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Increased Awareness of Mental Health Issues and Disparities

"More than ever before, people are interested in seeking mental health treatment," said Spear. She attributed it to two things: the increase in mental health issues during the pandemic and social media helping to decrease the stigma around mental health.

And as Enzor pointed out, "the effects of the lockdown have been felt differently" across different genders, races, ages and socioeconomic statuses. Symptoms of "serious psychological distress" have been reported across the board, said Lisa Smusz, LPC, principal and owner of The Social Changery, but young people and people of color are among those hit the hardest. "Optimal mental health, which is essential to healthy communities, should be a human right," she said. "But because of cost, a fragmented system of care, and social stigma still associated with mental and substance use disorders, most people do not receive treatment."

What to do: While correcting these types of disparities takes long-term change, you can also help by raising awareness of the problem, publicizing resources, and by putting your own mental health first. (Here's a list of mental health resources for BIPOC people to get you started.)