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(Leah Hogsten | The Salt Lake Tribune) Liz Felt, shown with her dog Elle, has dealt with anxiety and depression and has had to make adjustments to her life in the time of the COVID-19 pandemic, April 17, 2020.
The isolation is starting to nag at Liz Felt.
In the weeks since the COVID-19 pandemic has forced people all over the United States to hunker down at home, Felt, a Salt Lake City resident, has found it difficult adjusting. For years, she has suffered from anxiety, depression and schizophrenia, and last month was diagnosed with thyroid cancer.
While Felt has built effective coping mechanisms with the help of therapy and other treatments, the current situation has threatened them. A support group of friends she started fell by the wayside as those people dealt with their own stressors. Movie theaters, coffee shops and the gym — her safe havens — are closed.
Now that she’s stuck at home with only her dog, Elle, to keep her company, she has fewer ways to alleviate her symptoms.
“The coping mechanisms that typically work for me that I can do inside my home are not enough,” Felt said.
The virus has disrupted just about everything. Schools are closed. Sports seasons are either postponed or canceled altogether. Businesses have shuttered and some may never reopen. Those with mental health concerns, and the people who treat them, are no different.
Therapists and mental health experts have attempted new ways to offer support, including virtual visits and new hotlines, like the Emotional Health Relief Hotline through Intermountain Healthcare offered daily from 10 a.m. to 10 p.m. at 833-442-2211. These can help in a world where the reality is constantly shifting and will continue to for some time. But it doesn’t make up for everything.
The most significant change for Felt, who is in her mid-40s, has been losing the consistent support of her friends, who have been affected in various ways by the pandemic, she said. So during a time she needs more support than usual, those outlets aren’t as available.
“The isolation has been extremely challenging,” Felt said.
Adapting, and staying busy
Robin Eliason lives in Carbon County. She’s 56 and has schizoaffective disorder. And because she has other underlying health conditions, she’s at a higher risk if she contracts the coronavirus. So she’s been self-isolating since before government officials encouraged Utahns to do so.
The nature of her mental illness, Eliason said, already makes her feel less inclined to socialize and meet new people. That’s actually been a source of disagreement between her and her therapist. Eliason doesn’t want to make friends, but her therapist thinks she should go out more and try.
It’s one thing to voluntarily withdraw from society. But it’s whole other issue to be forced into doing it.
“Being told that you have to [self-isolate] is annoying, to say the least,” Eliason said.
Eliason copes with her condition by finding ways to stay busy. Too much downtime and boredom isn’t good for her. She’s recently lost sleep and feels a constant pressure hanging over her during this crisis.
“I’ve been kind of in a low-grade manic state since this whole thing started,” Eliason said. “There’s nothing to fight and there’s nothing to run from. You’ve got to stay here and sit patiently and wait. It just isn’t natural.”
But Eliason has been adapting. She’s been watching live concerts on the internet and has actually made a couple of new friends that way. She’s playing guitar and drawing. She’s making sure to reach out to friends who don’t have mental health issues as well as those who do.
“In a way, I have actually been a little more socially active, although in a filtered way, online and by phone than would be normal for me because of this,” Eliason said.
Felt has also found ways to effectively adapt and said she has found new coping mechanisms. They generally center around allowing herself to lay low and let feelings — whether they be anxious, depressive or paranoid — pass through her.
With the structure she needs on a day-to-day basis gone, Felt has adjusted the expectations for herself. That manifests into setting a goal of getting three things done per day.
“It helps me to think that I’m taking care of something,” Felt said.
The ways Felt and Eliason have coped with the isolation is consistent with what mental health experts see from their own patients. Eli Menet, a social worker in southern Utah, in his private practice mainly works with people who suffer from chemical addiction. He has seen his clients respond to the quarantine in a dichotomous way.
“For some of them, it’s almost like a protective factor,” Menet said while referencing liquor or grocery stores that have reduced hours. “However, being confined in your home and not being able to utilize all your coping skills once you get cravings or triggers or anything like that, that can be problematic.”
Jamie Hales, a licensed clinical social worker for the University Neuropsychiatric Institute, specializes in maternal mental health. She said levels of anxiety have risen in pregnant women and new moms alike, and the coping mechanisms available to them have also been compromised.
“A lot of what we’re seeing is that some of the difficulties that come with being postpartum really have amplified quite a bit under the current circumstances,” Hales said. “People really can’t access some of the support that we would normally sort of advise them to do because of social distancing.”
To combat that, Hales said she and others in her outpatient clinic have tried to help mothers manage their expectations.
“I think a lot of moms really can struggle with perfectionism and a lot of pressure to make sure that they’re still taking care of everything that needs to get done,” Hales said. “I think it’s helpful for them to hear that it’s OK and sometimes not everything happens in the way that they’re hoping to.”
Helping others mitigate their feelings
Having experienced managing mental health challenges has allowed some to help those who are experiencing anxiety, depression or heightened stress for the first time.
Eliason has noticed that posts from her friends on Facebook have been “a little bit more frantic” and she said she’s been the calming voice lately.
“It’s a complete polar opposite from the way things usually go,” Eliason said. “Usually I’m counting on other people to get me off the ceiling and tell me to calm down and that it’s going to be alright and we’ll get through this.”
With suicide rates in Utah clocking in above the national average in 2017 — the most recent year for which national data is available — mental health professionals are keeping a close eye on the number of people using various services.
“One of the indicators that we’re paying close attention to include the fact that we’re seeing — across the country, including in Utah — much lower numbers of people coming to care, both in an outpatient setting like therapy offices, but also in emergency settings who would normally seek psychological support,” said Morissa Henn, community health director for Intermountain Healthcare.
Henn said there is a specific concern about potential increases in “deaths of despair,” which include suicide and overdose. To combat that, Intermountain recently launched that Emotional Health Relief Hotline, which acts as an intermediary and connects people to resources depending on their needs.
A number of private mental providers have switched to virtual visits for their clients, per a search on Psychology Today. Providers through hospital networks like University of Utah Health and Intermountain have done the same.
While mental health experts believe virtual therapy visits could be less effective for clients overall, they agree it’s better than not seeking treatment at all. Part of the concern is phone or video sessions may not work well for people who are older and less technologically savvy, or those who don’t have reliable internet access.
“I think for sure there are some really important questions to be raised about how experiencing care in non-in-person settings may not be the best match for all people,” Henn said.
With those on the front lines of the mental health battle amid COVID-19 actively seeking ways to either find peace or help others do so, an unintended consequence could arise: a more universal sense of compassion and empathy for those with mental health issues or illnesses.
“I’m sorry people are suffering depression and anxiety from this,” Eliason said. “But I do hope it brings home what it’s like for some of us. … I hope this gets people to think about what it’s like for some of us that are normally not so connected.”
Editor’s note: Those seeking support can call the The Emotional Health Relief Hotline through Intermountain Healthcare at (833) 442-2211 seven days a week from 10 a.m.-10 p.m. Other resources include University of Utah’s crisis line available 24/7 at 801-587-3000, the SafeUT smartphone app, and the National Suicide Prevention Lifeline can be reached at 1-800-273-TALK.