MORGAN COUNTY — We’re getting very near the one year mark from when the United States first entered lockdown as a result of the COVID-19 pandemic.
Since then, the numbers have spread rapidly, killing hundreds of thousands of Americans and leaving many more sick and/or hospitalized. But the disease isn’t the only plague passing through the country at this moment.
With millions unemployed and sick and thousands of others dying, stress in American homes is at a high right now, right alongside reports of increased anxiety, depression and thoughts of suicide.
The mental effects
Naomi Byerley is a community outreach coordinator for Centerstone, which offers a variety of services throughout Indiana including a location in Martinsville that provides crisis and urgent care, addiction recovery, counseling and more.
Byerley said many of us have seen and felt this increased anxiety. There’s an level of insecurity, she said, or a feeling that we don’t know what’s going on in addition to a lack of control that contributes to these uneasy feelings.
“And, I think for the most part, a lot of us have only had to deal with that shorter amounts of time, but we’re looking at, what, 10 months of this,” she said. “There is an end in sight. There’s some hope, but you can only be stressed out and worried for so long.”
Time has been a factor in this pandemic, a major one in fact. Experts have been using the term “COVID-19 burnout.” A Google search prompts numerous scholarly articles on the topic, which is, in essence, that people are all just. so. tired.
The rules couldn’t be simpler: Wear a mask. Social distance. Wash your hands.
None of these safety measures are complicated, nor are they major impediments to the sustainability of life. Though they are taxing on an individual’s mental state, and that much is without debate. Isolation, stress and a disrupted norms don’t mix well in the human brain.
The first thing Byerley says people need to realize, though, is that these feelings are natural and they are valid.
“Yes, it is a real thing, and yes, it can happen to you, whether you work in a health-care field or you’re a stay-at-home parent or not a whole lot has changed in your life,” she said. “It’s perfectly valid to feel extra tired or you can’t put in more effort than is absolutely necessary. I mean, heck, I think my houseplants are suffering because I’m like, ‘I just don’t want to water you today.’”
Kimble Richardson is a licensed mental health counselor for Community Health Network, a central Indiana nonprofit health system. He, very simply, started off by explaining COVID-19 burnout as “mental fatigue as a result of needing to be hyper vigilant.”
Most people, he noted, at the start of COVID were afraid and didn’t fully understand what we were dealing with, even not knowing if it was safe to go outside or touch anything at all. The general public, he said, has — for the most part — behaved according to the advice of health-care professionals.
“But human beings can only keep up a level of vigilance for so long before people get tired, and I’ll use the word weary as well,” he said. “Because it takes extra energy to remind yourself to wear a mask, to not touch people, to keep social distance. Now, we all have heard it for almost a year, so we’re used to hearing it, but even so, it’s difficult to remember.”
We were busy and had complicated lives prior to COVID, he said, so when it comes together it can be overwhelming. And that’s not even considering the amount of civil unrest this country has seen in the past year.
COVID burnout is real, he said. You get people who are compliant a vigilant for the most part who begin to periodically slip up on the rules, he said. Sometimes people get angry and purposefully do things to subvert health regulations, he said. And finally he said there are people at the very extreme “who turn off their emotions and have no feelings.”
Numbness is another term one may hear from people when speaking about COVID-19, especially as it relates to yet another daily record of deaths or spread or even less severe statistics such as the unemployment rate. There can be, among many, a feeling of numbness after dealing with this for such a long period of time.
Richardson said this is the case and that often people become numb to things like this because they are unable to handle so much stimulus for such a long period of time.
“That’s the thing,” he said. “Most humans can withstand intensity and even tragedy and can be resilient, but this is such a sustained effect… Thank goodness for the vaccine, that’s at least some reprieve. … Hope and having a sense of hope is one of the top reasons that people are resilient.
“When people have a sense of hope, or let’s say even optimism, it helps to sustain them even for years.”
How to cope
So why do people get burnt out, especially as the situation only gets worse and the spread only increases? Why are people more willing to take risks now than they were back in April?
Well, Richardson says it’s because we’ve become accustomed to the danger of this pandemic. It’s not new any longer, and it’s started to become our new normal.
“The novelness of it has worn off,” he said. “And so we’re more used to the risks. I mean when this first came in March, we didn’t even know, ‘Could I go outside? Should I go outside? Should I touch anything? Should I wash my hands every 20 minutes?’… It was scary as hell.”
Byerley and Richardson did offer some hope, though, and some advice as well.
It’s important, she noted, that individuals are kind and patient with themselves during this stressful time, but she also had a few pieces of practical advice for healthy ways to move forward.
One thing that can help reduce anxiety, she said, is to get outside and exercise. It’s a bit harder to do in the winter, but she said if it’s possible for you to bundle up and stay warm while going on a short hike, it can do wonders for your mental health.
She also said if you can’t get outside, she has a simple trick she likes to use. It’s a method of mindfulness, she said, and it can be anything really. She encourages people, if they’re feeling particularly anxious or in-their-head about something, to find an activity and engage with it using all of their senses.
That can really be anything, she said. If it’s hiking, she encourages you to think and feel the cold wind touching your skin, taste and smell the air, listen to the sounds and engage with visuals.
Or it can be simpler, such as with a candy wrapper. Instead of just popping the candy into your mouth, take a moment to listen to the wrapper crunch and feel the foil or whatever wrapping it is between your fingers.
These things may sound simple, but she said they can help give you a break and can help disrupt our fight-or-flight response.
“Sometimes we need a break,” she said. “Sometimes we need to be able to not think about the future for just a couple minutes. Sometimes we need the chance to take a break from feeling sad about something that has recently happened for just a couple minutes. So those mindfulness exercises, they’re nice because you’re not escaping for a long time, you’re just taking a break and regrouping, reflecting.”
Richardson also recommends these exercise in mindfulness to his clients, encouraging them to practice breathing techniques or yoga in addition to therapy if they’re needing more help.
He says they encourage people to practice these activities on a daily basis, that they make them muscle memory and a daily habit. They encourage that, he said, so that if a person is feeling anxious or depressed, they can go to their tried-and-true activity rather than trying to remember how to do it when the time comes up.
Anxiety, Richardson said, is a future-oriented emotion. He’s not saying these activities will eliminate the anxiety completely, but they ground you in the present, in the moment you’re in.
And he said he’s used these techniques and works with people who are struggling with some of the worst things imaginable right now. They work with people who have lost loved ones to COVID-19 as well as with health care workers who are dealing with it all firsthand.
“They’re not easy issues, OK?” he said. “But we still can see people do OK, get through things and not only survive but thrive, even.”
Richardson also laid out what he called the four most popular factors or qualities that make a person resilient in the face of trauma such as this.
No. 1 is having a sense of hope or optimism. He said some people are born optimists and others are not. However, he said even for those naturally pessimistic, it is possible to learn to think positively.
The second is having a moral compass or a sense of faith/spirituality. It’s important, he said, for people to be able to distinguish right from wrong in these circumstances.
Thirdly he mentioned “cognitive flexibility,” which he explained as an individual’s ability to see shades of grey.
Finally, and what Richardson said is most important, is that people need to have a social support network. People need at least one other person to go to in the case that they are dealing with trauma or stress. It’s the case for adults and children alike, he said.
The more of these qualities you have, Richardson said, the better.
“And here’s the cool thing,” he said, “you can get them if you don’t have them. That’s the good news is that it’s not dependent on your genetics or your circumstances.”
Help is available
There are also many things the government can do, Byerley said, to ensure that the mental health needs of citizens, especially now, are being met. For one, she said they need to ensure they are maintaining resources like the National Suicide Prevention Hotlines and that the local hubs are receiving funding.
She also said they need to continue working to allow people to access health care as much as possible remotely, something that has been expanded upon during the emergency order. She said they have received messages from people in rural areas and those without easy access to transportation that this remote access has been a major benefit to them.
Richardson wanted to offer a personal example to show that this anxiety, that this long-term trauma many of us are feeling can get to anyone, even mental health counselors.
Prior to COVID-19, he said he had agreed to give a lecture at the University of Indianapolis that happened to fall after the outbreak had occurred. Well, in his profession, he said he was working 16-18 hours a day for weeks near the beginning of the shutdowns.
He decided to continue giving the lecture, virtually of course. He got through what he wanted to say to the class and right before leaving, he offered them a few words of farewell that affected him more than he expected them to.
“OK, everybody, be safe,” he said.
And then he started crying.
He doesn’t cry in public, he said, not that he thinks there’s anything wrong with it. He just doesn’t really do that. It was at that moment, he said, that he realized just how stressed he’d been. He said he’d barely slept in weeks, had hardly eaten, had a wife working as an intensive care unit nurse and a daughter who they were most likely sure had COVID at the time.
Looking out into a sea of students, all around the age of his daughter; it was the straw that broke him.
The next day, he went into a meeting he had for a crisis team he was leading at Community Health Network and told his colleagues. They assured him that they had experienced similar moments of release.
“I didn’t feel alone,” he said. “… So I use that personal story just to say that this can happen to anybody, even mental health professionals. Then you figure out, oh OK, you’re not alone and then you put the skills that you teach into practice.”
Byerley said she wants people to know that they are not alone, even if their thoughts shift to that of suicide or self-harm, that many people struggle with this even during less tense times.
She encourages folks to be there for each other and to be gentle and understanding with one another, knowing that people can be going through a hard time at any time. There’s no shame in feeling those feelings, either, she said.
“Feeling tired or depressed or anxious doesn’t make you weak,” she said, “it makes you human.”