We’ve all felt it. Early morning malaise, a sense of being trapped, a kind of miasmic hopelessness that permeates our days, a vague unease around other people and an inclination towards agoraphobia, fear of leaving your house. “I don’t know what to do with myself,” several friends have told me. “I’m so tired of wearing a mask.”

It’s COVID fatigue. And it’s not all in your head. Well, it is, but you’re not imagining it.

One of the consequences of the Coronavirus pandemic is an explosion in reported mental health issues—anxiety, depression and suicidal impulses. According to an August story in USA Today, women, young adults and children are suffering the most, but experts fear that across the population the coronavirus pandemic will be followed by a mental health pandemic—one that we’re equally unprepared for. Back in May, the World Health Organization called out “the need to urgently increase investment in services for mental health or risk a massive increase in mental health conditions in the coming months.”

The coming months are here. Just look at some numbers.

The Centers for Disease Control conducted a survey of 5,412 people between June 24 and 30 and the collected data on suicides is alarming. Roughly 25 percent of young adults between the ages of 18 and 24 say they’ve considered suicide because of the pandemic. About 30.9 percent of the respondents said that they “had symptoms of anxiety or depression” and about 26.3 percent reported trauma and stress-related disorders caused by the stress of the Coronavirus. Over 13 percent said that they have used alcohol, prescription and/or illegal drugs to deal with their pandemic-induced stress and anxiety.

“I just want to give up and I don’t know what to do.”

To make that more locally specific, Dr. Kristin Francis of the University of Utah Neuropsychiatric Institute says, “Since March, University Neuropsychiatric Institute (UNI) has observed a significant increase in calls to our CrisisLine and WarmLine. Call volume increased by almost 25 percent in May. Mental health providers are noting increases in the self-reporting of stress, anxiety, depression, fear, and suicidal thoughts, even among people who do not have a prior psychiatric history. Individuals are talking about their fear of the unknown because of the pandemic, relationship strain, physical isolation as a family, transitioning to working from home, economic uncertainty and social justice, all while expressing fatigue and, for some, a sense of hopelessness.”

“Everywhere I look, there’s nothing but bad news.”

Add to the Coronavirus itself the anxiety about climate change—heat waves, forest fires and hurricanes—political upheaval and family turmoil resulting from changed school schedules, workplaces and scrambled routines and we’ve got a bubbling mudpot of stress and confusion.

Plus, we live in Utah where mental health services are notably lacking.

A Salt Lake Tribune article quoted a report released in August by the Kem C. Gardner Policy Institute in partnership with the Utah Hospital Association, “Fewer than half the adults with a mental illness in Utah are getting treatment or counseling, and suicide is the leading cause of death for the state’s youth. Last year, Utah ranked 51 in a national mental health ranking because of its high rates of mental illness and suicidal thinking and significant unmet needs.”

2020 was the first gubernatorial election where candidates included mental health as part of their platform. Concerns and reactions to COVID-19—social distancing, quarantines, school closures, work-at-home programs, mask-wearing—started last March but the public’s emotional reaction has seemed to crescendo, peaking now. This is normal, according to Dr. Francis. “Looking back at the financial crisis in 2007-8 and studying trends, we found a “lag effect”—months after it started, there was an increase in reported anxiety and depression and suicide rates went up four percent.” At first, everyone is ok. There’s a lag between trauma and its manifestation.

“I just don’t see a reason to get up in the morning.” 

We’ve reached a COVID breaking point now. With a significant absence of resources to address it.

Why the care shortage? Experts cite everything from the high cost of treatment to a cultural bias against seeking help for mental health. “Often,” one local psychologist said, “We are told depression is a matter of will power and fortitude. Or we are advised to pray about it.”

The fact is, mental health is brain health—complex chemical interactions in your brain can cause depression and despair.

“I just want to hug someone. But I can’t.”

For example, you’re not just missing the human touch in a sentimental way: You need it like you need sunshine and fresh air. It’s part of our good health. According to Dr. Francis, one survey reported, “Thirty-five percent of respondents said it had been four months or longer since they hugged someone outside their family. Humans are meant to be in physical contact with one another—we have a physiologic endocrine reaction, the release of endorphin when we’re touched.”

People still don’t think of the brain as an organ, part of the body. “When your brain is sick or ill, you have pain and dysfunction, you have body consequences,” says Francis.

You literally feel it.

“We see it when there are disruptions in speech, behavior or verbal symptoms. But when it’s depression or anxiety, we think it’s a personality issue, not a manifestation of a brain illness.”

But there is even a barrier between admitting you need help and getting it—ironically, especially during this pandemic, because people don’t like to leave their houses. And in rural areas, a shortage of rural mental health care providers exacerbates the problem. Telehealth is one potential solution that has gained traction during the pandemic, said Nanci Klein, professional affairs director for the Utah Psychological Association. And Tele counseling is easier for some to deal with than face-to-face therapy.

Some of today’s mental health problems can be self-alleviated by frequent exercise, healthy eating, sufficient sleep or abstention from alcohol and drugs—your brain is your body, remember—but most therapies need an expert’s help. 

The Kids Aren’t Alright: School closures have exacerbated student mental health issues and rendered help harder to reach.

“We’ve switched the vocabulary to refer to it as ‘crisis teaching’ rather than ‘remote teaching.’ That’s a much more accurate descriptor of what we’re confronting,” says Betsy Weidner, a 9th grade English teacher at Waterford School in Sandy. “Isolation experienced by our students is the number one concern. It’s what keeps me up at night.” Waterford, a private school, began the school year with a hybrid teaching model consisting of both remote and in-person learning. It was just one of several discordant ways Utah schools attempted to educate and engage students as schools reopened during the pandemic. Others opened for in-person instruction, while others, including Salt Lake public schools, were entirely remote. Regardless of the model, students, teachers and administrators encountered unprecedented circumstances upon their return extending far beyond the mechanics of instruction. Addressing student mental health needs has historically been an underappreciated aspect of teaching, and it’s become simultaneously more imperative and difficult to do in the age of COVID. “The reality is teachers are boots on the ground and often the first people to identify students who need help,” says Weidner. “There’s an organic network between teachers who know the same students, but we’ve lost that connection now that we’re isolated from one another. I worry we’re going to miss something.” The combination of wearing masks—which are essential to mitigate the spread of coronavirus—distance learning, limiting classroom capacity and curbing extracurricular activities are reinforcing the mental health stressors induced by student isolation. Abandoning those policies would have a disastrous public health impact, so educators are scrambling to make do. “Kids are unbelievably resilient, and they’re conditioned to tell you everything’s fine,” Weidner says. But many haven’t developed healthy coping mechanisms to help them process what has become profound societal trauma. “A lot of students have their own version of therapy through interpersonal connections and passions, whether that’s athletics, art or just connecting with their friends. If you replace that with chronic isolation, you start to see some students drifting to dark places.” Providing access to mental health resources during the pandemic is an urgent concern, especially locally in Utah which, according to the CDC’s latest data, has the seventh-highest teen suicide rate in the United States. Waterford is better positioned than many schools thanks to having multiple counselors on staff, substantial dean involvement and consistently high parent engagement, but it still at times doesn’t feel adequate in a suddenly extremely online world. “The negative echo chambers you can encounter when so much of your life is online can be dangerous. How do you cultivate a healthy, authentic community online when so much of your experience has been grounded in anonymity?” Weidner asks. Perhaps if we’d focused energy and resources towards creating an environment safe enough to open schools instead of squabbling over opening bars and restaurants to alleviate collective boredom, we wouldn’t be scrambling for an answer. —Tony Gill

So who you gonna call? Your first resource might be acknowledging that depression and anxiety are real illnesses. So see your regular physician. Your primary care doctor can prescribe lifestyle changes and some basic medications. Make an appointment with a psychologist, a therapist who has a Masters’s in counseling or social work. You can see a psychologist either in person or, very easily, online. Tele-counseling has seen a big surge during Covid and is likely to be the norm in the future. Patients are often more comfortable talking via Zoom from the comfort of their own home. Psychologists can’t prescribe or do psychological testing, but they can help guide you to someone who can. Talk-therapy plus medication is often the most effective treatment. If you (or your psychologist/therapist) think you need medication, see a psychiatrist. Psychiatrists are full medical doctors who specialize in brain health. They can prescribe appropriate medication. These drugs do not alter you, they restore you to your full self, much like insulin restores your body’s blood sugar balance. Our neural system communicates via chemicals which may need to be adjusted. Guided meditation and mindfulness, like therapy, can help in changing your perspective. Working with a recommended life-coach can help you prioritize and organize what kind of help to seek.

Tech Resources Can Help SafeUT is an app facilitating a real-time crisis chat and tip line run by the University of Utah. The free, confidential app connects you with licensed clinicians 24/7 who can assist with supportive or crisis counseling, suicide prevention and referral services. SafeUT has been embraced by many schools throughout the state and is a vital tool for teens, young adults and anyone who connects with them. SafeUT is available for download on your smartphone in the apple app store or on Google Play. https://healthcare.utah.edu/uni/safe-ut/

Coaches aren’t just for Athletes Another resource for those seeking help is by gaining the assistance of a life coach. More practical than traditional counseling and less clinical than psychiatrists, life coaches can aid in breaking old negative patterns, provide structure and a game plan to bring about desired changes. Issues can include anything from weight loss and healthy living to helping an adult-aged child become more independent. According to a local life coach at Clarity Coaching Institute, Kathryn Dixon, “In my 17 years of practice, this year I’ve noticed that folks are being more honest about their pain and struggles. With the added stress, people are ready to make changes. The status quo no longer suffices—people are looking for more authenticity and deeper meaning in their lives—and they are moving forward faster than ever before. I find it thrilling.”—by Jen Hill Kathryn Dixon, Life Coach, Clarity Coaching Institute ClarityCoachingInstitute.com 801-953-3942