It’s been more than two months since the COVID-19 pandemic brought the first stay-at-home orders from government officials striving to “flatten the curve” of the virus as it has worked its way through Delaware and the nation.
Whether we’re sheltering at home to avoid exposure to the virus or working in health care or other essential services, the virus has impacted more than how we work, shop or gather – it has affected how we function as human beings.
Until March, mental health counselor Allison Scrivani saw clients in her home near Bethany Beach. Now, she meets with them virtually – by FaceTime or another video application, or over the phone.
What Scrivani is hearing from them, she said, is largely that they feel they have lost control of their lives, and that loss of control manifests itself in different ways.
What she called a “generalized reaction” to that loss of control causes issues like lack of concentration, sleep issues, short tempers, anxiety about contracting the coronavirus, developing an obsession with the news, and depression caused by lack of social interaction with friends and family.
“This pandemic has become a type of mental addiction for many people,” she said. “They have become obsessed with COVID.” This obsession, Scrivani said, is “often not by choice, but by the constant bombardment of information and statistics, thanks to our 24/7 news cycles.”
Scrivani said she urges her clients to use an approach similar to the Serenity Prayer used in the treatment of addiction: “Accept the things they cannot change, change the things they can, and recognize the difference,” she said.
Step away from the 24/7 news cycle
To combat the potential overexposure to COVID-19 news, Scrivani said, “the most important step is to severely limit the time watching and listening to news, radio and traditional TV.” She said the constant reporting on the coronavirus raises anxiety levels. “Even when the news is not on TV, there are public service announcements constantly from the government, advertisers, local businesses, etc.
“They act as a constant reminder,” she said, “that we are in trouble.” Although such programming is designed to be helpful, Scrivani said she believes they can have a “reverse impact.
“I urge my clients to switch to Netflix, Hulu, Amazon Prime or some other streaming service,” to watch TV, she said. “This significantly reduces the visuals that will raise anxiety levels. There is very little, if any, of what you hear or see on the news that you as an individual can impact.”
Instead, Scrivani said, she encourages clients to structure their daily activities. “We have the government telling us what can be opened, where we can go and how we can interact with people,” she said. “We cannot control those issues. We can control and decide what we do, based on those restrictions, each day.
“Getting out a little each day will help,” she said. “Go for a walk, have a picnic lunch, go watch the people fishing at the inlet, sit in your backyard and enjoy the sun, read a book, do a craft.
She said she also recommends yoga, meditation and mindfulness techniques. “Most people have a ‘happy place’ they go to in times of stress,” Scrivani said, whether it be an actual place or an activity. “Anything that will help an individual gain control of their lives is helpful,” she said.
Scrivani said she is seeing, in the general population, a form of “battle fatigue” – officially, combat stress reaction. Defined as a range of adverse behaviors resulting from the stress of battle, some symptoms of CSR are exhaustion, a decrease in responsiveness, as well as feelings of hesitancy and uncertainty, “feeling like you are disconnected, and inability to focus,” she said.
“As a mental health professional, I am seeing these symptoms all present themselves on a daily basis,” she said. “The battle against COVID has been characterized as ‘fighting the invisible enemy,” Scrivani said, “and we are seeing the results this battle is having on people.”
Red flags, signs of trouble
Some “red flags” that people are struggling to a point that they need professional help, she said, include “are normal stress-reducing activities not working? Is there a heightened anxiety level? Is substance abuse presenting itself,” whether it be drugs, alcohol or food. “Is the client becoming more isolated from friends and family? Are there increased signs of depression?” Any one of these suggests a crisis point may be approaching, Scrivani said, and professional assistance may be helpful.
As a former hospital social worker, Scrivani said she is “quite familiar” with mental health issues of health care workers.
“Hospitals have traditionally been considered safe places,” she said. Staff members are trained in “normal safe practices and anti-infection techniques.
“Unless you worked in an area that handled infectious diseases, you were not normally exposed to the mental strain required on a daily basis to maintain your safety.” This has changed since the arrival of COVID-19, she said.
“We routinely see pictures of doctors and nurses in scrubs, masks and face shields. What you cannot see is the enormous stress and anxiety putting on and taking off that equipment creates for the individual wearing the equipment,” Scrivani said. One mistake can result in sickness and death. Is the mask on right; is the face shield properly positioned? Is the gown protecting me; are the gloves going on and coming off with the right procedure?”
Scrivani said this heightened anxiety in health care workers lasts “for an entire shift, not just for an occasional patient” and that the stress is cumulative, meaning it piles on top of itself from one day to the next. This, she said, makes health care workers more prone to developing CSR, and later, post-traumatic stress disorder-type behaviors.
Retail workers on the “front line”
It’s not just health care workers, though, who are feeling such intense stress. Retail workers, she said, “have another set of issues they need to deal with as they perform their daily functions.
“We are now asking retail workers, as part of their jobs, to be accessible to strangers wearing masks, standing behind plastic barriers,” as well as wearing gloves and mask themselves, to be protected from a virus that can make them sick or kill them,” Scrivani said, adding that many don’t have the option to stay home because they need to feed their families and pay their bills.
“Their lives and those of their family are put at risk on a daily basis, for a low hourly rate of pay. The stress and anxiety associated with these jobs is tremendous and we all need to be thankful for their work,” she said.
“The socio-economic impact of this pandemic is devastating,” she said. “Working and having a job to support yourself and a family is critically important,” she said, “and that has been impacted at a level not seen since the Great Depression.
“This is going to be the biggest challenge for us to face in the coming months and years. Until we move forward with getting people back to work and becoming functional individuals in our society, mental health issues will continue to increase,” she said.
Stay honest, positive with your children
Children, Scrivani said, are also vulnerable to the mental health effects of COVID-19. She suggested that parents, in general, be honest with their children about the virus, and respond in an age-appropriate way to their questions and worries.
“Keep a positive outlook when addressing the issue,” she said, adding that parents should stress to their children that “this will pass.” Keeping children busy with activities and giving them creative outlets can also be helpful. Like adults, Scrivani said, children need to feel they have some control over their lives, so giving them choices about what they’ll do on a given day can be helpful.
Also, adults should limit what children see on television, she said. “There is so much misinformation that it may confuse or scare them,” she said. “Just make sure they know that you care about them and that you will keep them safe.”
Focusing on one’s self and one’s family, rather than on issues beyond one’s control, holds the key, Scrivani said, to maintaining a balanced and healthy outlook during the pandemic. “We will get through this event,” she said.
As many are now utilizing such platforms as Zoom and FaceTime for doing work-related communication, Scrivani suggests using them to keep in touch with family during this time of social isolation. “If clients embrace modern technology to stay in contact with their “bubble” (close friends and family), she said, “they can take control of their lives and not feel left out of their relationships.”
Scrivani said there are a variety of sources for mental health assistance in Delaware, including the 211 assistance line through which callers will be directed to the appropriate assistance that is available in their area. A web site, HelpIsHereDE.com offers options, although she said more of those are available in New Castle and Kent counties than in Sussex.
“Sometimes,” she said, speaking with a priest, a rabbi or other religious leader, or your primary care physician, can be helpful in bringing down the stress levels.