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Not Your Normal: Discussions of mental health ramp up during quarantine

Financial concerns and feelings of isolation are common reasons that people have cited for turning to mental health professionals during quarantine. [Source: Pixabay]

When the impact of COVID-19 started to gain mainstream attention in early 2020, frontline workers were tasked with keeping the world turning while others were told to shelter-in-place for an indefinite amount of time. For some, this means hours of nonstop work or having to shelter in less-than-ideal conditions.

For others, the abrupt change in routine and constant onslaught of fatality statistics is enough to turn a new situation into a distressing one.

In response to the varying amounts of distress, the Saint Louis Mental Health Board [Saint Louis MHB] forged a partnership between the United Way and Behavioral Health Response, a mental health service provider in Creve Coeur. For many years, United Way’s 211 hotline has been a free and confidential referral and information helpline that helps connect individuals of all ages to essential health resources in a variety of fields. However, when Saint Louis MHB introduced a collaborative element with the Behavioral Health Response team the helpline became a hotline that combines experts in both the fields of mental health and social services.

The hotline provides access to free, professional mental health resources for St. Louis-area individuals during the COVID-19 pandemic. The line is accessible by dialing 211 and pressing 1. Doing so will connect the caller with a medical health professional while the caller’s identity remains completely confidential.

According to Serena Muhammad, director of Strategic Initiatives at Saint Louis MHB, the service is funded by all local governments that have taxes for children’s’ mental health, including St. Louis County.

There is also a separate text-based line that is available for youths who are feeling stressed. The service is available by texting BHEARD to 31658.

“Some young people don’t feel comfortable making a phone call as the first point of contact,” Muhammad said.

The goal of both systems is to provide guidance to those who are feeling overwhelmed by current events. According to Muhammad, the 211 hotline and its text counterpart differ from other similar services in that they are not solely crisis or emergency response lines.

“You can call if you’re just feeling different and you’re not feeling like yourself, or you’re not sure what’s going on,” Muhammad said. “Maybe you’re anxious or you’re not sleeping well. Whatever is happening with you that you feel like is not your normal, you can call this line. We don’t screen anybody out.”

According to Muhammad, the referral system also works for individuals who are suffering from intense anxiety or need emergency medical attention.

“For some people, they just need someone to talk to and express things, and that’s all,” Muhammad said. “Others may have a more serious need, and they would be connected to professional mental health sources. Even if you are in crisis and are suicidal, this same number can connect you to emergency response services. It really does run the gamut.”

According to Muhammad, some of the most common stressors that individuals call about are related to job loss or a reduction in income. Because this hotline is tied to United Way’s network, callers can be instantly connected with a network of professionals that can provide information on a wide array of services. This includes applying for supplemental food and nutrition programs, shelter and housing options, veterans’ resources and more.

“There’s a lot of anxiety around the economic impact of [COVID-19], and people are calling because of that,” Muhammad said.

In fact, according to Muhammad, the hotline has seen a considerable spike in calls during the pandemic.

“The important thing for people to realize is that this impacts everyone, so there is no individual that isn’t feeling something different as a result of having their whole life shift in the past few months,” Muhammad said.

According to other medical professionals, this increased interest in examining mental health resources coincides with an increasing number of individuals scheduling visits to explore remediation opportunities at home or starting the process of finding a therapist or psychologist.

And adults are not the only ones asking for help.

The impact of anxiety on kids

After the closure of schools due to COVID-19, students of all ages suddenly found themselves adapting to a new form of classroom learning while remaining socially isolated from friends and peers.

According to Dr. Delene Musielak, dual-boarded internist and pediatrician at St. Luke’s, there has been an increase in both patients and parents of adolescents reaching out during quarantine about mental health resources, therapists and psychologists. While some of these patients have history of anxiety or depression, others do not.

For young children, feelings of increased stress and anxiety can manifest through mood swings, irritability, acting out, crying, temper tantrums, complaints of not feeling well or self-initiated isolation.

“We have to remember that most of our children have never been through a situation like this,” Musielak said in an email interview with West Newsmagazine. “It is all new to them. Children flourish with routine. Their normal routine has been disrupted. At this time, there is a new norm for them, and not everyone handles change well.”

Sometimes, feelings of distress can be so intense that children will experience them in forms of physical discomfort. This can include stomach pains, nausea, headaches and even vomiting.

“As adults, we can even experience these symptoms,” Musielak said.

As for mitigating stress levels for preteens who may already be experiencing changes in demeanor as a result of puberty or other factors, Musielak said that maintaining open channels of communication can help parents discern normal mood changes from more severe stress symptoms.

“Allow your children to express their feelings and emotions about the current situation freely,” Musielak advised. “Do not undermine their feelings and sensitivity. Communication is key. When puberty hits, most kids don’t want to talk about it. That’s why it is important to establish a good relationship even before that time. Your child will be more approachable and not think that you’re just trying to get into their business.”

This open dialogue can also help parents make sure their own stress levels remain in check and that their concerns or anxieties are not being transferred to their children or teens.

“Another important aspect is leading by example,” Musielak said. “If you are a worrywart and anxious about the current situation, your children will sense that. As a result, those emotions can transfer to your children. The current pandemic does make most people worried. It’s normal, but you don’t want that anxiety to start affecting your quality of life and happiness, because then it will affect your children’s quality of life. Use it instead to teach them wisdom and how to make good decisions during unprecedented times like this.”

For teenagers, signs of intense anxiety may manifest in the form of mood swings, irritation, crying, isolation, complaints of pain, or even a decrease in performance in academic or extracurricular activities. This is also a time when individuals may turn to outlets such as drugs or alcohol.

“Do not ignore warning signs,” Musielak said. “If you feel that your child is depressed, anxious or stressed, please seek the appropriate help. Even though a lot of facilities have limited in-person visits, telemedicine visits through video or by telephone are available. Early intervention is always better!”

For every age group, including adults, one of the best ways to facilitate a sense of normalcy during turbulent times is to find a routine and stick to it. Examples include dedicated mealtimes, sleep schedules and a balanced amount of chores or assignments per day.

“Keeping a good balance is important,” Musielak said. “Life gets difficult when it’s skewed.”

Musielak also recommends that families take time to play games, connect with others through virtual video-conferencing applications, and designate “me time” when individuals can decompress from the day’s activities.

“Try to make the best positive environment at home, create a good support system, be an example and get help early,” Musielak advised.

Personal mental health check-ups

According to Muhammad, there are multiple measures individuals of all ages can take at home to help minimize stress.

The first recommendation is to get outside.

“The first thing you should try to do, if you can do it safely, is get out in nature,” Muhammad said. “Whether you’re just outside in your yard or you’re taking a walk, it does have a significant impact on your mental health and not just your physical health.”

Muhammad also recommends that people try to be more cognizant of any emotional patterns, especially negative ones.

“Document it every day,” Muhammad said. “‘These are the things I’m worried about, these are the things that upset and worry me’ and start to look for patterns.”

Individuals of all ages, especially those in complete isolation, should also find ways to reach out to loved ones via phone or video-conferencing applications for safe human contact.

“Figuring out if you can carve out a few minutes a day to chat with that person over the phone is a good way to keep your mental health intact,” Muhammad said. “Finally, if you’ve done all those things and you still feel overwhelmed, we really suggest that you call 211 and tell them what’s going on and see what kind of support they can offer.”

Whether an individual ultimately decides to schedule a doctor’s visit for themselves or a loved one or reach out to a hotline, the act of speaking with a mental health professional can help maintain an open dialogue about personal wellness for the remainder of the COVID-19 quarantine and beyond.

“We don’t talk about mental health enough in our culture, and this pandemic has really given us the opportunity to all be mental health advocates,” Muhammad said. “It’s one thing to read about what it’s like to feel anxious or depressed, but it’s another thing to experience it.”

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