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Coronavirus and mental health: 'It's a scary feeling'

Northwest Florida Daily News - 3/20/2020

Mar. 20--------

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Monica Mason and her co-workers have been cursed at, had water bottles thrown at them and taken the brunt of customers' frustrations at Dollar General in Mossy Head since the coronavirus sent grocery shoppers out in swarms.

They sell toilet paper after all.

"It's a scary feeling, considering not only my mental health, but my physical health," Mason said. "We have a lot of people come in there. Is this going to be the time someone would test positive and we don't know? I enjoyed my job; now it's hard to go in because of the stress of it. We've been busy and trying to please everybody -- I just can't do it."

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Mason suffers from anxiety and depression, and has been diagnosed with bipolar disorder, which is associated with episodes of mood swings. She takes medication to treat her bipolar symptoms, but being treated poorly by customers is a trigger.

"I really have had to be careful as far as being cussed at work and not coming back at the customers," Mason said. "It's hard. When you're in a public workplace, you really can't -- not if you expect to keep your job. Everybody out there's stressed out. The public, I realize they're scared and everybody's worried, but we're there for them; we're not there for us. We're doing the best we can."

Mason has stayed home as much as possible. It's all she can do.

"Now at work, I do go out and smoke a cigarette to keep from coming back at somebody, but it's been close," Mason said.

Anxiety

DeFuniak Springs resident Tasha Estes saw her psychologist with coronavirus-driven anxiety Wednesday.

"The thing I'm mentally battling now is no one knows about their jobs -- whether they're going to have a job to go back to or how they're going to get income for the next two weeks," Estes said.

Estes, a single parent, works for the Walton County School Board and gets paid monthly. Her last paycheck was at the end of February and she won't see another until March.

"I'm living hand to mouth," Estes said. "My children are living hand to mouth. All of the shelves are empty. There's limitations on what people can buy ... People are asking, 'Are you freaking out about this?' Externally, I'm not. But internally, I don't know whether I can feed my children."

The anxiety grows and affects her daily life.

"Just to go to Walmart, I have to figure out, am I going to leave the kids in the car?" Estes said. "I don't want to take them inside and have them exposing people if they've been exposed, or conversely them being exposed if they haven't been."

It's not just her family she's worried about. It's literally everyone.

"What's going on with my neighbors, too?'" Estes said. "We're surviving hand to mouth, but what do my neighbors have going on?"

The coronavirus craze

Melissa Nelson knows the financial and social impacts of the pandemic can affect mental health and increase the symptoms of anxiety and depression. The licensed mental health counselor hears stories like Mason's and Estes' everyday now from her clients at Living Free Therapy Services in Fort Walton Beach.

"Everything from stress and worry about finances -- with businesses being shut down, they're worried they will be laid off from employment and how do they pay their bills?" Nelson said. "To earlier, what do we do with the kids being out of school? To general concerns about loved ones, especially elderly and medically vulnerable -- and a lot of jokes about toilet paper."

While Floridians frequently broach the topic of hurricane preparedness; mental health preparedness isn't often a part of the crisis conversation. Nelson thinks it should be.

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"I think that it's people who aren't typically identified as having mental health concerns who are struggling the most," Nelson said. "The clients I've talked to who do suffer from depression and anxiety already do a lot of social distancing. For them, they're like, 'OK, this normal,' and probably already go through a lot of fear and anxiety with regard to illness. They don't seem as impacted by all of this as people who aren't normal consumers of mental health services."

Like Nelson, Destin resident Alaine Willis has seen many different aspects of how the coronavirus affects mental health. She is a medical social worker currently completing her licensure while working for a home healthcare company.

"Mainly, it's the financial and health impact that people appear to worry about because of the changes to their livelihoods and well being," Willis said. "Since we have not seen a pandemic of this magnitude in our lifetime, the fear it invokes of the unknown seems to fuel the panic. This is all out of our immediate control other than following our local and federal government guidelines and us, as healthcare professionals, doing our part to treat, remain as calm as possible, and insure the safety and stability of our patients both physically and mentally."

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The uncontrollable nature of the pandemic can cause mental instability including depression, anger and extreme anxiety, Willis said.

"We likely will see a spike in domestic violence due to the environmental stressors of job loss, illness, loss of childcare and inability to provide basic needs," Willis said. "This being prolonged often causes extreme reactions, including domestic violence."

Closing the social distance

Social distancing is today's most popular addition to people's working vocabulary.

The term means increasing the physical distance between people to prevent the spread of contagious illness. And, yes, it affects mental health.

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"That's a nice new fancy term, but a lot of people are hearing isolation," Nelson said. "A lot of social events being canceled, a lot of social gathering places being closed, so I'm seeing and hearing impacts from clients with regard to places, like, 'Oh, I used to just sit at a coffee shop and study. Can't do that, because Starbucks is closing their lobby.' 'I can't go to the library even for whatever group I had because the libraries are closing.' 'I can't go to the movie theaters to celebrate my anniversary with my spouse, even though that's our tradition, because theaters aren't recommended places to be right now even if they aren't closed already.'"

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The question becomes how to be social and distant simultaneously.

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"When we're seeing a lot of coverage about what not to do, there does tend to be a question mark left over, 'What do I do?'" Nelson said. "We live in a technological era where connection doesn't necessarily need to be in person. Let's utilize what we already have in terms of -- for example, in the therapy and medical realm, we're being advised to move to telehealth, which we will meet with clients over video conference and in some circumstances, via phone."

Nelson thinks people sometimes take technology for granted. They can Skype, video call or talk on the phone.

"Sometimes it takes being intentional," Nelson said. "I notice a lot of times people think they're connecting with people by posting or interacting on social media, but that doesn't necessarily fill that need. Being intentional to reach out and actually call and talk to our loved ones, our friends when we can't necessarily see them in person."

How telehealth can help

Nelson recommends therapy for a number of life situations, she said -- the coronavirus included.

"As mental health providers, we are specifically trained to help people work through and process any number of stressors," Nelson said.

The state of Florida is set up well for telehealth, too, she said. She will advise her clients to receive therapy via phone or video call if recommended by state officials.

"Our state allows us to practice telehealth for anyone that's living throughout the state of Florida," Nelson said. "Even if you can't find someone locally, there are other providers throughout the state that can provide telehealth mental health therapy. A lot of insurance companies are going ahead and covering that, even if they didn't previously."

If clients use an established mental health provider, the transition from in-person therapy to telehealth can be seamless, Nelson said.

"When I've met with clients intermittently using telehealth, we've picked up right where we left off in person," Nelson said. "For people using it for the first time, getting comfortable can be a little slower of a process. But in some cases, I've seen it be very quick.

Nelson admits telehealth has drawbacks.

"The concerns I hear are, 'I don't have a space that I trust to be private,'" Nelson said. "For example, a mom who is stuck at home with her kids and wants to do therapy, but can't get a space in her home that is private for an hour without being interrupted. It's great for what it is, but there are still some concerns where it's not quite the same as being in person in a time you set apart in a dedicate space that's private and set up for that purpose."

Tips beyond therapy

Nelson has several strategies to improve mental health sans therapy.

"There's some recommendations that being outside in the sunshine is really good, even if you're sick," Nelson said. "Just getting in the yard and doing some yard work for adults or sending the kids outside to play -- I think that would be a great idea as well."

For those suffering from anxiety or stress, she recommends being mindful of the information they consume. Filter through it and consume only material from reputable sources, she said.

"People tend to get a lot of their information these days through social media," Nelson said. "Instead of taking that social media post as true, let's fact check and make sure we're following recommendations from city, state and county officials -- really watching and monitoring reputable pages, like the Department of Health page that have information for consumers."

She also advises against modeling behavior after crowds.

"We went to the grocery stores over the weekend, and all the shelves were cleared of paper products," Nelson said. "That's clearly not coming from any sort of recommendation given by any official. Let's make sure we're making decisions based on our individual situations."

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