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A 'psychological pandemic': Emotional stressors drive unprecedented demand for therapy

There is a new pandemic spreading across the U.S., but this one isn’t fueled by microscopic infectious parasites.  

It is the result of the emotional overload tied to a once-in-a-lifetime convergence of a worldwide health crisis on top of social, economic, racial and political unrest that has exhausted American psyches, mental health experts say.  

“We have uncertainty to the max,” Temple University psychologist Frank Farley said. “We’ve had a sort of piling on of stressors, which I have never seen in my lifetime. No break and restrictions on our response because of COVID.”

The “psychological pandemic,” as Farley calls it, has resulted in unprecedented demands and needs for mental health resources, support and services. 

And some mental health service providers say they are overwhelmed with requests for online support groups and counseling. They are seeing more people describe symptoms of extreme anxiety, depression and post-traumatic stress.

That feeling you can't name? It's called emotional exhaustion.

For people living with diagnosed serious mental illness, the last 10 months of unrest has been a dangerous time with one emotional trigger after another, providers said. The impact is likely to linger long after the world returns to the pre-pandemic life, they added. 

Thousands of President Donald Trump's  supporters storm the U.S. Capitol on Jan. 06, 2021.

“If you have paranoid thoughts or anxiety, think what your brain could do with all this,” said Nicholas Emeigh, director of Outreach and Development at National Alliance on Mental Illness, Bucks County, Pennsylvania. “This could take a toll on somebody’s mental wellness when you don't have a mental illness.” 

Since the pandemic started NAMI Bucks County typically schedules 33 online mental health support group meetings a month. 

For January 130 meetings are scheduled, Emeigh said. Six support group meetings were planned Thursday, the day after the D.C. riots, and like all groups lately they were at capacity.  

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Some people are attending multiple sessions a day, Emeigh added.  

A common theme in the groups he moderates is people are torn between wanting to turn off the news cycle to get a break, but afraid what might happen if they do.

People attending the Thursday morning support group were looking for perspective and reassurance with the unrest in D.C., he said. 

“A lot of people are afraid, if they turn the news off it will seem like they don’t care,” he said. “For portions of the population, it’s hard to know what is real and what to believe and what not to believe. They call and ask if it’s real. It’s so stressful for them. It’s too much.”

NAMI support group attendance has increased since the end of summer, said Abby Grasso, executive director in Montgomery County.

Among the topics seen in support groups are increased symptoms of anxiety and depression related to COVID-related social isolations, perceived social injustices and people who are unemployed and feeling a lack of purpose, Grasso said.

Requests are also up for support groups targeting families and child caregivers and youth, she said. They are also seeing an increase in calls from employers looking to connect employees with mental health help. 

The Montgomery County chapter has 15 groups a month, which increases to 20 next month with the addition of “Teen Chat,” a weekly online group targeting high school students. 

Demand for student counseling services at Bucks County Community College, which has three campuses, has not slowed since March 15, when the college shifted to mostly remote operations.

About 1,000 students have requested virtual counseling appointments with no usual slow down over the summer and at the start of the Fall term, said Dekia Smith, associate dean of student success and retention and a licensed mental health counselor. 

“We had students emailing us in August, saying ‘I want to set up an appointment right now for Fall,’ and it’s never ended,” Smith said.

Another shift Smith has seen is the nature of the counseling requests from a mix of career, personal and general issues to more mental and emotional-health concerns.   

Some students, with identified mental health challenges, such as anxiety, depression or substance use, experienced relapse of symptoms that caused them to struggle, Smith said.  

Counselors are also seeing onset of mental health disorders in students that never experienced symptoms before, she added. 

“The pandemic put a huge strain on all of us, staff and faculty as well,” Smith added. “We all feel the constant stress of living in a remote and semi-isolated bubble, and it’s tough.”

Smith compared the mass mental health struggles as reminiscent of what most Americans experienced after the  Sept. 11 2001 terrorist attacks in New York, Washington D.C. and Pennsylvania. 

“We all have a decent understanding that this will pass. We have a vaccine. Normalcy will come back,” Smith said. “But impact of all this, it’s going to linger for a long time. There is no telling what that is going to look like the next year, the next five years.” 

For people with vulnerabilities to mental health issues, stressors of any kind can make it harder to manage symptoms, said clinical psychologist Diane Rosenbaum, a professor at Penn State’s Abington campus

When stressors are particularly significant, their impact may overwhelm existing coping skills, which can lead to symptoms worsening, and/or new symptoms emerging, she said.

“Emotions serve important functions, such as motivating us to take action when we are faced with a problem,” Rosenbaum said. “It’s a natural reaction to have a strong emotional response when acts of violence, hate, and tragedy occur.” 

Over the last year, Americans, in particular, have been hit with a lot of difficult stressors with no significant break for reflection, said Temple’s Farley, who is also past president of the American Psychological Association.

Uncertainty is a major source of human stress and the COVID-19 related restrictions have forced many people to find new coping mechanisms and limited familiar outlets for stress reduction, Farley said.  

He suspects the rise in uncivil and uncharacteristic behavior among some Americans is a form of coping response to pandemic-related social restrictions. 

Emotional stressors impact decision-making ability, they distort the cognitive process and interfere with rational thought and evaluation, known as executive function, Farley said.

Farley believes this stress overload also explains a rise in perceived uncivil behavior among some Americans. 

They are seeking to exert control with things they feel they can change such as defying cultural and societal norms by refusing to wear face masks and ignoring indoor dining bans. 

“Our normal behavior and stimulation seeking tendencies are being strongly curtailed, so we are constructing defenses and rationals like, 'This is government controlled,’ and ‘It’s not right so I’m not going to follow the rules.’” 

If you need to talk to someone 

National Suicide Prevention Lifeline: 1-800-273-8255

Substance Abuse and Mental Health Services Administration National Helpline – 1-800-662-HELP (4357)

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