It’s been a tough seven months. There are children who haven’t played with another child or seen their grandparents. Many singles living alone haven’t touched another person. There’s been more domestic violence. More fighting between couples. Seniors who feel completely isolated and depressed. Teachers, health-care workers and other employees fretting about the risks on the job, particularly if they are living with an elder or autoimmune-compromised family member. The deepening economic crisis is causing many people to lose their jobs and possibly their home and for young adults to miss out on a college education.
As winter approaches and the pandemic shows no signs of abating, mental health experts worry that the psychological effects will be long-term, particularly for children and young adults. They also noted a few positives: more bonding in families as parents work from home and spend more time with their children, more time spent outdoors in nature, a re-adjustment of values and a reckoning among many people of how to live a better life through more meaningful work and engagement with others.
But as the holidays approach, many people who are already fatigued from the social distancing, the lack of contact with others, the confinement of home—and who isn’t?—face the daunting task of spending them alone. National health experts recommend avoiding gatherings indoors with friends and families, which have proven to be an effective spreader of the virus, but even for the most resilient of us, it won’t be easy.
While fatal opioid overdoses are up a mind-bending 153 percent in Ulster County from January through September compared to the same period in 2019—non-fatal opioid overdoses are up 73 percent—Tara McDonald, Deputy Commissioner of the Ulster County Department of Mental Health, warns against attributing the increase solely to the pandemic. “There are so many other contributing factors,” she said, noting that while suicides increased in April and May—she said there is always a higher incidence of suicides in the spring—there were none in August and September. (So far this year, there have been 20 suicides, the majority by men and half by people age 41 and older, which is older than usual, she said. Her department is responding by pivoting its suicide-prevention communication methods to include more traditional media such as radio and newspapers.) Despite the mixed messages of these statistics, there’s no doubt the pandemic has resulted in people feeling more stress, say mental health professionals.
The call volume at Family of Woodstock’s 24-Hour Crisis Hotline (845-338-2370) has increased overall since March and at times has doubled, according to Tamara Cooper, team leader of the hotline and head of agency training. “People want to hear a human voice,” she said, noting that thanks to the Internet there are more callers from outside the region; she predicts that as the cold weather sets in, the volume will increase even more. “There are a lot of external things people are responding to. One driver is the perception of loss—of connection, financial security, and your job,” Cooper said. “The subset of this is loss of family and friends. There’s a loss of connection around the political system. People are feeling more desperate.”
What therapists are seeing
Nina Schmidbaur, a Kingston-based psychotherapist who treats both children and adults, said people who live alone are affected the most. “Many are experiencing symptoms similar to [those of] solitary confinement and experiencing extreme bouts of depression and an increase in suicidal thoughts,” she said. “The lack of physical touch is severe. It has an impact similar to that revealed in studies done on infants raised in an orphanage.”
Schmidbaur is particularly concerned about the isolation experienced by children under the age of 12, who, perhaps because they or their parents have a condition that makes them vulnerable to infection, have not seen another child in eight months; some have not even left the house. “They’re not interacting,” she said. “Children who used to be extremely creative in their play in my office now want to watch a video. I’m worried about the long-term impacts on young children who are internalizing this lack of contact. There’s a natural need for us to be more hyper-vigilant of those around us, which means the need to brace and feel tension in the body as a survival mechanism is much more present. If children are normalizing feeling tense in their body in every social circumstance, that creates long-term physical and mental impacts.” (As with all sources quoted in this article, Schmidbaur is conducting her sessions remotely.)
Psychiatrist Ernest Shaw, also based in Kingston, said he’s similarly concerned about the physiological effects on people as the virus lingers and possibly intensifies over the winter. “Acute stress doesn’t kill us, but chronic stress does,” he said. “Older people are feeling very lonely and isolated, which puts a stress on their mental health and cognitive functioning. People who live alone are also under a lot of duress… I’m seeing a fundamental anxiety and often a kind of despairing sense of hopelessness.” While the pandemic “affects everything,” the disease “finds its foothold where there’s poverty and people are more crowded and some can’t even buy masks. Single mothers are pretty overwhelmed caught been the economics of having to work and take care of their kids.”
Teens are perhaps best able to navigate the technology that now defines much of our lives, Schmidbaur said, though she’s observed “nihilistic beliefs” among this group that “was not the case before….they were looking forward to living independently and now they’re feeling there is nothing ahead.” College-aged teens and young adults “in some ways are having the most devastating time. This group is typically the most idealistic, but now their hope for the future is very minimal,“ she said.
Most at risk from a physical safety perspective are “certain populations living in violence. Their ease of access to a safe person out of their home is thwarted. Children who used to rely on school lunches and breakfast have been impacted, though most local school districts are making a huge effort to provide food,” said Schmidbaur.
While more financially secure people obviously are at far less risk than the poor, “everyone is affected,” noted psychologist Andrea Grunblatt, who employs 18 therapists, four of them full-time, in her Kingston-based practice. The combination of the impacts from the pandemic with the nation’s deep political divide and economic insecurity has been lethal: “There’s a huge amount of dissension in families and couples. Now that people are staying home and having financial difficulties, those differences have escalated. There’s a lot of domestic violence and drinking,” Grunblatt said. “People don’t have contact with other people, which further multiplies those differences. And the financial strain is much bigger. The feelings of isolation and depression are huge, even in families and couples.”
Those who are still going to work outside the home have to deal with the anxiety of “doing what they don’t want to do. They may have to deal with co-workers who aren’t very cognizant about wearing masks. Some like to confront others, while others suffer in silence.” Besides the bitter fights people are having over what’s real news versus fake, “if there’s any kind of prejudice it’s exaggerated. Some people are convinced they need to have food rations in the house,” said Grunblatt. “Others feel they have the liberty of using a gun. It’s just a mess…people are more aggressive and scared.”
Plus, some people who’ve been laid off cannot find affordable local housing. “I had a patient who was in sales and his complete income source is now gone. He got some unemployment for a while, but that’s running out. People are just despairing,” said Grunblatt.
Seniors in particular “are horribly isolated. Some have not seen their grandchildren or children in eight months,” said Sharon Murray-Cohen, executive director of Jewish Family Services of Ulster County, based in Kingston. “They’re fearful because they are at high risk.” Jewish Family Services serves approximately 500 seniors; prior to the pandemic, her agency’s licensed clinical social workers would meet with seniors in their home to help them deal with transitions, such as moving in with a son or daughter or into a senior residence, but now that contact has been limited to phone calls. Many seniors aren’t computer literate, which further limits their access to the outside world, Murray-Cohen said.
To reach out, her agency, along with the Ulster County Office of Aging, does “warm calls”—calls by volunteers to the seniors that occur at least once a week, just to check in and see how they’re doing. Her agency is also encouraging them to “start developing contacts to reach out and call people they know. It would be good if they could organize phone chains.” A student intern suggested setting up weekly Zoom meetings at which people could play games and otherwise interact with others—a wonderful idea, said Murray-Cohen, if only the seniors could get up to speed on the technology.
A silver lining?
As mentioned, there have some positive outcomes from the pandemic, such as more family togetherness with members playing board games, baking, and otherwise bonding with each other; more engagement with nature; and a reset in values. “The pandemic is leading people to more wellness, more connection to family and loved ones, more ease in their body,” noted Schmidbaur. “It’s allowing people to access a part of themselves they haven’t had to before.”
Besides more hiking and walking, they’re also cooking a lot more, gardening, and doing construction and repair projects around the house, according to Grunblatt. “They’re valuing their environment more,” she noted. And they’re also reconnecting with those at a distance. “People are reaching out to friends they haven’t spoken to for years, because they’re at a distance but now with video links it doesn’t matter where they live,” said Grunblatt.
“The epidemic is a helpful time to understand to be there for each other,” said Shaw. “A lot of us are paying attention to life where we are and slowing down. We find life where it is. Because we feel vulnerable, we open our hearts and mind more and life becomes more alive.”
The therapists said the impacts from Covid-19 have resulted in some shifts in their practice. For Schmidbaur, “there’s much less talk and more body work. I’m working with [my patients] on the way trauma manifests in the body. Somatic work enables people to experience a release and tap into the innate wisdom and strength of the body.” She guides people toward “co-regulation and self-regulation, a self-soothing technique in which you use one hand to cradle yourself in a hug position…hugging pets has been a huge comfort for people.” In finding ways to help people ground themselves, she’s also encouraging them to be out in nature, “to take off their shoes or do gardening to connect with the earth.”
To help couples and families, Grunblatt has them do “sand tray” work, in which they create a replica of their life using miniature figures. The exercise enables people to take a step away from their perceived attacks and gain some objectivity. She also recommends people write out their issue on a piece of paper and give it to their partner.
Shaw encourages his patients to “break down the details of what they have do in the moment…if we observe the moment we can be with it instead of worrying about the moment to come or those past.” He quotes Camus, who wrote in The Plague, “the only treatment for a pandemic is human decency.” Put into action, that means you should “care about your neighbor, call people who you know are lonely,” Shaw said. “Therapy is an ethical and moral task. It’s a way of feeling our interconnection with all of humanity.”
Ultimately, the pandemic presents individuals — and society — with the chance of moving toward a more caring, liberating experience, Shaw said. How people utilize their internal resources “seems to be predicated on their ability to be flexible and adaptable,” noted Cooper. But challenges such as loss of income and one’s home, which are out of people’s control, point to systemic problems that demand “we as a society look at issues differently” and come up with more equitable solutions, she said.