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“Historically, we know that pandemics and other public health crises, much like natural disasters, have a lasting impact,” said Itai Danovitch, MD, chair of the Department of Psychiatry and Behavioral Neurosciences.
Danovitch said that past traumatic experiences – like major natural disasters and previous public health crises – have been associated with increased rates of substance use, post-traumatic stress and depression. Cedars-Sinai investigators are trying to find out, in real time, whether those same issues are arising now, and what healthcare providers can do about it.
“We want to know what the impact of COVID-19 is on people’s mental health, and how, or through what mechanism, COVID-19 affects mental health,” Danovitch said. “We also want to understand the role of psychosocial disparities on these health outcomes.”
Danovitch’s team is studying how COVID-19 affects people with mental health conditions, by adding specific measures to existing studies for patients with depression, chronic pain, and substance use disorders.
While it’s taken time to start accumulating data, “national surveys are beginning to show what we expected, which is that there are increased prevalence rates of stress and depression,” Danovitch said. “We’re also seeing reduced initiation of treatment for patients with substance use disorders, and a reversal of last year’s reduction in overdose deaths.”
Problems like these disproportionately affect people who have limited access to care, like those without health insurance and those who live in multifamily homes, where limited private space and internet bandwidth make attending even virtual events and meetings challenging.
“It’s often those people who are most disenfranchised to begin with who bear the greatest consequences of new stressors,” he said. “We’re witnessing a real-time example of how social disparities turn into new health disparities.”
Suzanne Silverstein, MA, ATR, founding director of the Psychological Trauma Center and Share and Care program at Cedars-Sinai, and an expert in psychological trauma, says that families with school-age children are bearing the additional burden of adapting to online or hybrid learning. Silverstein says she’s especially concerned about the long-term effects on families coping with instability, and those with children who have behavioral issues or other special needs.
“Everyone is struggling right now, but for these families, the loss of structure and routine can be especially daunting,” Silverstein said.
She and her team usually work closely with Los Angeles area schools to provide professional counseling to at-risk students who are experiencing emotional challenges due to traumatic situations and stressors.
At the beginning of the pandemic, Share and Care counselors scrambled to adapt their programs and services to the distance-learning environment, creating resource sheets and YouTube videos for families on topics like showing compassion, expressing gratitude and staying organized.
Silverstein recommends that families implement a daily schedule to keep children on task, and find new ways to have fun together at home, like scavenger hunts and virtual dance parties with friends and family.
Similarly, Danovitch emphasized the need to establish and keep up with a consistent routine.
“Make sure that you are exercising, getting good sleep and getting good nutrition,” he said. “Make sure you’re not spending too much time on screens, that you’re not getting overloaded with information that you can’t do anything about, but that you’re getting information from reliable resources.”
Danovitch says that in order to maintain good mental health over the long term, people should find ways to connect with loved ones and, importantly, find ways to be of service.
“Having a sense of purpose is enormous. It allows people to cope with a lot of adversity,” he said. “But if you are finding yourself having persistent anxiety, or feeling so down that you’re not able to function, ask for help. Reach out to your physician and get some support.”
The silver lining, both experts said, is that the pandemic has created space in many people’s lives to slow down, spend time with family, refocus on what’s important, and connect with one another in new ways.
“The other side of this coin is that events like this can be associated with post-traumatic growth,” Danovitch said. “People develop resilience. They learn how to deal with mental health challenges, and they find resources, internal and external, that they didn’t know existed.”
Read more on the Cedars-Sinai blog: Good Sleep in Times of Stress
