The pandemic has wreaked havoc for many people. Some lost their jobs, some had to balance their work with children at home, some experienced food insecurity, some people worked despite stay-at-home orders in order to keep their lights on. The extreme amount of stress many have experienced and in the short time they had to adjust has most notably impacted the mental health of many.
According to the Census Bureau, prior to the COVID-19 pandemic, one in four people experienced depressed mood; during the COVID-19 pandemic, one in two people experienced depressed mood. If you are married or in a relationship, chances are you or your partner have encountered this (situation).
If you have roommates or colleagues with whom you are close, it’s likely someone you know is experiencing an exacerbated depressed mood lately as a result of the residual effects of a global and national shut down.
We crave human connection and interaction; isolation and quarantine hasten depression and anxiety. There is great similarity to those in confinement as they are denied access to their loved ones, their routine and sense of self in small ways that accumulate over time. For those with pre-existing depression and anxiety, the pandemic limitations hinders their ability to cope in the way they have known how to, thus exacerbating their low mood for longer periods of time and with little available to aid in their self-management (Venkatesh& Edirappuli, 2020).
Many rely on their social circles and friends and families for support, however with stay-at-home orders, mandatory self-quarantines and social-distancing which often feels like social-isolation to those struggling with depression and anxiety, it can feel nearly impossible to dig out of a hole they did not jump into.
It becomes critical for those dealing with depression to find outlets during the pandemic to keep their symptoms, such as lack of motivation, withdrawal, and low energy, at bay. These people tend to struggle more even with pharmaceutical interventions already in place.
For those working on the medical front lines, the experience is even more profound. According to Elbay et al. (2020), healthcare workers on the frontline all experienced at least one of the following: anxiety, depression, and stress. T
This experience is a result of increased working hours and shifts because of the higher demand for healthcare providers during the pandemic. Also, increased number of COVID-19 patients resulted in many healthcare workers developing COVID-19 themselves and having to then self-quarantine, then return to work with anxiety that they will relapse with COVID-19 again.
The repetition of this cycle for healthcare workers makes them at risk for developing PTSD or vicarious trauma from witnessing so much COVID-19 related death. This, combined with overall lower levels of support as a result of social distancing rules, explains why all healthcare workers, despite a pre-existing diagnosis of depression or anxiety are experiencing a higher level of depression and anxiety.
Those with pre-existing diagnosis of depression or anxiety who are women and also working in healthcare during the pandemic are especially high risk (Elbay et al., 2020).
Dealing with death at any time is challenging, however dealing with the death of a loved one during a time of social-distancing and limited access to hospitals and funeral homes, the grief journey may not feel like what it may have felt like when a loved one passed prior to the pandemic.
Many people with ill relatives experience anticipatory grief, which posits a great amount of fear and anxiety of potential deaths in the family for those who may be high risk or in vulnerable locations, such as nursing homes.
Death during the pandemic can often be traumatic especially if the decline in health status is sudden and unexpected. Often times, this type of reaction is associated with death from a traumatic loss such as a car accident. This type of loss does not allow individuals to prepare in any sense of the word and can further push the bereaved into a deeper depression.
Furthermore, the national, state and local policies have included limitations for visitors in healthcare settings which makes saying goodbye even more difficult. The bereaved can often be left feeling excess guilt for not being present even though stay-at-home orders are what prohibited them.
Additionally, the grief felt may feel very disenfranchised as a result of not being able to mourn together with family as many funeral homes have limited their capacity for services to smaller groups. Many families are experiencing the death of a loved one in silos which makes that grief journey more complex, and further compounded by those already dealing with depression or anxiety (Wallace et al., 2020).
For those in romantic relationships and marriages, the implications of the pandemic will depend on several factors. First, if one or both parties have a pre-existing depression or anxiety diagnosis. Second, if one or both work in healthcare or are otherwise deemed essential. Third, how much access they have to their self-management strategies and how well supported they feel with their partner. Fourth, how the pandemic impacted one or both partners: job loss, death of a loved one, food insecurity, lack of childcare, etc.
The pandemic will be a time where partners may experience a higher level of tension because of competing needs that may or may not have to do with the relationship itself. However, given the confinement to our partners if living together or spending time together, conflict can feel overwhelmingly skewed toward the relationship (Eckhard, 2020).
Consequently, many relationships or marriages may end due to a lack of separation of pandemic-related stress from relational stress and also a lack of individual needs being met which can mask itself as a lack of relationship needs being met.
The pandemic is far from over and it is important to discuss with friends, families and your healthcare providers the ways it has impacted you or a loved one. Finding ways to support those dealing with depression during this time will be pivotal for their health and the health of those dealing with this in relationships/marriages, while working their essential jobs or grieving the loss of a loved one.
Since 50 percent of the country is currently experiencing depressed mood, it is time we discuss mental health publicly and advocate for better funding nationally, at our work places and for those working on the frontlines.
Eckhard, J. (2020). Social isolation as a consequence of transitions in partner relationships: How formations and endings of partner relationships affect the risk of social disconnectedness. Journal of Family Research, 1-50.
Elbay, R.Y., Kurtulmus, A., Selim, A., & Karadere, E. (2020). Depression, anxiety, stress levels of physicians and associated factors in Covid-19 pandemics. Psychiatry Research, 290, 113-130.
Venkatesh, A. & Edirappuli, S. (2020). Social distancing in covid-19: what are the mental
health implications? The British Medical Journal.
Wallace, C.L, Wladkowski, S.P., Gibson, A., & White, P. (2020). Grief During the COVID-19 Pandemic: Considerations for Palliative Care Providers. Journal of Pain and Symptom Management, 59, 6, 1-7.