Physician Burnout What Psychiatrists Need to Know

Mental Health in the Time of COVID: The Pandemic Under the Pandemic

The coronavirus pandemic has caused fear and suffering unlike anything seen in our lifetimes. Millions of people have become ill and hundreds of thousands have perished. Families are grieving. Others are living in fear of becoming ill or losing loved ones. Jobs have been lost and systems of support and healthcare are at their limit. The world now seems like a scary and unpredictable place. People are left feeling helpless and overwhelmed.

The stress of COVID-19 has resulted an increase risk factors for mental health problems including depression, anxiety, substance abuse, and other conditions. This increase in risk is giving rise to a second pandemic that threatens to come roaring to the forefront as COVID runs its course.

The Looming Mental Health Pandemic

We are social creatures and need social interactions. Our social networks provide support and comfort, safety, and a sense of belonging. Staying safer has required people to change the way they interact. Working from home, distance learning, masking, and social distancing have created a world of isolation. And that feeling of being all alone is unsettling and unhealthy when it goes on with no end in sight.

When faced with threats or extreme adversity, it is normal to experience fear and anxiety. Under normal conditions, people seek comfort and support from those in their social circles. Public health responses such as social distancing have eliminated that source of support leaving people isolated and lonely. This stress can give rise to disturbances emotions and behavior, including depression and anxiety, even for people with no previous mental health struggles.

People who have previous mental health issues are finding the increased stress of the pandemic difficult to manage as well. The increased stress can potentially exacerbate symptoms and, with healthcare resources spread thin and the scarcity of face-to-face care, there is concern for an increase in mental health emergencies.

Pre-existing severe mental health conditions have been associated with a higher risk for contracting COVID and more severe course possibly because of the presence of associated comorbid conditions.1

The full impact of the pandemic on mental health is still yet to come and there is much that remains unknown. Early surveys are suggesting that people are experiencing:2

  • increased symptoms of depression,
  • anxiety, and stress related to COVID-19, due to psychosocial stressors such as life disruption, fear of illness, or fear of negative economic effects
  • Phobic anxiety
  • Panic buying
  • Binge-watching television
  • sleep disturbances
  • low energy
  • impairment in self-regulation/impulsivity

The effects of quarantine are equally concerning and have been associated with:2

  • stress
  • anger
  • increase in risky behaviors such as online gambling

It appears that young people are particularly at risk for mental health issues. Calls to hotlines have increased. Like jobs for adults, school has been a primary source of social support for kids that is now lost.  Alcohol sales have increased dramatically giving rise to worries about increased conflict and family violence and abuse.3 There is also concern that suicidality may increase with increased hopelessness, extended isolation and mental health needs that go unaddressed.

While the public health response is necessary, the result is a world of people traumatized by a threat for which they were not prepared.  As COVID runs its course, people remain isolated while trying to maintain their jobs, manage home life and family, stay healthy and stay safe. The fear and uncertainty are palpable. What will the world look like when this extended isolation ends? What will people come back to when the world opens up? How well will they be able to adapt to the new normal? What can we as a community do to help people emerge from this event in a healthy place?

How To Help Now

Waiting until people return to their lives to offer help isn’t the answer. It’s much harder to undo emotional damage than it is to minimize or mitigate the damage early. You want to help your people whether they’re co-workers, employees, students, or friends. But how?

The key to managing the effect of COVID on mental health is to act now. Providing resources or support now can help people feel connected and address their needs in a healthy way.

Employers can encourage social connection and interaction, even if you are all working remotely.

  • Offer employee wellness meet ups or live webinars. Choose topics that are timely and encourage discussion.
  • Meet ups can give co-workers an opportunity to interact and reconnect. It’s like a support group for your employees.
  • Reach out to your employees. Let them know you are still there and that you support them.
  • Make sure that EAP information (if your company offers that) is readily available. Encourage its use.
  • Encourage your employees to make mental health a priority. Share local resources such as support groups or hot lines or community services.
  • Encourage people to set healthy boundaries. Working from home can feel like working 24/7. Remind them to end their workday on time. And, remind them that they are not expected to answer an email from their boss at 2 am.

For friends and family, reach out. Don’t wait for them to call you. They might be waiting for you too.

  • Establish regular check-ins
  • Consider group chats on video platforms like Skype or Zoom or Facetime
  • Plan fun, safe activities even if they have to be online
  • Share your feelings. Let people know how you’re doing and accept support from them.
  • Offer support. Let others know you are there if they need to talk.

If you work in healthcare, you may be at the forefront of early detection of mental health issues. It’s okay to ask a patient (or even a co-worker) how they’re doing emotionally. Know the warning signs that someone is struggling. If you think there’s a need, offer a referral to someone who can help. And, if you’re struggling, don’t be afraid to ask for help. Heroes need support too.

For anyone who sees a need, don’t be afraid to encourage someone to seek help. You never know what someone is going through and when your kindness will make the difference.

You’ve probably heard a lot of stories about a shortage of mental health providers. In some places, that may be true. The good news is, online therapy options have made finding a therapist less difficult even during the pandemic. While therapists are also living this same stressful situation, many remain on the frontlines, ready to assist their clients as best as the situation allows.

What else can you do? Push for mental health services to be made available in your community for those most in need. Support the mental health community and partner with local therapists in whatever ways you can. The mental health crisis is coming and therapists are ready to take it on.

As COVID continues its course, we must all do what we can to help ourselves and others.  What we do now will profoundly affect what life after COVID looks like and how well each of us copes. Let’s look back and know that not only did we defeat the virus, we came through emotionally well and ready to step back into the world stronger than ever.


  1. Yao, H., Chen, J., & Xu, Y. (2020). Patients with mental health disorders in the COVID-19 epidemic. The Lancet Psychiatry7(4), e21.
  2. Moreno, C., Wykes, T., Galderisi, S., Nordentoft, M., Crossley, N., Jones, N., Cannon, M., Correll, C. U., Byrne, L., Carr, S., Chen, E. Y., Gorwood, P., Johnson, S., Kärkkäinen, H., Krystal, J. H., Lee, J., Lieberman, J., López-Jaramillo, C., Männikkö, M., … Arango, C. (2020). How mental health care should change as a consequence of the COVID-19 pandemic. The Lancet Psychiatry
  3. Usher, K., Bhullar, N., Durkin, J., Gyamfi, N., & Jackson, D. (2020). Family violence and COVID‐19: Increased vulnerability and reduced options for support. International Journal of Mental Health Nursing29(4), 549-552.

Babita Spinelli is the owner of Opening the Doors Psychotherapy and Babita Spinelli Coaching. She is a Licensed Psychotherapist, Certified Relationship Coach, Collaborative Divorce Coach and Parenting Coordinator with offices in NYC, NJ and Florida offering in-person and online services globally. She has worked successfully with couples and individuals to get unstuck in their relationships, rebuild and create more meaningful connection. Babita is a Certified Gottman Level 2 Couples Therapist whose areas of expertise include infidelity and parenting issues. Babita has been featured in podcasts, articles, and vlogs.


Mental Health in the Time of COVID: The Pandemic Under the Pandemic


APA Reference
Spinelli,, B. (2020). Mental Health in the Time of COVID: The Pandemic Under the Pandemic. Psych Central. Retrieved on December 4, 2020, from


Scientifically Reviewed
Last updated: 26 Aug 2020
Last reviewed: By John M. Grohol, Psy.D. on 26 Aug 2020
Published on All rights reserved.