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Pandemic weighs on mental health as people cope with anxiety, fears

Pittsburgh Tribune-Review - 3/8/2021

Mar. 8—Almost a year into the covid-19 pandemic, feeling stressed is an understatement, Jenn Sillett said.

The 42-year-old mother of three has not set foot inside a store or restaurant for the better part of the past year, only leaving her Hempfield home to take her 19-year-old daughter, Sierra Williams, to her job at a day care or to do curbside pickup for groceries and other items.

Sillett, who does medical billing for UPMC, has worked from home for months as she navigates through complications from Langerhans cell histiocytosis, a rare disorder that causes some white blood cells to multiply excessively and form tumors after building up in certain areas of the body.

The disorder impacts Sillett's lungs.

"I've become agoraphobic," she said of the anxiety disorder in which people fear crowds or places where they feel trapped or helpless. "To leave my house becomes a mental weighing back and forth. Like, do I need to do this, do I need to do that? I could just have that delivered. There's no need for me to go out. Between my house and my car, that's pretty much where I have lived for the past 10 months."

Susie Kramer, a 42-year-old senior respiratory therapist at Excela Health Frick Hospital in Mt. Pleasant, spent weeks donning personal protection equipment before entering a room, only to strip it off and start the process over again as she rushed from patient to patient.

She is one of several therapists who helped patients through their covid battle as cases spiked last fall. For weeks, the Ligonier resident handled an intense workload. It all took a mental toll and left her with little energy when she got home to her husband, Jon, 45, and their children, Cole, 10, and Tori, 6.

"Every 10 to 20 minutes, we'd be getting a call to go somewhere to check on somebody or help somebody," she said. "Just the anxiety everywhere you went in the hospital was palpable."

It's been nearly a year since the first covid-19 case was detected in Western PennsylvaniaMarch 13, 2020, in Washington County. In all, there have been some 525,000 deaths from covid-19 in the United States. Millions of people across the country are unemployed. Others struggle to pay rent. The year also has been filled with social distancing from family and friends.

"People are dealing with not just 'I'm afraid of a pandemic' but 'I'm afraid about my job,' 'I'm afraid about what happened to my kid's education,' 'I'm afraid about my housing and whether or not I get to keep it' and 'I don't know when it's going to change,' " said Dr. Jack Rozel, medical director of emergency psychiatry at UPMC Western Psychiatric Hospital.

Several studies suggest the toll of stay-at-home orders, lockdowns and other mitigation efforts have taken a serious toll on the mental health of people across the country.

According to a report from the Pew Research Center, 33% of Americans experienced high levels of psychological distress during a period of extended social distancing last spring. Many crisis centers reported up to 40% increases in the number of people seeking help, according to Pew.

Rozel noted the problem with the coronavirus pandemic is it "has saturated the country. You can't get away from it, and it's varied in intensity but it's sustained," meaning there is seemingly no end to the disaster.

"So much of what we understand and know about how to help people in a disaster is based on the way most disasters work, which is the building collapses, you extricate who you can, you get them to the emergency department and then people just sort of deal with the trauma," he said.

The ongoing nature of covid-19 makes it a difficult reality to accept.

Collateral damage

Since the beginning of the pandemic, Sillett has tried to come in direct contact only with those she lives with.

"It's tough. It's hard to explain," Sillett said. "You feel lonely and isolated even though you're surrounded by people. I miss the people that I don't live with."

Despite taking precautions, Sillett said, her daughter contracted covid-19 from work, passing it to Sillett and her husband, Erich, 43. While Sillett said she did not have symptoms from the virus, she still has a fear of her two other kids, 9 and 7, contracting it from school and passing it to their grandparents.

Sillett noted she likely will have a hard time returning to normal and already has decided to continue wearing a mask even after the pandemic is over.

Julie Krizner, director of Axiom Family Counseling, which has several locations in the area including one in New Kensington, said the facility has seen more people reaching out for help with anxiety and depression. Those previously diagnosed with those conditions also are seeing increased symptoms, she noted.

"I think now, across the board, mental health has gotten worse for even the more stable clients we've had in the clinic," Krizner said.

Being on the front lines of the mental health battle during the pandemic, Axiom has created ways to stay in touch with patients even if offices were forced to shutter. Patients were able to contact counselors over the phone or via telehealth services. The organization is working to return to in-person sessions for patients wanting person-to-person contact.

To help reduce anxiety and depression during the pandemic, Krizner suggested people return to normal routines as much as possible, as long as they are being safe.

"If they need to get out of their homes and move around, even if it's just for a walk outside because the weather is nice, I think that just will really, really help everybody a little bit," she said.

But, according to Rozel, oftentimes, people do not realize when they are having a mental health crisis.

Instead, people are calling primary care doctors with symptoms such as acid reflux, insomnia and headaches, which could all be signs of stress. Other signs include irritation and fatigue, which might come out in the form of pandemic dreams or dreams that focus on death or fear.

While mental health has not hit a point where people are reaching out for services in droves, Rozel said he expects a surge.

"We're going to have collective and national trauma," Rozel said.

He added: "(The pandemic) added to our stress, and it's also taken away a lot of the ways we cope with stress. That makes it a pretty dangerous situation."

Rozel noted people used to go to the bar or hang out with friends as a way to destress from work or other situations. Now, social distancing measures largely have taken those destressors away.

The way to get through, he said, is to focus on other coping mechanisms that work for each person, such as connecting virtually with friends and family.

Annaliese See, a sophomore attending the Hempfield Area Cyber Academy, said she often stays up until 4 a.m. studying and turning in assignments. The stress load for the 15-year-old, who is balancing school, club volleyball and a job at Chick-fil-A, has only amplified during the pandemic, she said.

She said she handles stress through exercise.

"I like to go on runs during the day," she said. "I find exercise really helps mental health and just clears the head whenever there's stress going on."

According to the Centers for Disease Control and Prevention, coping with stress could mean taking breaks from news stories, exercising or doing mindfulness practices, avoiding excessive substance abuse and connecting virtually with community organizations.

Those who are dealing with grief during the pandemic are encouraged to focus on memories or creating rituals, like making a memory book or planting a tree in honor of somebody, according to the Pennsylvania state website. People are also encouraged to utilize grief counselors.

"Eventually, hopefully we'll be in a safe place where we're able to do that more introspective therapy type of work individually and collectively, but in the middle of the house fire it's not necessarily the right time to say, 'So how do you feel about house fires?' It's the right time to say, 'Get down, get small, let's get out of the house,'" Rozel said.

"In Allegheny County, we're super lucky because we're able to send out the mobile crisis teams or we're able to have people come to our center for help," Rozel said. "So now what we've got to figure out to do is make sure that someone in Elk County can have access to the same kind of resources that we have in Edgewood."

Small frustrations

On top of anxieties surrounding health, school and other factors, both Sillett and Kramer have expressed frustrations over not seeing people take basic precautions like wearing face masks.

"I have a problem with that obviously because I'm like no, you need to protect yourself and you need to protect other people or you could end up (on a ventilator) or somebody you love could end up like this," Kramer said. "It's basic to me but it's definitely a tough battle to fight out there in the public."

Sillett noted that there is more to the story than the argument that people are having their rights taken away through stay-at-home orders or mask mandates.

Some people, she said, don't have a choice.

"To me, this is what humanity is supposed to be about is caring for each other and caring for the wellbeing for everyone," Sillett said. "This disease hits like a tornado. It puts healthy people on ventilators and sick people may get very little symptoms like I did. Even vaccinated, I'm still terrified of what's to come with all the variants and everything else."

Megan Tomasic is a Tribune-Review staff writer. You can contact Megan at 724-850-1203, or via Twitter .


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