How to Help Your Patients Cope During the Pandemic

Written by Scott Wilson

The question of how to cope with the pandemic has been a big one for everyone over the past year. But it’s been a particularly difficult one for counseling psychologists. Not only have they had to deal with their own difficulties and anxieties, but they’ve also had to be the big shoulders for their patients. In these times, mental health counseling has become more important than ever.

Dealing with depression during COVID has been a big deal, but there was no playbook for psychologists to work from. Mental health crisis coping strategies that are effective in the middle of a global pandemic have had to be invented on the fly.

Social distancing and mental health just aren’t compatible for most people. There’s no amount of counseling or rationalization that will change that. Humans are social animals and we need social contacts for our mental well-being.

Without that contact, we all suffer. That suffering has been going on in most communities for more than a year at this point.

Even though the end may be in sight, the mental health crisis that the pandemic has provoked will be ongoing. There are good reasons to keep your skills sharp in pandemic-compatible mental health coping strategies, either to see out the end of this one, or to prepare for the next.

Social Distancing and COVID-19 Risks Hit Mental Health Hard in The U.S.

Although the disease itself created the biggest waves in the medical community as the infections spread, among mental health workers there was always a sense that COVID-19 itself was only going to be part of the problem. The trauma of the sickness and death was just the leading edge. The psychological hit from the quarantines and upheaval to society itself seemed like it was going to come with a big crash on top of that.

Today, the data supports the intuition that the pandemic was a crushing mental health event in the United States.

According to the Kaiser Family Foundation, which runs a health tracking poll to determine changes in American health and wellness over time, around 40 percent of adults have been reporting symptoms of anxiety or depressive disorder since the start of the pandemic. That’s a 30 percent increase over pre-pandemic levels.

Those symptoms have shown up through a 12 percent increase in substance abuse or alcohol consumption, 36 percent reporting difficulty sleeping, and another 12 percent reporting worsening chronic conditions.

Among young adults, ages 18 to 24, the pandemic has hit even harder. More than half, 56 percent, have anxiety and depression symptoms. Further, the rate experiencing suicidal thoughts has jumped up to 26 percent. The CDC reported a spike in drug overdose deaths at the beginning of the pandemic, just as the lockdowns began.

And like most mental health issues, these have hit minority communities hardest. The rates among communities of color hover around 10 percent higher than those of white Americans, and essential workers drawn from those communities higher yet.

Helping patients dealing with depression during covid is becoming a major part of mental health therapy today. Figuring out how to cope with the surge in demand is a challenge for mental health counselors, but it’s a challenge that the profession is meeting head-on even in the face of enormous obstacles.

The Challenges of Practicing Counseling Psychiatry During the COVID-19 Pandemic

Mental health counseling had as big a shift as every other industry during the pandemic. With in-person interactions heavily restricted, counselors had to adapt almost overnight.

With office visits off the table, most counselors made the shift to practicing via telehealth. Working with clients through a screen is not the preferred method of delivering counseling, but it has proven to be better than nothing.

With telehealth a small part of the profession prior to COVID-19, however, few counselors had any training or experience in practicing remotely. All kinds of glitches, both technical and process-oriented, came out in the mix. Entirely new skillsets for building a rapport and establishing trust had to be developed and learned.

Of course, many clients are in an even more difficult bind when it comes to receiving remote counseling. Financial and technical obstacles made it hard to get connected. That put counselors in the awkward position of having to offer technical support along with emotional support and care.

On top of all the sudden changes in how counselors practice their profession, they’re suddenly being swamped with new cases. USA Today reported that a survey of Texas mental health counselors had experienced an 84 percent jump in caseloads since the start of the pandemic.

That means many counselors are working beyond their normal capacity. Long hours and little sleep get stacked on top of debugging Zoom connections and actually delivering treatment.

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Pandemic Cripples Treatments For People Already In Distress

While everyone is suffering from new mental health challenges from the pandemic, there are probably some of your clients who are getting a double whammy.

The kind of stresses imposed by social isolation and a rampaging virus are almost tailor-made to trigger patients already struggling with conditions such as obsessive compulsive disorder (particularly germaphobes), agoraphobia and hoarding. Calls for frequent hand washing, to stock up on supplies, to stay in the house and away from other people… these all act as reinforcements on conditions those patients were already having trouble fighting.

It’s important to work with these patients to help them disconnect their condition from the flow of current events. Mental health crisis coping strategies for these patients might include:

  • Putting in place safety plans that limit compulsive responses, such as stressing that hands only need to be washed for 20 seconds, and only after certain specific risk events
  • Limiting news and social media exposure
  • Using telehealth support and therapy sessions to maintain therapist connections

Naturally, dealing with depression during COVID doesn’t really have any bright spots. The world became an objectively sadder place during the pandemic.

It may be the right time to stress that the kind of mindfulness and coping skills that are always used to handle depression are still important and effective, however. Cognitive Behavioral Therapy (CBT) is a useful tool for helping patients process their feelings without reinforcing them. It can be used on COVID-driven fears and anxieties with just as much success as any other traumatic event.

One key element of CBT that is particularly useful for situations that demand social distancing and mental health treatment at the same time is that it can be done without direct contact with the therapist. A patient who has been taught CBT techniques is able to use them at any time. When pandemic precautions prevent visits and technical difficulties block telehealth appointments, those patients still have tools to handle the onset of mental crises.

Teaching Your Patients How To Cope With The Pandemic Starts With Teaching Yourself

Your patients don’t know—and shouldn’t know—that the pandemic affects you, too. Therapists are people and the experience all the same pandemic-driven pressures as everyone else.

Helping your patients through the COVID-19 crisis has to start with helping yourself.

Counselors can’t do any good teaching anyone how to stay calm during the coronavirus crisis if can’t first manage it themselves.

Although your tools for teaching people how to cope with the pandemic are going to come out of the same toolbox you have always used, the way you deliver them is probably going to be all new. You will not only be dealing with depression during COVID, but also learning how to use new and unfamiliar remote therapy techniques at the same time. That’s sure to add frustration to your process.

Working from home is as difficult for psychologists as everyone else. You may experience the same mental roadblocks in adopting a professional tone while delivering counseling from your kitchen; you may have kids who are also home who need help with their homework at the same time a client is experiencing a Force 10 mental breakdown on your computer screen. And you might have difficulty leaving work behind at the end of the day. Long hours are compounded with the combination of home and office in a way that makes clear transitions between work time and down time impossible.

As you are probably doing with your patients, however, you’ll need to stress the need for self-care. Be gentle with yourself as the new processes become familiar. No one is starting off with real expertise in this situation. There’s no reasonable expectation that we will all get it right on the first try.

What Are Some Healthy Ways to Cope With Stress During Pandemics?

The pandemic hasn’t magically removed all of our traditional ways to help patients dealing with depression and mental health issues. Many of the same things you were counseling patients to use as mental health crisis coping strategies before the pandemic will be the same things you prescribe now.

  • Exercise
  • Art and creative hobbies
  • Volunteering
  • Healthy diet

All of these techniques and approaches to dealing with stress and depression strike at the heart of what is counseling psychology. They aren’t new to mental health professionals. But the scope and character of delivering those therapies right now is.

One key thing for mental health workers to realize is that they aren’t alone in trying to figure out how to cope with the pandemic. The CDC has put together a comprehensive page of recommendations for mental health crisis coping strategies to deal with stress during the pandemic. It’s loaded down with practical self-care tips and strategies that are effective in coping with social distancing situations.

We’re All in This Together is a Kind of Therapy

Just reminding patients they are not the only ones in difficulty is its own strategy, in fact. Helping patients understand that they are going through completely normal reactions to abnormal times removes feelings of loneliness and guilt. The very fact that the crisis is so widespread helps patients put their individual suffering into perspective. And the very act of offering compassion to others is effective therapy for the patients who express it… a double victory for dealing with depression during COVID.

Cutting Back on The News Can Keep Stress Levels Lower

On the other hand, another important coping strategy is avoiding too much information… or, in the case of this pandemic, too much misinformation. Media coverage of the pandemic has been relentless. By its nature, it tends to focus on the negative and on the threats, rather than the rays of hope or more level perspectives on risk. Overconsumption of that sort of news can create terrible mental anxiety over things completely outside the patient’s control. That’s never healthy, and recommending a news diet can be a big help.

Internet Addiction Has Become The Lesser Evil

Psychologists in some cases have had to do a pretty rapid about-face when it comes to counseling about screen time in the middle of the pandemic. Not so long ago, mental health professionals were warning about the increased risks of obesity, sleep disorders, and depression that came from spending too many hours staring at computers or devices.

Now, though, those very same screens are a lifeline to social connections that are otherwise entirely unavailable. The research about negative health effects hasn’t disappeared, but counselors are realizing those are far more manageable and less acute than the negative impact of social isolation. So extra surfing, chatting, and social networking is back on the menu as an antidote to social distancing anxieties.

Facing Facts and Taking Actions Builds Resilience and Stability

Speaking of anxiety, not all anxieties are bad anxieties. It’s up to mental health professionals to point out that taking productive steps to address their fears can both protect patients and ease their concerns. Separating the factors they can and cannot control is a critical part of this kind of counseling. Getting patients to focus on things that can protect themselves can help them take control of their perspective:

  • Maintaining physical distancing precautions
  • Wearing masks
  • Keeping surfaces and areas clean
  • Spending free time outside in open areas away from other people

And getting them to let go of the factors they can’t control can alleviate stresses that otherwise create unbreakable feedback loops:

  • How other people handle physical distancing and masking
  • Government rules and restrictions
  • The pace of vaccination efforts
  • Political and media commentary on the pandemic

As it happens, though, one of the best ways for coping with social distancing and mental health is to remove it from the equation. And now, we finally have a way to do it.

When The Best Mental Health Crisis Coping Strategy Come From a Needle

There’s also a new tool in your kit for handling stress coming from the coronavirus: startling effective vaccines that are becoming widely available.

While most of the tricks and tips that go into mental healthcare tend to be more thought-oriented, there’s one big, concrete action that almost everyone can take to drop COVID-19-related stress in one month or less. And that is going out and getting vaccinated.

With effectiveness rates ranging from 80 percent to 95 percent, the SARS-CoV-2 vaccines in the United States are as close to magic as medical science has to offer for stress relief. Anyone worried about the risks of COVID-19 itself can all but eliminate it by getting vaccinated. Those suffering from depression due to social distancing can get vaccinated and go mingle with other vaccinated people in a return to normalcy. And we can all squash the pandemic by getting vaccinated to the point of developing herd immunity.

So the most effective mental health treatment for COVID-19 might actually be a medical treatment. Any patient who is eligible but has not yet received a vaccine should be encouraged to get one immediately.

Learn How To Provide Support to a Person Suffering From COVID-19

Unfortunately, all too many psychologists were faced with this particular challenge during the height of the pandemic. Although the case numbers are dropping now, there are still thousands of people going through the terrors of a COVID-19 infection in the United States right now. And the chance of a resurgence from new strains of the virus in the coming months and years remains real. It’s the job of psychologists to be prepared for those chances, no matter how remote.

Every therapist understands that facts and figures aren’t always useful as mental health crisis coping strategies. In a society that is swimming in misinformation about COVID-19, however, they may be a good place to get started.

While COVID-19 is a dangerous disease, much of the anxiety comes from the unknown. It’s a new threat, but that doesn’t automatically make it a more potent one. The breakdown of risk factors is clear:

  • Age over 50, with the greatest threat to patients 85 or older
  • Patients with pre-existing lung conditions including:
    • COPD
    • Lung cancer
    • Cystic or pulmonary fibrosis
    • Moderate to severe asthma
  • Patients with heart disease
  • Obese or diabetic patients
  • Cancers
  • Immunosuppressed patients

With your patients who don’t fall into those categories, it may be important to stress that their chances of survival are over 99 percent. Putting that risk into perspective can be helpful; according to the CDC, the average adjusted life expectancy risk for those under 50 who are infected is only one day. That is about equivalent to the risk of death for driving 50,000 miles… a risk people take without a second thought about every three years.

Of course, with so many people infected, chances are you will be dealing with some patients who do not have such good chances.

Those cases are particularly difficult for psychotherapists. That’s not because you don’t have a good toolset for handling patients facing death… that’s a situation that therapists handle all the time. But coping with social distancing while providing therapy to patients is a new scenario for most counselors.

Handling The Aftermath of COVID-19 Deaths

Even as those patients move on to their final rest, there’s a tremendous amount of therapy work left to be done with the help of grief counselors. Each of those individuals leaves behind friends, family, and colleagues. More than half a million deaths in the United States have torn apart the fabric of half a million families and their social networks. Not all of those millions of people will seek out counseling. Those who do, though, will struggle with mental health crisis coping strategies in so broad a landscape of tragedy.

It’s made worse by the lack of closure and the obvious suffering of those who passed at the end. The lack of human contact and interaction and the gruesome struggle of suffocation is unquestionably traumatic.

For those survivors, the healing process may be arrested by those same social distancing restrictions. Funerals, wakes, even small remembrances may have been cancelled or postponed due to the pandemic.

That complicates the therapist’s usual job of easing the grief of loss.

Some counselors are having success encouraging virtual remembrances. Hugging may be out of the question, but stories and memories of the deceased can be shared over Zoom as easily as in person. Other approaches include recommending planning for future in-person memorials. As the pandemic subsides, the day those will be possible grows closer and closer all the time. Sometimes simply the process of planning and imagining the ceremony can be helpful for survivors.

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Even though the end is in sight for the COVID-19 pandemic itself, the work of mental health therapists dealing with the fallout of the pandemic will continue for decades. Some may spend the rest of their career helping people cope with the trauma they have experienced. It’s never a bad time to brush up on your skills for helping patients cope with the pandemic.