Updated on April 10, 2020.
Almost everyone is on edge right now as a result of the COVID-19 pandemic, but feelings of panic, worry and stress can be worse for people living with mental illness.
“Those with a diagnosed mental health disorder are at increased risk for experiencing both an exacerbation of their symptoms or new psychiatric symptoms,” says Jena Lee, MD, a psychiatrist at the David Geffen School of Medicine at UCLA in Los Angeles.
If you’ve been diagnosed with depression, anxiety and/or another mental health condition, you don’t need to suffer in silence or isolation. Here’s what you can do to get help right now.
Connect through telehealth
While keeping in-office appointments might not be possible at the moment, more providers are switching to telehealth so they can continue to see patients. The Coronavirus Aid, Relief and Economic Security (CARES) Act has made this easier too, by providing funding for telehealth services and easing regulations on who can use them. Many private health insurance plans are also waiving co-pays for telehealth services right now too.
“Telemedicine can feel very similar to regular visits that are done in person, and people tend to get more comfortable with telemedicine after the first few visits,” says Dr. Lee. Since this is a new experience for many people, she says to plan for some technical difficulties and “ensure extra time, if possible” for the appointment.
If you haven’t seen your therapist or physician in a while, that’s okay, too. The CARES Act waives the typical requirement that you must have had an in-person visit within the previous three years to get help via telehealth. If you’re looking for a new therapist or doctor, check with your health insurance plan to see if they offer their own telemedicine services or if they partner with other companies. Many of these services accept cash payments as well.
Don’t change your medication on your own
If you are on medication to treat anxiety or depression, don’t make any changes by yourself, even if you feel like your current regimen isn’t working.
“Often when people feel more stressed, they start to make changes to their own treatment. They feel like they can adjust their own dosages,” says Richa Bhatia, MD, a child, adolescent and adult psychiatrist and member of the Anxiety and Depression Association of America.
If you feel the need to do this, contact your physician or therapist instead to talk about how you’re feeling. They may then recommend a different dosage or type of medication.
Make sure you’re also well stocked with your medications. If you are worried about running out, see if your healthcare provider can provide you with a 90-day prescription. Sometimes these can be sent directly to your house. You can also check with your insurance company about early refills.
Schedule a productive worry time
Consider setting aside a block of time every day—at the same time daily—to let yourself worry. “Spend time with a paper and pen worrying about everything in a prescribed amount of time, and problem solve around it,” says Elissa Kozlov, PhD, instructor in the school of public health and core faculty at the Institute for Health Policy and Aging Research at Rutgers University in New Jersey. She recommends about a half hour for this.
Forcing yourself to worry may seem counterintuitive, but Kozlov says scheduling a block of time puts boundaries on it.
“At the end, you say, ‘Okay it’s time to do something else and tomorrow I’ll have another 30 minutes,’” she says. “If you start to worry about something later in the day, you can quickly jot it down and tomorrow, during your prescribed worry time, sort it out.”
Practice mindfulness and meditation
Mindfulness and meditation can help train your brain to stay in the present versus spinning out of control. “Worry about the future is common during this pandemic,” Dr. Bhatia says. “Mindfulness helps you practice being in the moment.”
If you’ve never practiced mindfulness, there are many apps that can help you get started and may even be offering free services during this time. Kozlov also recommends free apps created by the U.S. Department of Veterans Affairs, which are available at mentalhealthapps.org. There are also plenty of guided meditations on YouTube and music streaming services.
Stay connected, digitally
Physical isolation doesn’t mean shutting out the world. “There are ways to be physically distant but socially connected,” says M. Dolores Cimini, PhD, psychologist and director of the Center for Behavioral Health Promotion and Applied Research at the University of Albany in New York.
Video chatting and conferencing is all the rage right now; software companies like Zoom, Microsoft and Google are offering their apps, at certain levels of use, for free. Cimini suggests using social media, email and phone to stay connected with family and friends.
She also recommends seeking out support groups for those diagnosed with the same mental illness. Many groups that previously met in person are now moving online. “People are coming up with some very creative ideas,” she says. Narcotics Anonymous, for example, has moved meetings online using video platforms like Zoom and Skype. The Anxiety and Depression Association of America also has a list of support groups on their website.
Call for help
If you feel like you may do harm to yourself or others, call for help: try 911 or reach the National Suicide Prevention Lifeline at 1-800-273-8255 or call, text, or chat 988. The Lifeline is available to help 24/7. Most states also have their own mental health hotlines offering free and confidential support throughout this crisis.
