This column is the first in a series on mental health issues during the COVID-19 pandemic. 

The COVID-19 pandemic can produce fear, anxiety, and stress in individuals and communities. Mental distress in Americans has been shown to have increased dramatically. According to Time magazine, a recent study currently in preprint reported that “as the full weight of the COVID-19 crises was settling on the country’s shoulders, more than one in four American adults met the criteria that psychologists use to diagnose serious mental distress and illness.”

This is approximately a 700% increase compared to pre-pandemic data in 2018. The psychological footprint of a pandemic is larger than its medical footprint, according to Dr. Joshua C. Morganstein, chair of the American Psychiatric Association’s Committee on the Psychiatric Dimensions of Disaster. 

Disasters —including the COVID-19 pandemic— result in varying psychological and behavioral responses. These responses can be placed into three categories:

  • Distress reactions: e.g., sleeping difficulties, irritability, isolation, decreased sense of safety.  
  • Health risk behaviors: e.g., family distress, interpersonal conflict, restricted activities, substance use. 
  • Psychiatric disorders: e.g., depression, anxiety, PTSD. 

This is because in addition to being impacted directly by COVID-19 there are a plethora of ways to be affected by the pandemic socially, economically and psychologically. Many people feel isolated due to physical distancing and unease, not knowing when we will return to normal life. Individuals with an essential job may feel worried about getting sick or bringing the virus home, thus infecting their family members. 

Experts are working to care for people’s mental health and be on the preventive front to mitigate a mental health crisis. Last week researchers published a list of recommendations aiming to reduce risks resulting from the impact of the pandemic. These include increasing investment in suicide prevention, extending expansion of telehealth services and developing systems that connect patients to social services.

The uncertainty and ambiguity of the future can be anxiety provoking. WSU President M. Roy Wilson has said that WSU is considering a combination of online and in-person classes for the fall. Experts are still discussing the best way to systematically reopen, while being cautious to prevent a second wave of the pandemic. Thus, it may be helpful to keep in mind that we ought to treat this as a marathon rather than a sprint. We must develop healthy ways of dealing with the stress of the unknown and the rapid change in our daily lives —whether it be related to our work, academic, social or personal lives. To combat the stress associated with these difficulties, many methods and resources have been recommended by different organizations. The National Alliance on Mental Illness has published a COVID-19 resource and information guide with critical and helpful information in the form of a Q&A. The Centers for Disease Control and Prevention has advised unplugging from news stories and social media, taking care of your physical health, setting time aside to unwind and connecting with others.

Let’s dive into some of these recommendations to maintain mental health and emotional wellbeing.

News Stories and Social Media Exposure:

It is important to stay in touch with the outside world, but to do so moderately. Morganstein recommended staying informed when it impacts your actions but being mindful that constant exposure can increase your stress. Furthermore, be aware of misinformation and help reduce COVID-19 related stigma or myths by being knowledgeable of the facts and cautious of the validity of information before sharing it.  

Taking Care of your Physical Health:

Staying active during this pandemic is critical for your body and mind. Choose an activity you enjoy whether it’s running, biking, dancing, yoga or walking and try to do it regularly. Decide whether you prefer to do your activity alone, with friends over video chat or via an online class. As always, be sure to follow physical distancing rules during your exercise. In addition to exercise, it is also important to make sure you are eating healthy and sleeping sufficiently.

Taking Care of your Mental Health and Staying Connected:

Staying connected with people is crucial, in fact some experts have recommended using the term physical distancing rather than social distancing to avoid making people feel isolated. You can keep in touch with family, friends and people in your community while maintaining physical distancing. This is possible through phone calls, video calls and other virtual means. You may even be able to volunteer virtually through varying opportunities listed on the website. Lastly, remember to set realistic expectations to avoid stressing yourself out when placing goals around work, school and personal aspirations. Try to embrace the idea that it is okay to have unproductive or “off” days. After all, we are in the middle of a pandemic. 

Mental Health Resources:

  1. Telepsychiatry: Psychiatrists and psychologists have telemedicine visits to care for their patients and minimize in person contact. Telemedicine is an important resource to provide quality medical care. This month researchers have demonstrated that internet based cognitive behavioral therapy is just as effective as in person CBT for patients with health anxiety. Contact your health and insurance provider to find out more.
  2. Crisis hotlines: The National Suicide Prevention Line, the Disaster Distress Helpline and the Crisis Textline offer urgent and free confidential support and counseling. An additional resource is the National Helpline, which is a free treatment referral and information service.
  3. Community resources:
    1. WSU Campus Health Center: Please call to make an appointment at 313-577-5041. Appointments can be either over the phone, video or in person. Also, you can use their ask an expert service where questions can be asked anonymously and they will reply to all questions the following week in a Q&A post. 
    2. WSU Counseling and Psychological Services: Check out their website for information on more resources and how to make appointments for their telemental health services.
  4. National and global resources: Offering informations and other services is NAMI or your local NAMI chapter, the CDC and the World Health Organization which has resources in multiple languages.

May Chammaa is a contributor for TSE, a medical student and AMA member. She can be reached at