COVID-19 and Mental Health

Carly Randolph, Manager, Youth Mental Health, CHMC

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Symptoms

Fever

Cough

Shortness of Breath

These symptoms may appear 2-14 days after exposure

When to Seek Medical Attention

If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include:

Trouble breathing

Persistent pain or pressure in chest

New confusion or inability to arouse

Bluish lips or face

https://www.cdc.gov/coronavirus/2019-ncov/index.html

What is COVID-19?

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• Los Angeles County Department of Public Health’s Coronavirus website

• Los Angeles County’s COVID-19 website

• California Department of Public Health COVID-19 updates

• Centers for Disease Control and Prevention (CDC) Coronavirus updates

• World Health Organization (WHO) Coronavirus website

• LA County residents can also call 2-1-1

General Information Resources

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Dignity Health COVID-19 Patient Education Material

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Tips on How to Manage Your Health with COVID-19

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COVID-19 and Stress

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• A physical, chemical, or emotional factor (stressors) that causes bodily or mental tension and may be a factor in disease causation. Source (https://www.merriam-webster.com/dictionary/stress)

• “Stressors” are stimuli that cause stress

• Stress is how the brain and body respond to any demand. Every type of demand or stressor can be stressful.

• Examples of demands/stressors include: exercise, work, school, major life changes, traumatic events, and/or COVID-19

What is Stress?

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• Disbelief and shock

• Irritability and tension

• Fear and anxiety about the future

• Difficulty making decisions

• Feeling numb

• Loss of interest

• Loss of appetite

• Nightmares

• Anger

• Sadness/depression

• Feeling powerless

• Crying

• Sleep problems

• Headaches

• Trouble concentrating

Symptoms of Stress

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The stress response begins in the brain.

1. Amygdala sends a distress signal to the hypothalamus.

2. Hypothalamus functions like a command center, communicating with the rest of the body through the nervous system

3. Fight or Flight Response

Stress and the Brain: Fight or Flight Response

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• Central stress response system!

• Hypothalamus, anterior pituitary gland, and adrenal gland

• CRH: corticotropin releasing hormone

• ACTH: Adrenocorticotropinhormone

HPA Axis: Hypothalamic-Pituitary-Adrenal Axis

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• The coronavirus disease 2019 (COVID-19) may be stressful for people.

• Everyone reacts differently to stressful situations.

• Stress during an outbreak can include fear, changes in sleeping and eating patterns, worsening of chronic health problems, increase in drug and alcohol use.

• People who may encounter more stress around COVID-19 include:

• Older people and people with chronic diseases who are at higher risk for COVID-19

• Children and teens

• People who are helping with the response to COVID-19, like doctors and other health care providers, or first responders

• People who have mental health conditions including problems with substance use

Managing Anxiety and Stress, Center for Disease Control and Prevention

COVID-19 and Stress

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• Exercise

• Meditation

• Sleep

• Eat healthy, balanced meals

• Avoid drugs and alcohol

• Connect with others (virtually)

Coping with Stress Related to COVID-19

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• COVID-19 (Coronavirus) Information and Resources, National Alliance on Mental Illness (NAMI)

• Coronavirus Update: Mental Health Tips, Public Health News and Resources, National Alliance on Mental Illness (NAMI)

• Managing Anxiety & Stress, Center for Disease Control and Prevention

• Coping with a Disaster or Traumatic Event, Center for Disease Control and Prevention

• Taking Care of Your Emotional Health, Center for Disease Control and Prevention

• Mental Health and Psychosocial Considerations During COVID-19 Outbreak, World Health Organization

• 7 science-based strategies to cope with coronavirus anxiety, The Conversation

• Reducing Stigma During COVID-19, Center for Disease Control and Prevention

Resources for Coping with COVID-19

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COVID-19 and Managing Mental Health

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• COVID-19 can cause fear and anxiety.

• Unknown and uncertainty contributes to fear/anxiety.

• It is important to know how to manage anxiety and keep perspective as the COVID-19 pandemic unfolds.

COVID-19 and Mental Health

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• Coping with a Disaster or Traumatic Event, Center for Disease Control and Prevention

• Taking Care of Your Emotional Health, Center for Disease Control and Prevention

• PsychHub, Well Being Trust

• Disaster Distress Helpline, Substance Abuse and Mental Health Services Administration

General Mental Health Resources

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COVID-19 and Youth Mental Health

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• The Centers for Disease Control (CDC) has guidance on managing mental health and coping during COVID-19 for children and caregivers, as well as guidance for higher education administrators.

• The Child Mind Institute has published a resource on how to talk to young people about COVID-19.

• The Hope Center has outlined resources for supporting college students during this crisis.

• The American College Health Association has created a guide to help college health staff and campus administrators address COVID-19 on campus.

• The World Health Organization (WHO) has information on travel, media resources, and other research on COVID-19.

• Anxiety and Depression Association of America Psychologist JelenaKecmanovic provides some science-based strategies and tips for coping with COVID-19 anxiety.

COVID-19 and Youth Mental Health Resources

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• How to Talk to Kids About Coronavirus, The New York Times

• Helping Children Code with Emergencies, Center for Disease Control and Protection

• 10 tips for talking to your kids about COVID-19 with your kids, PBS SoCal

• Caring for Children in a Disaster, Centers for Disease Control and Prevention

• Coping After a Disaster, U.S. Department of Health and Human Services

• Just For Kids: A Comic Exploring The New Coronavirus, NPR

• How to Talk to Your Anxious Child or Teen About Coronavirus, Anxiety and Depression Association of America

More Resources on COVID-19 and Youth Mental Health

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Recommended Apps Compiled by LA County

“Your Wellbeing on Your Terms” brochure.

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COVID-19 and Social Isolation

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• Social isolation and loneliness can lead to an increased risk of death.

• Social isolation and loneliness become more common with age.

• COVID-19 can make social isolation and loneliness worse.

Social Isolation and Loneliness

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• Peer Support Network, Project Return (PRPSN)

• California Peer-Run Warm Line, Mental Health Association of San Francisco

• Self-Help Support Groups, Share!

• Community Connections in Times of Physical Separation, Each Mind Matters

• Teens Helping Teens, Teen Line Online

• Support Services, Project Return Peer Support Network

Stay Connected: Support Services

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Stress Management, Mindfulness, and How to Assist Someone in Distress

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• Take care of yourself. Get enough sleep, exercise, and eat healthy meals.

• Make time to give yourself a break.

• Practice relaxation. There are many ways to do this: yoga, meditation, reading, listening to music, or going for a walk.

• Avoid drugs and alcohol.

• Focus on what you can control. Try to separate what you can control from what you can’t and let go of what you can’t control.

• Keep things in perspective. Try to see things as ‘glass half full’ - if you expect things to go wrong or see things in a negative light, you will more likely feel stressed.

• Focus on the positives. Try to focus on your strengths and the positive things around you.

• Talk it out. Talk to your family or friends, your medical provider, or a counselor about what you are experiencing.

Source: The JED Foundation

How to Cultivate Mindfulness

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• Assess for risk of suicide or harm. Identify if they’re experiencing a crisis such as a panic attack or suicidal thoughts, and address that first. It’s OK to do the assessment over the phone, text or social media. If the person’s life is in immediate danger, call 911.

• Listen nonjudgmentally. If the person isn’t in a crisis, ask how they’re feeling and how long they’ve been feeling that way. Pay attention and show you care.

• Give reassurance and information. Your support can have a huge impact on the person. Reassure them that it is appropriate to experience fear, sadness or anxiety during situations like this. Remind them that help is available, and you’ll be there for them along the way.

• Encourage appropriate professional help. Offer to help them find a professional for support, such as a primary care physician, mental health professional, psychiatrist or certified peer specialist. Behavioral health care providers can provide services by phone and/or secure videoconferencing, so they will be able to maintain physical distancing.

• Encourage self-help and other support strategies. Self-help strategies and reaching out for support from family, friends, faith communities and others who have experienced depression or anxiety (peer supporters) can make a difference.

Mental Health First Aid

How to Assist Someone with Anxiety and Depression: ALGEE

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Use tips from the MHFA curriculum to reach out to someone who might need you.

• Treat the person with respect and dignity. Listen nonjudgmentally, and respect the person’s privacy and confidentiality.

• Offer consistent emotional support and understanding. In difficult times, we all need additional love and understanding. Remember to be empathetic, compassionate and patient.

• Have realistic expectations. Accept the person as they are. Tough times can make it harder than usual to do everyday activities like cleaning the house, paying bills or feeding the dog.

• Give the person hope. Remind your loved one that with time and treatment, they will feel better and there is hope for a more positive future.

• Provide practical help. Offer help with overwhelming tasks, but be careful not to take over or encourage dependency. For example, offer to bring groceries over.

• Offer information. Provide information and resources for additional support, including self-help strategies and professional help.

How to Support a Loved One During COVID-19

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National Suicide Prevention Lifeline, call 1-800-273-TALK (8255).

Text “START” to 741-741 to reach the Crisis Text Line.

Thank You