You’ve been furloughed. You’ve lost your job. You don’t know how you’ll pay next month’s mortgage. You don’t know how you’ll afford groceries in two weeks.
You’re working from home. There are deadlines. There are teleconferences. The kids need to eat. The kids need help with their online classes. They demand attention. Ditto your spouse. Your marital relationship is, ah, tense.
You’re a senior. You’re immobile. You’re isolated by the coronavirus distancing. You need medication in a hurry. You need a hug that isn’t coming anytime soon.
You’re an essential worker or the spouse of an essential worker. You’re a nurse. You’re working the counter at McDonald’s on the I-95 rest stop. You’re afraid of COVID-19. Anxiety has turned into a panic.
These aren’t potential scenarios.
This is our life in April 2020. Our life in what Don Fischer, a peer recovery program coordinator at the Connecticut chapter of the National Alliance on Mental Illness, likes to call “Covidistan.”
And what if those aforementioned situations include one of the millions of Americans already diagnosed with depression or some form of mental illness?
The next time we rush to call someone who hits a ninth-inning home run or a last-second 3-pointer “a hero,” maybe we ought to think twice about what a real hero is. And when we turn to those heroes in the medical profession, we ought to remember that a sound body is only as good as a sound mind.
Our nation’s mental health is under attack these days as sure as our immune systems are.
After speaking for the better part of an hour with Fischer and listening for a full hour to leading mental health experts at a Bloomberg Businessweek town hall, I agree with the assertion that our national fears over the pandemic have pushed interest in mental health to a historical high. Among all the bad, that is good.
I listened carefully to Dr. Neil Leibowitz, of Talkspace, Dr. Mimi Winsberg, of Brightside, Dr. Ken Duckworth, of NAMI and Dr. Christine Moutier, of the American Foundation for Suicide Prevention — chief medical officers at national organizations — and also came away believing that teletherapy and telepsychology not only are here to stay. They will be a transformative tool in the 21st century.
So much mental health work, of course, is done at the grassroots level. These are our local heroes. You have a man like Fischer, a man who has known the depths of depression. He coordinates NAMI Connecticut, facilitating local peer recovery groups — my wife Liz has one — that normally meet twice a month. Fischer has been running one group on Zoom on Monday and Wednesday during the COVID-19 outbreak. In his part-time position, he also is involved with In Our Own Voice, a program in which people doing well in their recovery talk about their experiences, their worst times and what they’ve done to stay well. He is a presenter and helps train other presenters.
In 1991, Fischer lost his career in medical equipment. He couldn’t find equivalent work or pay. He endured a job from hell. Not only had he lost a job, he lost a way of life. He got to the point where he didn’t have enough money to live on. By 1994, there only was anguish, despair, hopelessness.
“I was feeling quite suicidal,” said Fischer, of Stratford. “The odd thing was by having that suicidal ideation, I was trying to save my life by taking my life. The pain of living was so much more than the fear of death. Looking at it, it was quite understandable. I was at a dead end.
“One day instead of getting into a car, driving to the river and jumping in or something as terminal as that, I went to an outpatient clinic. And just broke down.”
He went into an inpatient unit for 10 days and continued as an outpatient for several months. That was the beginning of his recovery.
“Or as I like to call it, a reconstruction, because I probably never was fully well,” said Fischer, speaking personally and not on behalf of NAMI. “I got a diagnosis of major depression when I was in the hospital and probably had carried that around for many, many years. Life was always one frying pan into another.”
Fischer, 63, is doing well right now, especially compared to 1994. He has developed coping skills and resiliency. He has some savings.
As the husband of a woman who has suffered from major depression for 30 years, I also know you never throw up your arms and yell, “I’m cured!”
And now we all have a threat to our systems. We use our personal experiences and rational thought to project what will happen next week or next month. All that is out the window with the coronavirus. We live in a time of total uncertainty. And that is frightening.
Leibowitz said in the Businessweek town hall that there has been a 65 percent spike at Talkspace in demand from people looking for therapy in the past three weeks. Winsberg said there has been a 50 percent spike in the year’s first quarter at Brightside.
A good walk or breathing exercises may be the answer to relieve stress. There is no easy answer to mental illness. It does start with this question: How much of what you’re going through interferes with your daily ability to function?
Some participants in the support groups, NAMI Connecticut Executive Director Lisa Winjum said, have a diagnosis of Contamination Obsessive Compulsive Disorder. There is high anxiety with the pandemic. Whether someone has lost a job, had a business closed, or isolation has been especially taxing, there is so much to address.
There is a NAMI family support group online. There is a daily young adult connection community support group for ages 18 to 29. Last week, a virtual dance party was held. Song requests were sent in and there was a virtual DJ. There are two veteran support groups and NAMI CAN (Child and Adolescent Network) for parents of children under 18 with mental health conditions.
“Social distancing is hard for some people,” Fischer said. “Even for people who like to be alone. Whether someone is more outgoing or not, each of them can get people starved.
“There is a distinction between alone time where you can thrive, be imaginative, creative, focused, but after a while that can become too much. And isolating in depression can be like a hamster wheel. ‘What’s going on? I don’t understand. I feel lousy. I’m desperate. I want to be left alone.’ Yet at the same time there is a need to be reassured. You need person-to-person contact at some point.”
Fischer is attempting to transfer In Our Own Voice to an online format. As far as the results from the Zoom group sessions?
“I have gotten some positive emails,” Fischer said. “As far as the support they give and receive from each other, I think it’s too early to tell. We’ve just been doing it for a few weeks. It isn’t quite the same. I think it is diminished in that there’s a lot that can be communicated that isn’t verbal. There are vibes that can be gotten. People on the screen, it’s two dimensional.”
There are also charts and other materials that can’t be hung on walls or left on tables for easy reference.
“On the other hand, one of the advantages is people don’t have to travel,” Fischer said. “They don’t have to make the effort to get into a car, get on a bus, to go to a meeting.”
When someone is deeply depressed, that’s not a small matter. It’s a great barrier. Many people will express a willingness to attend a group support session. Whether it is a lack of energy or of great anxiety, the reality is most don’t. Just getting there can be so much of the battle. And as Fischer pointed out, one of the principles of NAMI is finding strength through sharing experiences.
During the town hall, Winsberg said the COVID-19 pandemic has become a “real inflection point” for telemedicine, a great tailwind for it.
“It’s not just a lifestyle choice or a convenience; our lives might actually depend on it,” she said. “I think it’s going to make us reevaluate the way we communicate in general in all areas of our lives, but particularly in medicine.”
Mautier said scientific literature from previous national disasters, wars, and pandemics shows it is not a forgone conclusion that the suicide rate will rise. In fact, there are mixed results that suggest it could go down. There is rallying during times of great turmoil. This, of course, doesn’t lessen the stress of anxiety, grief, isolation and economic peril.
“This is unlike anything we’ve ever experienced in our life,” Winjum said. “We’re not going to know what the impact is on all of us for a long time afterward.”
Fischer, completing his 12th year with NAMI, said there have been new people joining the sessions since the outbreak, yet most already have been involved and dealt with mental health issues. They have developed some coping skills and seem to be taking it OK.
“Sometimes people say they are OK, but things are bothering them that they don’t quite understand or grasp,” Fischer said. “When is it a mental health issue and when is it life? Everyone is feeling it but may not be able to articulate it. We haven’t had this before. This is a once-in-a-lifetime thing. We’re not used to having our freedom restricted. It’s sort of like being in prison without being prison.”
For those in need, go online to namict.org. Contact 860-882-0236 during business hours, 800-950-6264 for the NAMI HelpLine or in a crisis text NAMI to 741-741.