Anxiety and depression have become offshoots of the pandemic, according to mental health experts in Ohio and Michigan.
A Household Pulse Survey by the U.S. Census Bureau reports that about 32 percent of adults in the nation reported symptoms of anxiety or depressive disorder in February of 2023. While Michigan's rate was the same as the national average, Ohio saw a slightly higher rate at 35 percent.
That number rises to 50 percent if the age range is narrowed to 18 to 24.
“We are still seeing a syndrome of stress. It is pretty clear we have a population that has experienced a shared trauma,” said Dr. Vincent Caringi, who specializes in child and adolescent psychology at University Hospitals. “One of the things we know for certain is that access (to services) is not what it should be. There are not nearly enough beds available in the state.”
It has not been a surprise to mental health professionals who predicted, as early as 2020, a tsunami of psychiatric illnesses and suicide would result from the chronic stressors brought on from the pandemic. In 2023, the numbers of those dying from suicide surpassed 50,000 in the United States, the highest rate seen since 1941, according to Darcy Granello, founder and director of the Ohio State University Suicide Prevention Program, and a professor of mental health counseling.
“With prolonged stress, you do see some chronic issues develop,” said Jackie Van Zile, a clinical therapist with ProMedica in Sylvania.
She pointed out that physically people might see migraines or digestive issues. Mentally, they might experience anxiety and depression that can spiral downward into suicidal ideation.
“Self harm and suicidal ideation have increased. That is concerning,” Ms. Van Zile said. “Some are starting to understand the effect that the prolonged isolation had on them. How they adapted then may not be helping now.”
Ms. Van Zile said anxiety typically arises when people don't know something or cannot control something.
“Things were out of our control,” she said of the day-to-day realities of the pandemic. “It was a perfect breeding ground for anxiety.”
No going back
Many want to go back to how things were before the pandemic, but there is no going back, according to Ms. Van Zile.
“Sometimes it takes time to understand how things have changed,” she said of the cataclysmic shift in worldwide perceptions. “Understand what is causing anxiety now and try to create new instead of going back to what was.”
Younger people seem to have been most susceptible to mental health issues during and after the pandemic. Ms. Van Zile says she has seen young adults who have voiced concerns about the lack of control over their daily lives, decreased interaction with friends, and a feeling of being excluded in the decision-making process impacting their health as underlying causes for their difficulties in adjustment.
“A lot of times with younger folks, we forget that they need to have some voice in their care,” said Dr. Nasuh Malas, director of child psychiatry at the University of Michigan. He added that such interaction improves patient engagement in treatments and lends to further customization in dealing with each person's unique situation.
In 2021, the American Academy of Pediatrics declared a national emergency in child and adolescent mental health. Trends from before the pandemic were already identified in rising rates of childhood mental health concerns since 2010, and by 2018, the academy's declaration noted that suicide had become the second leading cause of death for youth ages 10 to 24. Rates were exacerbated by the pandemic, then reduced a bit after but remained higher than before the worldwide lockdown, according to Dr. Malas, who treats patients ages 5 to 25.
“There are residual effects from the pandemic,” Dr. Malas said.
Dr. Malas describes access to mental health care services as “clunky,” which has led to a surge of emergency room personnel dealing with mental health crises. He says there is need for more intermediate services, such as day programs, crisis clinics, and transitional residential communities. There is demand for treatment for individuals who are dealing with both mental health issues and drug addiction.
“One of the silver linings of the pandemic is a rise in telehealth,” he said of the ability to reach people in rural areas or those on waiting lists.
Closer to home
In Ohio, Governor Mike DeWine's Pediatric Behavioral Health Initiative awarded $84 million in 2022 to hospitals statewide, including $17 million to ProMedica Russell J. Ebeid Children's Hospital in Toledo. Another $15 million was given to University Hospitals' Rainbow Babies and Children's psychiatric unit.
Much of that money allowed hospitals to add more beds. For instance, Dayton Children's Hospital President and CEO Debbie Feldman said the behavioral health inpatient unit opened in July of 2019 with 24 beds, but, by 2029, 45 to 50 inpatient beds would be needed. In February of 2022, 178 kids stayed in regular medical rooms at Dayton Children's, waiting for a bed in the behavioral health unit.
“The COVID-19 pandemic created a collective experience among Americans. While the early pandemic lockdowns may seem like the distant past, the aftermath remains,” said Arthur C. Evans, Jr., CEO of the American Psychological Association. “We cannot ignore the fact that we have been significantly changed by the loss of more than 1 million Americans, as well as the shift in our workplaces, school systems, and culture at large. To move toward post-traumatic growth, we must first identify and understand the psychological wounds that remain.”
Probing the brain
Further results of the pandemic stresses were documented in a Stanford study published in 2022, which had taken MRI scans of young people ages 9 to 13 in what was initially to be a search for clues why females were more inclined to depression than males. The first scan was taken before the pandemic and the second scan was taken at the end of 2020. The results concluded that the brains had aged beyond the subjects' chronological years during that time, presumably due to stress resulting from the pandemic.
Bodies know what to do in life-threatening situations, according to Dr. Caringi. While the pandemic was big and overwhelming, countering pandemic aftereffects does not have to be. Small, measured responses can reclaim control and confidence over daily lives.
“How you address that response doesn't have to be a big deal,” he said. “You can do one thing today and that will make a difference.”
There are choices to be made. Eat a balanced diet this week. Or institute some sort of dependable schedule to follow for a month — one that provides continuity. Decide to take a daily walk or go for a swim. Or make getting enough sleep each night a priority. Join a group that provides positive social interactions. Give yourself a small kindness or forgiveness for a mistake. Don’t try to do it all at once.
Another resource is to call 988 Suicide & Criss Hotline, which was launched by the U.S. Substance Abuse and Mental Health Services Administration in 2005. The routed network received 542,055 calls, texts and chats from March 1 through March 31.
Contact Kimberly Wynn at kwynn@theblade.com
First Published May 19, 2024, 4:00 a.m.
