It’s been a little over two months since we began quarantine and social distancing nationwide, so if you feel like you’re completely losing your mind, you are not alone. During this time of unprecedented uncertainty, many are struggling with stress and anxiety stemming from news regarding the COVID-19 pandemic.
Our mental health as a whole is impacted by these unprecedented times, and anxiety is a necessary feeling to carry, as we’re all dealing with something different in quarantine.
As for how those who aren’t struggling with a mental illness can remain emotionally and mentally fit as COVID-19 wages on, we must allow ourselves to grieve what we have lost, talk to one another, and, overall, accept what is happening as out of our control.
While the situation is bumming the entire world out, it’s important to remember to conduct mental health check-ins with ourselves and our loved ones in order to maintain peace amidst the frustration. However, how is this pandemic and period of isolation affecting those who struggle with severe mental illness, especially in communities of color? When it comes to mental illnesses such as bipolar disorder and schizophrenia—specifically for members of the black community—stress can be a triggering factor behind breakdowns and relapsing. As you can imagine, feeling trapped inside doesn’t exactly yield healthy behavioral results for those who already suffer from these disorders.
“When you feel like you’re confined or you’re struggling, and you don’t have the resources you need, that’s going to exacerbate all of these conditions,” Dr. Monnica Williams, Ph.D., tells The Root. Dr. Williams is a board-certified, licensed clinical psychologist who specializes in cognitive-behavioral therapies. She is also an Associate Professor in the School of Psychology at the University of Ottawa, as well as Clinical Director of the Behavioral Wellness Clinic, LLC in Tolland, Conn.
Before discussing the impact of quarantine on those who struggle with mental illness, it’s important to distinguish it from overall mental health. Dr. Thomas A. Vance, Ph.D., who is trained in several evidence-based therapies to assist with anxiety management, mood disorders, behavioral symptoms and more, explains that the difference between the two lies in how the individual thinks, behaves, and interacts with others. Currently, he’s a mental health clinician providing culturally-specific therapeutic care at Concierge Psychology in Atlanta, Ga., as well as a psychology teaching fellow at The New School for Social Research in New York City.
“With mental health, we’re referring to our emotional and psychological state, our wellbeing, and basically how we feel about ourselves and our interactions,” he begins. “Mental illness is actually struggling and dealing with the effects of psychological health on your physical life, your mental life, and, overall, your health wellness...I think it’s really important to start getting that language out there because of the differences (between mental health and illness).” He explains that severe mental illnesses such as major depressive disorder, bipolar disorder, schizophrenia and borderline personality disorder are part of a psychological category called “serious and persistent mental illness” (SPMI), which mental health professionals use to diagnose clients who are trying to get treatment.
While debilitating mental illnesses are not more prevalent in the black community than others, both doctors explain that due to a lack of resources to aid in treatment for black patients, mood and anxiety disorders in our community are often misdiagnosed or go untreated entirely.
“We have [patients] suffering for longer periods of time because people aren’t getting the help that they need,” Dr. Williams says. “A lot of us end up with the wrong kind of treatment because of racial biases concerning what sorts of problems black people have.”
When we are under stress, we react in different ways. For those experiencing mental illness, stress can impact their behavior in slight to extreme degrees. Dr. Vance says that the shelter-in-place and social distancing regulations enacted worldwide have the power to throw our stress levels through the roof, and those who suffer from mental illness may have it the worst.
“Mental illness, specifically bipolar disorder, rings up severe high and low moods, and it changes in sleep or energy or thinking or behavior,” he explains. “A lot of times with people who have a serious and severe and persistent mental illness, routines are fantastic, but everything is thrown off being in quarantine.”
What are some of the ways to combat—or, at the very least, alleviate some of the ramifications of quarantine on mental illness sufferers? Both doctors agree that medication and therapy could quell some of the more jarring effects that accompany breakdowns and relapses, such as delusions, mania, irritability, lack of sleep or depression. Yet right now, therapy visits are much easier said than done given the social distancing regulations. Dr. Williams explains that if someone is in need of mental assistance, it’s best to reach out to a doctor sooner rather than later, and during quarantine telehealth options such as phone calls and online meetings with a mental health professional have been implemented within some offices.
“Because of COVID-19, [therapists are] seeing people online or not at all,” she says of the hurdles psychologists have experienced on their end during this difficult period. “Then, you don’t have people really getting help until it’s an emergency and they’re in the ER, and that’s kind of the worst place to get your mental health care...[Sufferers are] going to get worse without treatment, and generally, for problems like bipolar disorder, each episode is worse than the last one. So if it’s not under control, you can probably expect a worsening trajectory over time.”
Both doctors explain that not all mental health issues require medication—it truly depends on the severity of the ailment. However, most mental illnesses could be managed with proper treatment such as medication and therapy, in order to keep the episodes under control, as well as social support and physical movement. (“Exercising, drinking water and trying to eat right [are important] because it could have an effect on the way we’re feeling,” Dr. Vance notes).
As we know, doctors are not the be-all and end-all when it comes to supporting those who are ailing. Family members and friends can do wonders for those who are experiencing periods of mental anguish, but it takes outstanding patience, understanding and accountability. Visible frustration with or appearing to “give up” on a family member dealing with mental illness could cause more pain in the long run.
“People, even when they’re in the throes of these illnesses, want to feel heard and respected and validated,” Dr. Williams says. “I think it’s really important to let them know that you care. Even if they have a delusion and you know that the delusion can’t possibly be true, you still want to show caring and concern because it’s bothering them...If they feel like they have a connection, they’re going to be more likely to listen to what you have to say. You can encourage them to get some help without saying things that might be upsetting or stigmatizing—that’s going to be counterproductive.”
Keeping all of this in mind, there’s a larger conversation to be had. Why does the black community run from therapy, or get defensive when someone suggests they need help? While this is not specific to our community, both professionals say that minority pain and trauma is not always addressed within therapeutic spaces, since historically, therapy can be seen as a very “white” thing.
“Honestly, the black community has a mistrust for health professionals,” Dr. Vance says. “This is based on historical trauma, or historically or higher than average institutionalization of black individuals in mental health. With that, we also have cultural barriers between providers and clients. ‘Does this person and his provider understand my cultural identity?’ I am more than just the diagnosis, but I come with this black identity and black culture.”
“We already feel so much like we’re being scrutinized and judged, and it’s like, we don’t want one more thing to be scrutinized and judged over,” Dr. Williams adds.
Despite the challenges, there are numerous ways for therapy, mental health and mental illness to be addressed with more immediacy and importance in the black community. Both doctors believe that having open conversations about how crucial mental wellness and treating mental illnesses are for black people specifically, as it has the power to show that we’re not alone.
“Many black families are suffering because someone in their family [may have mental issues], and we tend to kind of keep it quiet,” Dr. Williams notes. “I think that the more we’re willing to talk about our own experiences and the experiences of our loved ones in a non-stigmatizing way, we can put our heads together to solve the issues in our community. If you can’t talk about it, you can’t fix it.”