The mental health cost of containing the coronavirus outbreak

by Anagha Srikanth | Mar. 13, 2020

a person sitting on a bed buries their face into a pillow in a dark room with scant daylight coming in through the blinds of an adjacent window

If you or someone you know is having thoughts of suicide, you can call the National Suicide Prevention Lifeline at 800-273-8255 or the NAMI helpline at 800-950-NAMI (6264).

When Dawn Brown picked up the phone, the director of the National Alliance on Mental Illness (NAMI) HelpLine was trying to figure out how to set up the hotline remotely. Building management had just informed NAMI that they were considering locking up the building next week over concerns of the novel coronavirus outbreak.

“We have seen an uptick [in calls to the NAMI hotline] and we’re beginning to track the calls related to COVID-19,” Brown said. “Right now, the bigger concerns are around anxieties about the unknowns, you don’t know what you don’t know, and the people we serve tend to be a little more vulnerable to anxiety and panic.”

One caller was grieving a loved one who died of the disease in Japan, while another reported thoughts of suicide over concerns they would lose their job. Some callers have unstable housing or are homeless, while others are smokers, a group that is at a high risk for COVID-19.

To some extent, the reaction to the outbreak is expected, said Krystal Lewis, clinical psychologist at the National Institute of Mental Health.

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“I do think it’s important to just normalize people’s experience of what’s happening,” said Lewis. “Everyone is going to feel some level of discomfort and anxiety right now, and it’s normal.”

But for some, the anxiety can rise to a clinical level during an outbreak. Lewis said people should be aware of symptoms including difficulty sleeping, changes in eating patterns, rapid changes in mood, inability to carry out required or necessary tasks, self-medication using alcohol and drugs and prolonged self-isolation.

“For those who may already struggle with feelings of isolation due to depression, anxiety or other mental health conditions, social distancing could increase those feelings of loneliness and isolation,” Lewis said in an email.

Preventative measures such as social distancing and quarantines can also inhibit access to vital health care for people with serious mental illnesses. NAMI is developing a list of resources to direct people to possible technology solutions, such as virtual therapy sessions. But some don’t have access to the internet at home and even those who do might not be able to afford it. Health care providers that cover in-person therapy sessions don’t always cover online versions. Prescriptions of controlled substances can also be difficult to stock up on, as some require lab tests or in-person visits to a health care provider.

“Ultimately, it is important to seek help from a professional to help manage ongoing, persistent anxiety and other difficulties,” Lewis said in an email.

But there are some measures mental health professionals suggest for both people with preexisting mental health issues and those without. One of the biggest ones is to watch your media consumption.

“Mass media coverage of a topic can have long standing and far-reaching effects. It is common for children and adults with health anxiety and generalized anxiety to be triggered by world events and news,” said Lewis in an email.

She and Brown both recommended setting limits for how often and how long you tune into media coverage of the coronavirus outbreak, as well as the sources you consult. Brown said she checks the news once in the morning and then once in the evening, and even recommends turning off push notifications on your phone.

And while it’s important to stay informed, they both advised being mindful of where you’re getting your news. If more information makes you feel in control, Lewis said to keep the Centers for Disease Control and Prevention website up for the most up-to-date and accurate information.

Other suggestions for self-care include:

maintaining a routine
journaling and writing down your worries
talking to loved ones (by phone, text, social media or video) in a way that works for you
meditative practices (such as using guided meditations and listening to calming music)
taking walks (while avoiding large crowds)
talking through your fears by challenging anxious, irrational thoughts
disrupting the anxiety spiral by using techniques to bring you back into the present moment

NAMI also offers online support groups and a “warmline,” a confidential, noncrisis emotional support telephone hotline staffed by peer volunteers who are in recovery.

It’s also important to check in on those you love, especially those who are most vulnerable to mental health illnesses. Brown said to look for signs that they have been taking care of themselves and the environment around them and to ask whether they’ve eaten recently.

“Don’t be afraid to ask people pointed questions, even about suicide,” she said.

Even once measures such as social distancing and quarantine are lifted, there are still risks of lingering mental health effects, so it’s important to know the signs of distress and build up your support network.

“We’ll weather this,” Brown said. “Strength and resilience is what will get us through.”

If you or someone you know is struggling with thoughts of suicide, you can call the National Suicide Prevention Lifeline at 800-273-8255 or chat with a counselor here. To reach the NAMI helpline, call 800-950-NAMI, email info@nami.org or text “NAMI” to 741741.

You can also find more information and resources about managing anxiety and stress at: