COVID-19 Residuals Part I by Dr. Ee’a Jones ~ July 2020
We are currently in the midst of COVID-19 residual effects. The shelter in place and social distancing began for the United States of America around mid-March. Children were displaced from school and college. They had to adjust to online learning and the teachers had to do the same. The malls, movies, restaurants, beauty salons, nail shops, barber shops, and too many other businesses to name, all closed. I am thankful for online shopping as I’m sure many of you are as well. At least we could maintain beauty products, get gifts delivered for the celebration of quarantine birthdays, and have a meal delivered if we did not feel like cooking. Providing counseling also changed to only virtual sessions. I am thankful this was an option for my clients because COVID-19 is a stressful situation to be in. The majority of my sessions have had at least parts of them related to COVID-19 and how my clients were coping. Since mid-March, this has fallen with less and less talk of the actual virus. However, there is still some discussion about how life has changed since we were shut down (i.e., working remotely, little travel, etc.).
With social distancing, we can no longer shake hands with people when we meet. We can’t be in close proximity to loved ones and hug them. We can’t go to church or attend plays, operas, musicals, etc. Again, I am thankful for the world wide web because we can still “go to” church, plays, operas, musicals, etc., without leaving our homes. We can also see movies that are “in the theater” through different streaming apps. It goes without saying, there are numerous changes we have made and now we are left to deal with the residual effects of those changes.
Well, we are still in the throes of COVID-19 and, while there are some residual effects, we have no way of knowing how it all will end in the future. Even so, we still think about and have questions about it. In the last week or so, there’s been a tremendous spike in positive cases so the state of Texas has been sheltered in place again to help flatten the curve once more. Do we go back to the way things were? Do the kids go back to school fully this coming year? Do we go back to greeting family or friends with a hug? Do we go back to shaking hands with strangers? Will the economy bounce back since states are mostly “open” again? The short answer is no for going back to the way things were pre-COVID-19. There is no way we can’t be mindful, at least most of us, of how we approach others now. I am not sure fist bumps will be accepted as a greeting post-COVD-19. Perhaps a nod or smile will suffice as a greeting. Kids will likely be back in school for the new school year, but what precautions will they take since it is unclear if COVID-19 will stay away? That is questionable and we are still seeing state educational agencies and school districts drafting what the school year will look like for the fall semester. Will there be a vaccine that will help reduce risk of contracting the virus? Will more people work from home now since we know that we can?
Some of the questions are still up in the air and there’s really not a definitive answer to any of them. What about feelings of anxiety or depression that have surfaced during the COVID-19 pandemic? Know that most of the anxious feelings are normal for a situation that is unprecedented. It is human nature to be unnerved by going through something you haven’t experienced before. It is similar to other things unexpected experiences. Most of us become a bit nervous or anxious about it, but we battle through it to the other side and feel fine. The problem is if the anxious feelings due to COVID-19 are still lingering with you six months after the pandemic has been resolved. That would indicate you may need to seek professional help.
According to the DSM 5 (American Psychiatric Association, 2013), anxiety is defined as the following, and you would have to meet certain the criteria to be diagnosed with an anxiety disorder.
Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
The individual finds it difficult to control the worry.
The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months)
Note: Only one item is required in children.
- Restlessness or feeling keyed up or on edge.
- Being easily fatigued.
- Difficulty concentrating or mind going blank.
- Muscle tension.
- Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).
The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
If you find yourself in a situation in which you cannot shake the anxious feelings, it is okay to reach out for help. Utilize your insurance as a resource to see if you have mental health, or behavioral health, benefits. You can also contact me to inform you of community resources. There are some organizations that can help regardless of whether you have insurance or of your socioeconomic status. So it is not a problem if you do not have insurance. And most insurances are still covering virtual sessions via a telehealth platform; depending on your individual plan, some insurances covered telehealth for behavioral services pre-COVID-19. It’s a good idea to see what your insurance plan covers. Some offer telehealth but only via certain platforms like Teladoc, MDLive, or Doctor on Demand. When your provider calls to confirm eligibility and benefits, he or she should also ask whether telehealth is covered (for behavioral health services) on any other HIPAA-compliant platforms. It’s important for the provider to ask about telehealth specifically for behavioral health services because telehealth is covered more often for medical services only.
Many people have lost family and friends to COVID-19 as well. Some may still experience this going forward. Grief issues are normal and expected. Keep in mind people can grieve the loss of things the way they used to be as well. For example, you may have found yourself grieving the fact that you could not see your friends socially, meet with family at their homes, go to work every day, etc. The stages of grief (denial, anger, bargaining, depression, acceptance) can apply to any situation where you have lost something or someone you are used to having around. The stages are not linear meaning you do not go from one to the other (denial to acceptance) and you are done grieving. You can vacillate between different the stages before accepting the situation fully. This is a normal experience.
Again, I encourage you to take the step to get counseling if you are having a hard time dealing with anxious feelings, grief, or any other type of negative emotions. I will return to this topic for a Part II some time in the future to discuss how things have progressed (or regressed).
American Psychiatric Association. (2013). Diagnostic and Statistical
Manual of Mental Disorders (5th ed.). Washington, D. C: American