New Hampshire’s crawl toward reopening is now a sprint. Weeks after ending the state’s mask mandate, Gov. Chris Sununu will lift pandemic restrictions on businesses Friday and wants all state workers back to the office by Monday.
Not everyone is celebrating, say mental health workers. A year of isolation, death, uncertainty, and fear has been a tough haul for many, including those who’ve never experienced mental health challenges before.
“You may think with the arrival of spring, people would be outdoors, rejoicing,” said Lisa Boldin, a psychotherapist who works with adults at the Seacoast Mental Health Center. “But this one-year mark (of the pandemic) has made it very hard. I’ve seen an increase in depression and people not being able to pull out of it.”
While there is no single way to measure changes in Granite Staters’ mental health since COVID-19 hit the state in March 2020, some themes emerged in interviews with several mental health providers.
Some people are struggling with severe depression and its accompanying sense of hopelessness. Others are incapacitated by anxiety or exhausted by stress. Children and adolescents are reporting more acute mental illness and waiting days for hospital beds. Then there’s “languishing.”
In an April New York Times piece, Adam Grant, psychologist and professor at the University of Pennsylvania’s Wharton School, described it as not quite depression but rather a joyless and aimless sense of stagnation and emptiness.
“Languishing is the neglected middle child of mental health,” Grant wrote. “It’s the void between depression and flourishing – the absence of well-being. You don’t have symptoms of mental illness, but you’re not the picture of mental health either.”
Asked what she’s seen from her clients at the Center for Life Management in Derry and Salem, clinical social worker Celia Felsenberg said “moral fatigue.” Navigating differing advice on everything from when to wear a mask and the safety of vaccines to health risks to children and shopping and dining out is exhausting, Felsenberg said.
“Everything’s a question,” she said. “What’s the right thing to do? It hasn’t stopped and now that more and more restrictions are being lifted, it’s ‘you decide.’ There is so much uncertainty out there, and uncertainty causes stress.”
Boldin has noticed her clients are asking to see her frequently. Telecounseling by phone or video has allowed Boldin to meet that need. That has been especially critical for clients who may see no one other than Boldin or their case worker.
For some clients, the increased opportunity to socialize as more people get vaccinated is the challenge. “People I work with who have social anxiety or are agoraphobics, everyone else has been living the life they’ve always lived,” Boldin said. “Now that is coming to the flip side and they have to come out.”
The pandemic has been no less challenging for young people, and in some cases it’s been harder, said Megan Turchetti, a clinical psychologist who works primarily with children and adolescents at the Seacoast Mental Health Center. Not only have they absorbed adults’ anxiety, she said, they’ve experienced a series of losses that began with school closure last year, the canceling of summer plans and camps, little to no time with peers, and an inconsistent combination of in-person and remote learning this year.
And they’ve been introduced to an ever-present risk of death. “I’ve heard some professionals talk about this as a grief issue because we have to consider mortal peril on a regular basis,” she said. Turchetti said she’s seen two trends in the younger population: existing clients are experiencing more acute mental illness, and people who’ve never sought treatment before are asking for help now.
“Not everyone does great with change in the first place,” she said. “This has been a continual level of stress and change.”
Catie Borbotsina, the children admission coordinator at Riverbend Community Mental Health in Concord, said she’s noticed that more children – rather than their parents – are initiating therapy. “Families are reporting increased stress in family dynamics due to families or siblings being together all day, every day without respite or activities of their own. This seems to be causing an increase in sibling conflict in general.”
When asked about coping strategies, therapists stressed the need to ask for help immediately in crisis situations, whether that be 911, the National Suicide Prevention Line at 1-800-273-8255, a local community mental health center, or the nearest emergency room.
For non-crisis mental health challenges, they recommended routine and patience.
“As mindless as it might feel, it’s important to have a productive and positive routine that you stick to,” said Rik Cornell of Greater Manchester Mental Health. “You get up, have breakfast, and make a plan for the day. If you don’t, more than likely you’re going to still be sitting in that chair at 4 p.m.”
Felsenberg advises clients to keep the routine not only positive but doable. “It could just be getting outside for a walk today,” she said. “It could be you are going to make sure you are hydrated, that you drink that water. It could be reconnecting with a friend. Then you can say, ‘I did that.’ Then build on those small attainments.”
She also talks to clients about resilience and helps them identify what replenishes their energy and spirit. “I believe over the year our reservoirs have been slightly reduced,” she said. “A lot of the things we do for building our reservoirs have not been available to us.”
Turchetti urges her clients’ parents and guardians to tend to their own mental health needs as attentively as they do their child’s. “There is probably wear and tear on the mental health of your family system,” she said. “So many parents are pinched with working at home and trying to balance the work and family spheres. Take inventory. ”
Children will need help processing this year, Turchetti said, now and likely for years to come. Ask them about their mental health and be mindful that resuming old routines may feel stressful, at least initially.
The past year may have introduced changes that families want to hold onto, such as squeezing in fewer activities, finding time to walk in the evening, playing board games, or hiking. Turchetti urged families to keep those in mind as they think about the things the pandemic made impossible, like eating at restaurants or spending time with grandparents. “What do you want to keep, and what do I miss and bring back,” she said.
And, mental health providers said self-care and patience are crucial. If going to the grocery store feels overwhelming today, don’t condemn yourself or think it will forever. Reconnecting with good friends can feel good but also exhausting. Parents who blame themselves for allowing their children so much screen time this past year shouldn’t, they said. Make a plan to make changes when life starts to return to normal.
“Aim low and let yourself be awkward,” Turchetti said. “It’s fair to say that there’s fear and anxiety that you didn’t have before. You’re not making it up. You’re not being over-reactive.”