Coping with mental health in a pandemic

Teanna Byerts spent her Sunday watching the last few mushers finish Alaska's Iditarod sled dog race from her Dover Township home.

A self-proclaimed hermit, 64-year-old Byerts said she is actually enjoying not working for the time being, but what has been more difficult is managing her mental health.

With a nearly 20-year-old computer without a microphone or webcam and a limited data plan on her phone, it took two days to find a technology that would give her access to her therapist.

“What I have works for what I need to do, but now you’re telling me I have to have all this fancy crap to talk to my therapist?” Byerts said.

Like Byerts, many in the mental health community are struggling with how to adjust to the coronavirus crisis — with limited access to therapy and a cloud of panic that has aggravated underlying anxiety.

Teletherapy is an option for many, but it comes with its limitations.

Shari Kim, psychologist and founder of Susquehanna Valley Community Mental Health Services, with offices in York and Hanover, said at least two-thirds of her practice's clients have been able to access teletherapy.

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Human isolation has been become commonplace in the midst of the Covid-19 virus pandemic Tuesday, March 24, 2020. The National Association of Mental Illness is advocating for widely implemented telehealth, funding to continue treatment for mental health disorders, and temporary eviction bans. Photo illustration Bill Kalina

But some treatment modalities are difficult to do online, she said.

A client with post-traumatic stress disorder, for example, would normally work on eye movement desensitization and reprocessing therapy to get the brain to physically reprocess memory so it's not traumatic.

This involves following her fingers onscreen, but in a recent experience with a client, the video kept glitching, so they ended up just talking instead.  

"It’s definitely not as easy to treat people this way," Kim said, adding that sometimes therapists have to choose between doing enough to keep clients stable or risking other therapies in a less-than-ideal situation.

Stability is important, especially when isolation can have a greater effect on those with underlying anxiety, paranoia or trauma. 

"If you have a routine and a structure, that helps," Byerts said, but now that's "blown up" and a lot of people are going to find it harder to adapt. 

Desiree Irwin, executive director of the York/Adams counties chapter of the National Association of Mental Illness said it's helpful to limit exposure to media that could trigger more anxiety.

But staying connected on social media is encouraged, since "there’s a lot of good that's happening right now in the midst of this virus," Irwin said.

Therapies or groups such as Alcoholics Anonymous that are now online are sometimes the only point of contact for people living alone, Kim said.

With isolation, those who have anxiety can get trapped in their heads, or in the case of PTSD, become “stuck in their trauma,” she said.

They can become overwhelmed and paranoid, said Kim, who had one client who feared she wasn’t panicking enough — should she have been stockpiling food and toilet paper like everyone else? Was she not doing enough to protect her children?

Schools are closed statewide through April 6 — and several districts in York County have elected to not have students return until April 14.

That poses a greater risk for children with autism, who rely heavily on routines, said Denver-based psychotherapist Annette Nunez.

"What is the most challenging is schools were shut down almost automatically,” she said, adding that with no transitional warning, children with autism experience more stress, anxiety and meltdowns.

Because they are so tied to regularity, when their favorite items aren’t available at the grocery store because people overbought in a panic, sometimes they don’t eat, Nunez said.

Children with autism also feel underlying verbal stressors — from things such as parents listening to the news — more than others.

Nunez said instead of taking it one day at a time, it's best to take it one week at a time — create a routine for that week and seek out tools such as online music therapies and yoga practices online.

To stem panic, it's important to avoid misinformation — which Kim said, as a local volunteer for the Red Cross, she’s used to seeing circulating around Facebook.

Those rumors are easier to contain because they're on a much smaller scale, she said, adding that she's “never seen something on a global scale like this.” 

Leaders can help by offering a consistent message — one that's not too rosy, because no one can trust it.

"People need to trust their leaders in times like this," Kim said.