It’s been nearly two years since COVID-19 turned life as we knew it upside down, sending rates of depression and anxiety soaring. Then in November, just when many people began to feel that the pandemic was easing, the wildly infectious omicron strain brought new fears of illness, as well as despair: Will this thing ever end?

“Our brains are not designed to live under chronic stress,” says Karen Hahn, 54, a social worker in Washington, D.C., who says she has upped her dosage of antidepressants in recent weeks to try to lift herself out of a self-defeating depression-inertia loop worsened by omicron. “I’m laying on the couch napping all day Saturday going, ‘Yeah, if I could just put my tennis shoes on and go outside and walk for an hour I’d feel better.’ But I can’t even do that. I just want to nap.”  

Americans’ mental health needs during the pandemic already began raising alarms months ago. Last year, the National Alliance on Mental Illness (NAMI) HelpLine (see box below), which offers support for mental health and substance abuse issues, received 1,027,381 calls. That’s up 23 percent from 2020 — when call volume was up 27 percent over 2019. 

But the emotional strain has grown more acute in recent months, health experts say. Texas’ statewide mental health COVID support line, for example, has seen a 20 percent increase in calls since early December, says Greg Hansch, a social worker and executive director of the Texas chapter of NAMI.

While part of that uptick in calls for help was driven by the stress of the holiday season, he notes, it’s also related to “the uncertainty of the omicron variant.” Anxiety is often stoked by uncertainty, says Hansch, who believes that the pandemic’s general unpredictability “has been a big driver of a lot of the mental health concerns of the last few years.”

He also cites older people’s genuine anxiety about getting sick, since they’re more likely to suffer negative effects from a COVID-19 infection, as well as grief, with so many lives lost and experiences missed (weddings, grandchildren’s births). There’s also “guilt and shame, for people who do contract COVID-19 feeling like they’ve failed in some way,” he adds.

As we near the start of the pandemic’s third year (it officially began on March 11, 2020, based on the World Health Organization’s declaration), nerves are more frayed than ever, says Katherine Gold, M.D., an associate professor in family medicine at the University of Michigan Medical School and a primary care physician. “We’re absolutely seeing just exhaustion from the pandemic,” she reports. “People are tired of isolating and tired of all the restrictions and just tired of the fear of getting COVID — not only patients with existing mental health conditions, but people who don’t really have a diagnosis of a mental health condition are feeling increasingly isolated, or anxious.”

She and other experts say the persistent pandemic is responsible for exacerbating two particularly big risk factors for mental health issues:

Isolation

Reza Hosseini Ghomi, M.D., a geriatric neuropsychiatrist in Billings, Montana, says he’s seeing more depression and anxiety among his older patients, sometimes as a result of the loneliness that can come with isolation. It “manifests typically as either anxiety or depression. [There’s] a lot of sadness, hopelessness, ‘Oh, this is never going to end.’ And a lot of sleep issues.”  

Loneliness can worsen our health on many levels; it rivals smoking for its negative impact, and raises the risk of dementia by 50 percent, according to a 2020 report from the National Academies of Sciences, Engineering, and Medicine.

“Human beings are social animals,” says Samoon Ahmad, M.D., a clinical professor of psychiatry at New York University’s Grossman School of Medicine whose book Coping With COVID-19: The Medical, Mental, and Social Consequences of the Pandemic comes out in April. “We need to interact with other humans. When we are placed in isolation for long periods of time, we deteriorate psychologically and physically and these two have a reciprocal effect — meaning psychological deterioration accelerates physical deterioration and vice versa.”    

Chronic stress

Many people have felt higher levels of anxiety for many months now, making it a chronic problem with potentially serious health consequences (among other things, it can suppress the immune system). “People are very resilient — we tend to recover from even deeply traumatic events,” says Ahmad. “But that process of recovery becomes more difficult if the stress does not let up.”

With the rise of omicron, he adds, “I worry that people have not had time to recover from previous waves, and that this is going to lead to even more people experiencing some of the most common symptoms associated with stress disorders.”

Those include:

Intrusive thoughts or dreams associated with the traumatic experience 

Social withdrawal (or avoiding items, people or places associated with the experience)

Negative mood 

Hypervigilance (the sensation of being constantly on guard and easily startled)

Difficulty sleeping 

Low energy

Another risk associated with chronic stress: self-medicating with drugs or alcohol. In a February 2021 survey by the American Psychological Association (APA), 23 percent of adults reported drinking more in the first year of the pandemic. Like the anxiety alcohol users may be trying to alleviate, heavy drinking can impair immune function, as well as exacerbate other health conditions common among older adults, such as high blood pressure and heart disease. 

Ahmed says he’s seeing more alcohol consumption among his own patients. “It’s not that someone who used to only drink occasionally is suddenly going through a bottle of vodka every two or three days,” he notes. “Instead, it’s people who used to drink socially and have maybe six or seven drinks per month are noticing that they might have two or three drinks per night.”

Finding professional help

If you think therapy can help you, be persistent in finding the right therapist. Many are so busy they’re turning away new clients, says Gold, who’s been frustrated trying to find mental health professionals to whom she can refer her patients. “We don’t have enough people doing mental health care, and those who are doing it are just booked for weeks.” In the APA’s September 2021 survey of psychologists, 41 percent of 1,141 respondents said they were unable to meet demand for treatment, up from 30 percent in 2020.  

But don’t give up, says Ghomi: “I always tell people, go ahead and call five different people all at once, rather than one at a time. Cast a wide net… talk to a bunch of different people, and then decide.”

If you don’t have a referral, Psychology Today’s Find a Therapist and the APA’s Psychologist Locator, are good resources. Type in your zip code and you’ll find a list of professionals near you. Another way to go: Narrow the prospects based on your insurance to find in-network providers. After you’ve pared down your search, interview potential therapists by giving each one a call or requesting a free consultation. (Keep in mind, right now most therapists are conducting sessions over the phone or video conferencing because of the coronavirus.) For more on the different kinds of therapy and finding one that fits your needs, see our story “How to Find the Right Therapist.”

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