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Visions Journal

Coping with COVID-19

Examining how the pandemic affects mental health and well-being

Talia Morstead

Reprinted from the "COVID-19" issue of Visions Journal, 2020, 16 (2), pp. 8-9, 12

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The COVID-19 pandemic has disrupted lives across the globe on a massive scale. As scientists and medical practitioners work tirelessly to understand and combat the physiological impact of the virus, it is important to also consider the psychological and social impacts of the pandemic.

Ramifications ranging from the financial stress of being laid off from work to the emotional turmoil resulting from reduced social contact will likely have far-reaching implications for mental health. For some, the effects of the pandemic on their mental well-being will persist long after the imminent threat of the virus subsides.

The sheer scope of the psychological and social disruptions associated with the COVID-19 pandemic makes it difficult to forecast future mental health implications. But looking to past infectious disease outbreaks and other historical events that have generated stress on a widescale population level can provide us with insights into what the coming months and years may bring.

Historical insights on present-day problems

Past infectious disease outbreaks give us evidence of the mental health impact of epidemics and pandemics. For example, heightened anxiety and symptoms of depression were commonly reported during the outbreaks of SARS, Ebola and H1N1.1 In some cases, these symptoms were prolonged and lasted long after the epidemic had resolved.2, 3

Given the large scale of the COVID-19 pandemic, however, research on these relatively smaller outbreaks may not give us the full picture. It may also be worthwhile to look to other types of past events that have generated mass psychological trauma. For example, some researchers have put forward the 9/11 terrorist attacks as a reasonable comparison for the purpose of considering potential mental health implications in those affected directly and indirectly by COVID-19.4 Others have drawn parallels between the COVID-19 pandemic and recent natural disasters in order to illustrate how the mental health fallout generated by COVID-19 might persist long after the pandemic has passed.5

The common denominator of the current pandemic and the comparison cases is that each scenario generated (or continues to generate) an immense amount of stress that affects the lives of many. In each case, the stress generated can, for some individuals, contribute to the emergence or worsening of mental health challenges.6

The multifaceted psychological impact of a global pandemic

From the outset of the COVID-19 pandemic, mental health professionals have been aware of the diverse ways that the virus and the scale of the global response could have a significant psychological impact.1 The novel, uncontrollable and unpredictable nature of the pandemic and the threat posed by the virus to our sense of safety can contribute to heightened stress and worsening mental health.7 Experiences of discrimination, inequality, resource scarcity, economic instability, social isolation and relationship difficulties have also been pointed to as factors that could negatively impact mental health during the pandemic and in the long term.8

Many of these concerns have been noted in recent research on the impact of the pandemic as it unfolds. In multiple studies, heightened levels of anxiety and depressive symptoms have already been reported.9 Symptoms of post-traumatic stress disorder have also been found in some communities.10 In many cases, the heightened distress is associated with factors such as economic instability, social isolation and work disruption.9 Studies have also found that, despite the increased risk of the virus to the health of older individuals, younger people appear to be faring more poorly in terms of mental health, potentially due to the types of stressors they encounter or the ways in which they are coping with them.10-12 What remains to be seen, however, is how the mental health impacts of the virus will play out over time and how features unique to the COVID-19 pandemic will play a role.

As the pandemic continues, researchers across the globe are working to answer questions about how individuals’ mental health is being impacted in real time. One of the tools we use to do this is the longitudinal study, in which we follow up with the same individuals repeatedly throughout the course of the pandemic. In the lab where I work at the University of British Columbia, we are studying how individuals are coping with various stressors during the pandemic. We hope to provide insight into how these stressors are contributing to specific coping practices, and the impact of these stressors and coping responses on mental health over time.

Numerous studies have reported that psychological distress is, on average, higher than it was before the pandemic.13 In our research, factors such as social isolation, financial insecurity and resource scarcity are described by study participants as sources of stress during the pandemic, and those experiencing these stressors are at higher risk of psychological distress.14 This type of research is extremely valuable as it helps us understand the unique factors that contribute to mental health during the pandemic and provides insight into specific targets for intervention.

The value of empathy and resilience

Despite the current extraordinary circumstances, it is important to remind ourselves of the remarkable resilience repeatedly demonstrated by individuals and communities in the face of disaster. While individual factors such as personality can contribute to resilience outcomes, so, too, can family and community-level factors such as communication and cohesion.15 It is crucial to continue to examine the long-term impacts of the pandemic to see how individuals and communities evolve and adapt over time.15

In the context of COVID-19, many of the stressors we face seem overwhelming and are largely beyond our control. One area where we can exert some control is in how we cope with the stresses we face due to the pandemic. Reminding ourselves of our resilience, and how our coping strategies can foster that resilience, is key: how we cope with stress can have a bearing on psychological outcomes and our mental well-being.

Previous work out of our lab has demonstrated that, in the context of infectious disease outbreaks, a particularly effective form of coping is to consider others’ perspectives and offer support. During the SARS and H1N1 outbreaks, those who used this coping mechanism, called empathic responding, were more likely to take the precautions recommended by the public health authorities.16, 17 In other settings, empathic responding has been identified as a coping strategy that can promote relationship functioning18 and benefit both the provider and recipient of the empathic response.19

When we focus on our resilience and practise our positive coping strategies, we may be better equipped to follow the guidance of Provincial Health Officer Dr. Bonnie Henry to be kind, be calm and be safe for the benefit of others as well as ourselves. Given that how we cope with stress affects our physical and psychological health, our capacity to control our response to stressors in the context of the COVID-19 pandemic may reduce negative mental health impacts over time.

About the author

Talia is a student and project manager in the Psychology Department at the University of British Columbia. She is currently working under the supervision of Dr. Anita DeLongis and Dr. Nancy Sin, doing research on stress and coping responses in the context of the COVID-19 pandemic 

Footnotes:
  1. Chew, Q., Wei, K., Vasoo, S., Chua, H. & Sim, K. (2020). Narrative synthesis of psychological and coping responses towards emerging infectious disease outbreaks in the general population: Practical considerations for the COVID-19 pandemic. Singapore Medical Journal. doi.org/10.11622/smedj.2020046.
  2. Liu, X., Kakade, M., Fuller, C.J., Fan, B., Fang, Y., Kong, J., Guan, Z. & Wu, P. (2012). Depression after exposure to stressful events: Lessons learned from the severe acute respiratory syndrome epidemic. Comprehensive Psychiatry, 53(1), 15-23. doi.org/10.1016/j.comppsych.2011.02.003.
  3. James, P.B., Wardle, J., Steel, A. & Adams, J. (2019). Post‐Ebola psychosocial experiences and coping mechanisms among Ebola survivors: A systematic review. Tropical Medicine & International Health, 24(6), 671-691. doi.org/10.1111/tmi.13226.
  4. DePierro, J., Lowe, S. & Katz, C. (2020). Lessons learned from 9/11: Mental health perspectives on the COVID-19 pandemic. Psychiatry Research, 288, 113024. doi.org/10.1016/j.psychres.2020.113024.
  5. Hartmann-Boyce, J., Morris, E., Goyder, C., Kinton, J., Perring, J., Nunan, D., Mahtani, K., Buse, J.B., Del Prato, S., Ji, L., Roussel, R. & Khunti, K. (2020). Diabetes and COVID-19: Risks, Management, and Learnings From Other National Disasters. Diabetes Care. doi.org/10.2337/dc20-1192.
  6. Galatzer-Levy, I.R., Huang, S.H. & Bonanno, G.A. (2018). Trajectories of resilience and dysfunction following potential trauma: A review and statistical evaluation. Clinical Psychology Review, 63, 41-55. doi.org/10.1016/j.cpr.2018.05.008.
  7. Gruenewald, T. & Wang, D. (2019). Stress and health. In T.A. Revenson & R.A.R. Gurung (Eds.), Handbook of health psychology (pp. 213-224). New York: Routledge, Taylor and Francis.
  8. Van Bavel, J.J., Baicker, K., Boggio, P.S., Capraro, V., Cichocka, A., Cikara, M. et al. (2020). Using social and behavioural science to support COVID-19 pandemic response. Nature Human Behaviour, 4(5), 460-471. doi.org/10.1038/s41562-020-0884-z.
  9. Rajkumar, R.P. (2020). COVID-19 and mental health: A review of the existing literature. Asian Journal of Psychiatry, 52, 102066. doi.org/10.1016/j.ajp.2020.102066.
  10. Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R.S., Choo, F.N., Tran, B., Ho, R., Sharma, V.K. & Ho, C. (2020). A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, Behavior, and Immunity. doi.org/10.1016/j.bbi.2020.04.028.
  11. Bruine de Bruin, W. (2020). Age differences in COVID-19 risk perceptions and mental health: Evidence from a national US survey conducted in March 2020. The Journals of Gerontology: Series B. doi.org/10.1093/GERONB.
  12. Klaiber, P., Wen, J.H., DeLongis, A. & Sin, N.L. (2020). The ups and downs of daily life during COVID-19: Age differences in affect, stress, and positive events. The Journals of Gerontology: Series B.
  13. Vindegaard, N. & Benros, M.E. (2020). COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain, Behavior, and Immunity. doi.org/10.1016/j.bbi.2020.05.048.
  14. Morstead, T., Zheng, J., Sin, N., Klaiber, P., Umberson, D., Kamble, S. & DeLongis, A. (2020). Depressive symptoms during COVID-19: The role of pandemic-related stressors [Manuscript submitted for publication]. Department of Psychology, University of British Columbia, Vancouver, Canada.
  15. Chen, S. & Bonanno, G. A. (2020). Psychological adjustment during the global outbreak of COVID-19: A resilience perspective. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S51-S54. dx.doi.org/10.1037/tra0000685.
  16. Puterman, E., Delongis, A., Lee-Baggley, D. & Greenglass, E. (2009). Coping and health behaviours in times of global health crises: Lessons from SARS and West Nile. Global Public Health, 4(1), 69-81. doi.org/10.1080/17441690802063304.
  17. King, D.B., Kamble, S. & DeLongis, A. (2016). Coping with influenza A/H1N1 in India: Empathy is associated with increased vaccination and health precautions. International Journal of Health Promotion and Education, 54(6), 283-294.
  18. O’Brien, T.B., DeLongis, A., Pomaki, G., Puterman, E. &Zwicker, A. (2009). Couples coping with stress: The role of empathic responding. European Psychologist, 14(1), 18-28. doi: 10.1027/1016-9040.14.1.18.
  19. Stephenson, E., DeLongis, A., Esdaile, J.M. & Lehman, A.J. (2014). Depressive symptoms and rheumatoid arthritis: Spouse empathic responding as a buffer. Arthritis care & research, 66(4), 532-541. doi: 10.1002/acr.22161.

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