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Consequences for the Mentally Ill During the Coronavirus

It’s only been the past few weeks that I have seen news outlets, both online and on TV, as well as social media, talking about the ramifications of the Coronavirus on those with mental illness and those who develop Post Traumatic Stress Disorder (PTSD) as a result of working with the ill, enduring the virus and simply trying to get by, day by day.

My question is: why wouldn’t we pay attention to those with mental illness throughout this life-altering time? Wouldn’t this be obvious? I know the answer: why would it be obvious when the stigma around mental illness is alive and well in our society? It’s still extremely upsetting given our daily life experiences.

For me, the Coronavirus entered our country while I was in an Intensive Outpatient Program (IOP) due to depression. I had a bad reaction to a medication for a medical problem that made me hypomanic and then once off of the medication, I became depressed. Not the best time for a pandemic to hit, not that it ever would be. Moving from in-person groups to group therapy on Zoom was not a “normal” psychiatric treatment but I did it and was discharged last week, although I am still not yet stable. The world is not normal and I don’t feel normal.

My therapist and I switched to phone sessions and then to Zoom. Our schedule is usually 4x per week and having therapy through a screen is definitely not the same as in person.

I am now weaning off of my Lithium due to all of the side effects I am dealing with. I included them here as parts of my day since this is happening now. This is where it becomes complex. This is basically my current daily schedule:

  • Wake up
  • Hands tremble (side effect)
  • Exercise
  • Eat breakfast
  • Take morning meds
  • Take a walk
  • Feel off balance (side effect)
  • Try to decide what to do
  • Stomach ache (side effect)
  • Feel sad
  • Continue online art class
  • Feel tired (side effect)
  • Feel extremely thirsty (side effect)
  • Sit and watch TV
  • Hands tremble (side effect)
  • Ruminate over thoughts
  • Eat lunch with husband and daughter
  • Watch TV
  • Feel anxious about having so much time
  • Stomach ache (side effect)
  • Feel anxious about any feelings I’m feeling: bordering on hypomania and/or depression (yes, you can feel both at the same time or within minutes of each other)
  • Take walk with husband and daughter or alone
  • Have Zoom therapy session (right now, 5 days/week, usually 4 days/week)
  • Feel sad: not able to see therapist in person
  • Feel extremely thirsty (side effect)
  • Get dinner ready
  • Feel overwhelmed
  • Feel sad
  • Eat dinner with husband and daughter
  • Play Xbox with daughter or watch TV and do mandala coloring
  • Stomach ache (side effect)
  • Put daughter to bed
  • Feel exhausted
  • Take night meds
  • Binge-watch TV shows with husband
  • Stomach ache (side effect)
  • Go to bed and worry about next day, cry

Time is no one’s friend. Too much time plus being in the midst of an episode of mental illness is exhausting. Living through a pandemic, a virus that is easily spread, that requires everyone to stay home, while being in the midst of a mixed episode of depression and hypomania is paralyzing and incapacitating. There are consequences for everyone with mental illness living through this pandemic. The psychological consequence, for me, of not being well during a literal and figurative lockdown is that of defeat.

It’s just another fucking day during a pandemic for someone fighting with her mental illness.

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People Struggling with Mental Illness Pre-Coronavirus and Today

The current talk about the effects of social isolation on everyone due to the coronavirus is extremely important. This is a crucial topic as it is affecting millions of people all over the world. People are not meant to be isolated, not only those who live alone but also a family of 6 under one roof. In either scenario, a person can feel alone, set apart from his/her “outside” life which can include school, work, friends, going to the library, stores, etc.

But what about those who were already struggling with mental illness before the coronavirus hit? This is another group of people who are not only struggling with depression, anxiety, schizophrenia, etc. but must now also cope with the state of our world. Being one of these people, I can tell you it is a major complication for my recovery. As I have written before, moving from in-person therapy and group sessions to online has been difficult.

The main purpose of my attendance in an Intensive Outpatient Program (IOP) was to help stabilize and provide me with more support after reacting to medication for a nerve problem which caused hypomania followed by depression. I am still not stable even though medication changes are in the works and I am, for the most part, an active group member and try to be present in my individual sessions. My outpatient and IOP Psychiatrists describe what’s happening as a “rebound effect” where my brain (neurotransmitters) is trying to “figure things out” after what they’ve been through as a result of the medication that initially caused the first bout of hypomania/depression in December.

What I do not understand is why it has continued this long. Almost 4 months and lately I have been in what is called a “mixed state.” This basically means I experience major agitation and irritability, sometimes racing thoughts while also feeling sadness, low energy and a loss of interest in activities. There are times when I am tearful or even crying while also smiling, feeling grandiose. I may feel extremely happy and energetic for an hour and then feel tremendous sadness. It can be emotionally exhausting and it feels uncomfortable. I don’t like it and no one can give me a concrete answer as to why this has continued. That’s frustrating but I realize there’s no crystal ball for my professionals to tell what is happening, why and when or if it will stop.

Bring on the coronavirus and the levels of sadness I feel are so severe I can barely breathe. I miss my friends and I miss being with my group therapy members. I miss my therapist in such a way that I often cry during our online sessions thinking about how much I wish we were in her office. I limit my news check-ins as the tears I cry hearing of the utter mayhem of our healthcare system and the patients who are ill and those who died is too much and only mixes into my “mixed state” in a complex way.

This is where I am like you. We are stuck in our homes, making home-made masks for protection and trying to create structure for our kids this week of school vacation. I wear a mask when I go food shopping and keep a distance but inside, I am terrified, just like you. How do we handle this while being a steady guide for our children? I guess, for me, it’s simply been one step and then the next. I have been furloughed from my job and while I feel confident I will be re-hired once stores re-open, it remains a stress even though I had not been working for a few weeks leading up to the shut-down due to my mental health needs. So, we share quite a bit, we really do. There’s the personal: our families and friends, there’s the economy: will I have a job once things become safer? We don’t know.

All we can do is take one step and then the next. There is no crystal ball. One possible difference between you and me: when I take one step I may feel grandiose and have a sinister view of what’s in front of me and when I take the very next step, I am in tears, feeling the most intense sadness. I do hope there will be 2 crystal balls: one that will solve, cure and vaccinate against the Coronavirus and one that will provide answers and the best treatment to my almost 4 months of hypomania and depression as well as to all who have suffered with mental illness, pre-Coronavirus and currently.

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Online Therapy is NOT the Same as In-Person Therapy and I Miss My Providers

This image is washed in fog, difficult to see and difficult to grasp.

We all have the same questions and so many more. We are living in an unprecedented and terrifying time, something we haven’t dealt with before. What I’m left with is anger. My hypomania had just decreased to a point where I had insight, thanks to starting the medication, Lithium. A minute later life shut down: moving from in-person sessions to phone sessions with my therapist, then from in-person group therapy at my Intensive Outpatient Program (IOP) to online, to online sessions with my therapist.

I continue to have difficulty focusing as I recover from my hypomania/depression. This can make it difficult to write, as you can imagine, but I am trying. You see, I am sad, scared and tired. I have good times of the day but I also have not so great times. This is normal for the way our world is right now, but, currently, my thoughts center around all of my providers and supports. It’s great to connect online with my IOP people and it’s great to see my therapist via technology, but you know what? – it’s not the same. The novelty has worn off and I feel so sad as if I’m just flying out here alone. I miss these people so much. I count on them when meeting in person, but now, it’s not that I don’t count on them, it’s that it feels too separate. There’s a void between us that I am feeling, in a strong way. This is what has made me cry the past few days. I’m hanging on, holding on to my recovery, but it’s abstract, in some ways. I want my supports, my professional allies and I want to feel it, not remember it or imagine it as it will be in the future. I want to feel it NOW.

I heavily rely on my psychological team and right now, it feels surreal, as if no one is actually there. Intellectually I know they are, but the feeling of them, it’s as if it’s being chipped away and I’m scared by that. I am more vulnerable right now, still in IOP, still getting used to the Lithium, while also living this unbelievable existence in order to be safe and keep my family safe.

I just don’t want to feel alone, flying alone, because, in reality, I am not, not even close. My therapist, psychiatrist, my IOP therapist and psychiatrist are there for me and in touch with each other. I am simply not coping well with the lack of in-person meetings. When I feel alone in treatment, which can come about for many different reasons, I become very scared and sad. I talked to them during my zoom appointments today about this. That’s the only way to help myself, to make sure everyone is on the same page. My therapist told me today to not be afraid of my sadness or tears, that it’s all okay. She said I have to not only cope with the current state of our world but I also have to focus on my recovery from 3 months of extreme difficulty, psychologically. I felt validated and I have to keep reminding myself that this treatment team is there for me. I just hope I can get that feeling back soon and, of course, to meet again in person, once it’s safe enough. I just can’t wait to really feel it again.

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