To help slow down Nevada's coronavirus outbreak, officials are asking people to stay at home and avoid contact with others.
But people living with mental illness often struggle with isolation in their daily lives. Loneliness also has a proven connection to depression, anxiety and other conditions.
At the same time, Nevada has a very poor record of mental health care. Few psychiatrists, few facilities, few beds.
So how will the state-requested isolation to fight COVID-19 impact Nevadans—and not just those who diagnosed depression. But all of us?
“It does have the potential of making it worse depending on the types of activities that they may do because it increases their sense of being lonely and loneliness can be a key factor for increased depressive symptoms,” said Herbert Coard, a clinical psychologist with Renown Medical Group in Reno.
Coard said being isolated is not the same as being distanced from people. He advised that people keep connected through the phone, Skype or even text messages.
He said his office has been getting more calls since the social distancing rules went into place, but he said one way for everyone to face the situation is to look at as an opportunity, not a disaster.
Coard suggested people look for a new hobby or healthy habit to form. As an example, he and his son go out at night before bed to look at the stars. He said a hobby can make people feel as if they accomplished something.
Traumatic events can have a lot of different impacts on people but one of the most common is disturbed sleep. Dr. Coard says maintaining a regular sleep pattern can one of the best ways to combat depression and anxiety.
“Try to keep a regular routine with sleep. Go to bed about the same time. Don’t stay in bed for more than about 20, 25 minutes. If you can’t fall asleep, get up. And we shouldn’t be doing anything else in bed except sleep and sex… no watching TV, no doing anything. Just sleep and sex,” he said.
Debra Rilea is the president of the board for NAMI Northern Nevada and she's a family support group facilitator.
She agreed that getting good sleep is vital to maintaining good mental health. She also advised people to do something even more basic.
“Every individual needs to be considering, how to breathe. I know it sounds pretty basic, but we get tight in our chest. We forgot to breathe, maintaining those routines that help us stay healthy,” she said.
Everyone seems to be out of their daily routine, but for children, the lack of structure can be even more troubling. Daily structure and routine help children feel safe.
United Citizens Foundation works in schools to help kids with mental health conditions. With students out of class, the foundation's work has become more difficult.
Fred Woodard is the clinical director for the foundation. He said they are using teletherapy to reach out to students.
“We’re doing our very best not to be reactive so that we can be out in front. We can reach out to these individuals and say, ‘We’re here.’ We know that this is a time of uncertainty. We know that this is a time of chaos and confusion... when people don’t know what’s going on, then that’s when fear strikes,” he said.
Woodard said parents should watch for behavior changes in their children like increased aggressiveness or the opposite being more withdrawn. They should also look for problems with eating and sleeping patterns.
The foundation does not charge for services. It bills insurance when it can and uses grants when a family doesn't have insurance.
Other mental health organizations are also moving to online services. Robin Reedy is the executive director of the National Alliance on Mental Illness, which switched as many services as possible online.
She said acknowledged that Nevada is one of the most under-resourced states when it comes to mental health but she did give the state credit for moving quickly to improve telehealth services for people with mental illnesses.
“We’re trying to flip our services to online, phone call, warmline, several different things throughout the state," she said, "So that we can still reach out and work with anyone living with a mental health condition, the families that love those people and trying to keep things in recovery and stable and the fact that there is a whole universe of people out there who are now experiencing depression, anxiety, etc.”
One of Reedy's main goals is educating people about mental illness and fighting the stigma that can stop people from finding full recovery. She said the pandemic and its fallout might actually help in that effort.
“Now you have that universe of people, who maybe didn’t understand anxiety, who maybe didn’t understand depression, and now they’re getting a taste of what some people live with 24/7,” she said.
The people who are experiencing anxiety and depression because of the outbreak may bring a better understanding to those who have struggled with those issues their whole lives.
Reedy said whether someone has depression and anxiety triggered by current events or they've had it for years, it is important to reach out for help if you're in crisis.
“When that anxiety and depression get to a point where it truly affects your life and you feel, and you’re thinking thoughts and you’re going into crisis, you need to be talking to somebody,” she said.
If you’re in crisis, there is help available.
Please call the National Suicide Prevention Lifeline, 1-800-273-TALK (8255).
More mental health resources:
Telehealth Services, United Citizens Foundation: (702) 888-6300
COVID-19 Information And Resources, National Alliance on Mental Illness
Emotional Wellbeing During the COVID-19 Outbreak, National Suicide Prevention Lifeline
Living With Mental Illness During COVID-19 Outbreak, Mental Health America
Stay Home For Nevada: Resources, Nevada Department of Health and Human Services
Stress Management Techniques, Stacie Mathewson Behavioral Health and Addiction Institute at Renown
Herbert Coard, ED.D, Clinical psychologist, Renown Medical Group; Fred Woodard, Clinical Director, United Citizens Foundation; Robin Reedy, executive director, National Alliance on Mental Illness (NAMI) Nevada; Debra Rilea, President of the Board, NAMI Northern Nevada, Family Support Group facilitator