When the pandemic first sent Americans home in March 2020, licensed psychotherapist Lisa Bahar believes many of them were happy to have a break — from school, from work, from commuting, and taking to children. Also, most people had access to financial supports they hadn’t had before, like federal stimulus money.
But as COVID-19 progressed, the story changed and both sadness and depression increased. People gained unwanted weight. And they began to question if life would go back to normal or if they would have to adapt to a new version.
Bahar has seen an increase in stress, sadness, and depression at her family therapy practice in Newport Beach, California. Research studies also confirm the trend, including the American Family Survey 2021, a nationally representative annual study conducted by YouGov for Deseret News and Brigham Young University’s Center for the Study of Elections and Democracy.
Both mental and physical health have been affected by the pandemic, respondents said. It also became more difficult to access care, especially mental health services.
“One of the biggest ways this pandemic has affected our mental health is the loss of social support,” says David Routt, a licensed professional clinical counselor in Caldwell, Idaho. “Many of us rely heavily on others to keep the wheels of our lives turning, and when those supports are lost, we don’t move as well as we used to. This causes a significant increase in stress, which can easily lead to depressive or anxious symptoms.”
Who is suffering more?
Although many restrictions related to the pandemic have been lifted in recent months, life is still different from what it was.
“People of all ages come to me because they are experiencing feelings that result in lack of motivation, not being able to participate in social activities or withdrawing from family members,” said Laurie Singer, a licensed marriage and family therapist in Camarillo. California. “These people exhibit maladaptive behaviors because of these feelings.”
Singer believes the pandemic is to blame for the surge, and part of her therapy includes finding ways to help people see what’s positive in their lives.
“It’s harder to get people to focus on the positive during these uncertain times. People have different opinions and belief systems,” Singer said.
He noted that family and friends may pick on or avoid a person because of their beliefs about the pandemic. And school-age children pick up on the discord and struggle to process it, sometimes resulting in maladaptive behavior like aggression or noncompliance.
Meanwhile, older people are more likely to become isolated and lonely, which brings other problems, including a lack of self-care, he said.
People were used to interacting with friends, family and even places until the pandemic eliminated much of that behavior, David Simonsen, a family therapist from Olympia, Wash., told the Deseret News. “This inability to go out and express yourself, be social and generally be free to do whatever you want has had a negative impact on mental health.”
About a third of those surveyed in the American Family Survey said their feelings of sadness or depression increased. Only 9% said they felt less sad or depressed between March 2020 and when the survey was conducted in late June and early July 2021. The survey surveyed approximately 3,000 adults.
Nearly 1 in 4 said their family members had not received the mental health care they needed, while 20% said they did not receive the physical care they needed.
Also, more than a third said they gained weight, compared to 17% who lost weight and 49% whose weight stayed the same, the survey found.
Exercise habits generally didn’t change, but for people they often did: 1 in 5 people said they exercised more and the same proportion said they exercised less.
Single adults without children were the most likely to report greater depression or sadness (40%) in the survey.
Marital status and family structure
Bahar has seen many single adults who felt very lonely and sad, especially college students who had to leave their campuses, friends and classes or, conversely, those who were stuck where they were. High school kids missed out on a ton of fun activities and social occasions, and many also had their college plans on hold for a while.
The young people, he said, “had a lot of depression and disillusionment and felt isolated and losing their community.”
When asked if they felt more depressed or sad, single adults with children responded very similarly to married adults without children, at 34% and 33%, respectively. Just over 1 in 4 married adults with children said they have more depression or sadness.
Bahar said the childless married couples she knew seemed to grow closer, at least at first. For some, that changed later with too much togetherness.
Those with children had to make other adjustments, some quite stressful, including figuring out how to conduct class remotely. For the parents who struggled with it, “it became a big issue of not knowing how to teach the kids and feeling bad about it, as well as being frustrated that they had to do it,” she said.
For anyone who has been sick during the pandemic, “home quarantine can be extremely isolating and human beings were created to be relational, so it stands to reason that we suffer from this lack of human contact,” Routt said.
He thinks extroverts might have had a harder time with that. “There is a lot of truth to the fact that about half of our population is ‘rather fine’ with being home alone on a Saturday night.”
Just having others around, whether it’s children or a partner, provides a natural support system in the home. “Having those relationships can help us move forward,” Routt said.
However, it is also true that families sometimes increase stress, including in difficult (perhaps abusive) intimate relationships, when we depend on medical supports or child care or treatment, or when someone loses a job or is sick, among others.
“When we look at the many variables that affect our lives, there are many reasons why people may already be stressed or depressed,” Routt said. “With the addition of a global pandemic, it doesn’t make anything better, it makes it a lot worse.”
Monetary resources also mattered. The survey found that high-income people in households earning at least $80,000 a year were less likely to cite increases in sadness or depression (29%) compared to 34% of people with incomes below $40,000 and 31% for those with middle income. The poll’s margin of error is plus or minus 2%.
The good news in this survey, and somewhat at odds with some news reports and counselors’ experience with clients, is that while 12% said they drank alcohol more often, 20% said they drank less often. as the pandemic progressed.
heavy challenges
Problems with weight gain and eating can be a symptom of depression, according to Simonsen. And that is not unexpected in a global pandemic.
“When there are no places to go and nothing to do, sitting at home and watching the latest Netflix show is bound to be problematic,” he said.
Bahar said weight gain has been a common complaint from patients, and for many, the stress it causes is surprising.
“Food serves as a way to suppress feelings,” Bahar said. “It’s self-soothing and often a pointless thing.”
But for many people, as weight increased, so did negative self-talk, images of body problems, and self-doubt. For those already struggling with body image issues or an eating disorder, the pandemic was especially bad.
She said that more of her young male clients were eating more, drinking more and using more substances during COVID-19. Couples who stayed home for six months earlier in the year followed a similar pattern. And even though they didn’t drink, they cooked more meals at home: breakfast, lunch, dinner, and more snacks.
Among those surveyed, the proportion who added pounds ranged from 30% married parents to 36% single parents. Those without children were somewhere in the middle.
Eating is a tried-and-true coping mechanism, Routt said, noting that “eating releases dopamine in the brain, which makes us feel better. It is one of nature’s most natural drugs.
The 2021 US Stress Report by the American Psychological Association found even more dramatic unwanted weight gain by adults. Its March 2021 snapshot said that 61% of American adults said they experienced unwanted weight gain in the pandemic, with an average of 29 pounds.
Slightly fewer men (39%) than women (45%) said they gained unwanted weight, but the men who did gained more pounds, 37 compared to 22 for women.
In that survey, millennials were hit the hardest by so-called COVID pounds: 48% said they gained, and the average was 41 pounds.
But 47% said they delayed or canceled health care services.
The pandemic drags on
When the pandemic began, Americans braced for what they expected, and officials predicted, would be a dire but time-limited crisis. Instead, COVID-19 has found its own rhythm, ebbing, shifting, and roaring again in an unpredictable and daunting cycle.
Policymakers and public health officials find it difficult to predict what will happen next.
Uncertainty never reduces stress. Americans are in a “slow process of accepting a new reality whose end is not clear here,” Bahar said. “It could be a way of life that we have to accept.”
Still, many people, including Simonsen, are hopeful.
“With life returning to a new normal, I imagine we’ll see reduced rates of depression and decreased weight gain, which is a great thing,” he said.
