Dr. Ani Kalayjian, Jasmin Guevarra, and Erin Antona
Towards the end of 2019, the outbreak of coronavirus (COVID-19) began in China and quickly spread to other countries within months. COVID-19 is an infectious virus that easily spreads with mild to moderate symptoms, mainly infecting older individuals with underlying medical problems (WHO, 2020). By March 11, 2020, the coronavirus became a global pandemic according to the report put forth by the World Health Organization. By March 13, 2020, it was declared a national emergency in the United States (CDC, 2020). The United States became the epicenter of COVID-19 and by June 2020, there were 1,920,904 total cases and 10,990 total deaths (CDC, 2020). In order to slow down and eventually stop the spread of the virus, the government implemented a series of guidelines such as quarantine, social distancing, wearing facemasks, and wearing gloves. For the sake of this paper, social distancing will be referred to as ‘physical distancing,’ as the popular saying “social distancing” is not a healthy statement. We as humans, are a social animal, and thrive with positive social support.
As we emerge into a new way of living in order to cope with the pandemic, mental health has become a major issue amongst people of all ages. Students have to adjust overnight to an online learning environment and many parents have to work from home if they still have employment. Domestic violence and abuse rates have risen to 30% in France and 18% in Spain, China, and the U.S. (Duncan, Weaver, et al., 2020). Additionally, grieving the death of loved ones from the coronavirus has become extremely challenging.
The Association for Trauma and Outreach (ATOP), MeaningfulWorld, has spearheaded free weekly zoom support groups since mid-March to help strengthen those that are struggling. The goals of the support groups were to help discharge negative feelings; transform fear, anxiety, and worry to lessons learned; and to help communities at large. This article will examine the mental health challenges entailed in coping with a global pandemic.
A study in China has revealed signs of psychological distress caused by the crisis of COVID-19 . The study measured the peritraumatic distress of the general Chinese population by conducting the country’s first large-scale nationwide survey (Qiu et al., 2020). The questionnaires used in this survey measured the frequency of anxiety, fear, worry, depression, and other symptoms that might indicate struggles with mental stability during the pandemic. The results of the study showed that 35% of the population showed signs of psychological distress. The highest levels of psychological distress were shown in migrant workers and also in women, young adults, elderly, and individuals with higher education (Qui et al., 2020).
Moreover, multiple factors impacted the outcome of this research. These factors are:
- Higher scores of distress in young adults due to excessive use of social media.
- Higher scores in elderly due to high mortality rates in this age group.
- Higher levels of stress in women.
- Level of education (individuals with higher education tended to be aware of their mental health issues and seek assistance).
- Higher scores in migrant workers due to income hardship and high exposure to the virus as they utilize public transport (Qui et al., 2020).
Other factors highlighted in this article were availability of local medical resources, efficiency of the regional public health system, and prevention and control measures taken against the epidemic. The study emphasized the importance of mental health services during the crisis of COVID-19 in China (Qui et al., 2020).
The panic of the pandemic from the public is not the only cause of mental health challenges. Healthcare providers have also been experiencing emotional distress not only due to the high exposure to the virus, but also due to the traumatic experiences that are associated with providing care for COVID-19 patients (Pfefferbaum et al., 2020). It is also evident that the stay-at-home order, although necessary, has also caused some individuals to experience the following psychological symptoms: anxiety, irritability, fear, frustration, depression, isolation, and insomnia (Pfefferbaum et al., 2020). Not only has the physical isolation been challenging, but the lack of supplies and medication, as well as the general financial depression has tended to exacerbate levels of distress. Furthermore, those who have lost loved ones from COVID-19 are also impacted with grief, especially since they must grieve in isolation (Pfefferbaum et al., 2020).
The emotional impact from this pandemic has caused higher risk of suicide. Head of Trauma at John Muir Medical Center, Dr. Mike deBloisblanc, reported that the number of suicides in the month of May were equivalent to the number of suicides reported in a year (Hoonout, 2020). The effects of the pandemic can be damaging to those who already live with a mental illness. Fear from the pandemic as well as the psychological effects of physical distancing can put those with mental disorders at higher risk of suicide (Gunell et al., 2020). Others with no prior mental illness have been susceptible to developing high levels of post-traumatic stress disorder.
As mentioned earlier, healthcare providers continue to be heavily impacted emotionally by the global pandemic. It was reported that a top E.R. medical doctor, Lorna M. Breen, completed suicide after witnessing the horror of the virus (Watkins et al., 2020). Healthcare workers not only struggle with the influx of patients in a short period of time, but they are also lacking the equipment to treat it. There has been a shortage in personal protective equipment (PPE) in the United States, which puts healthcare workers at a higher risk of being infected by COVID-19 (Watson & Juman, 2020). Additionally, healthcare workers have to comfort COVID-19 patients by acting as a family member, due to the risk of exposing the virus to the patient’s loved ones (Watson & Juman, 2020). These are factors in the psychological distress that frontline medical workers are experiencing. We have also been notified of several suicides taking place in our communities.
Rates of domestic violence and alcohol consumption have also risen, and these are known to be precipitants of suicide (Gunnell et al., 2020). In a recent study, the United Nations projected about 15 million new domestic abuse cases worldwide (Ott, 2020). The United Nations has already reported a rise in domestic abuse cases to 32% in France, as well as rise in cases in Argentina, China, Germany, Turkey, Honduras, South Africa, the UK, and the United States (“UN backs global action to end violence against women and girls amid COVID-19 crisis”, 2020).
What is the United Nations Doing?
The United Nations has always been a helping hand in making the world a better place. Since the beginning of the coronavirus pandemic, the United Nations included a separate site within their main website to feature news related to the global health crisis. On this site, there are specific tabs for announcements from the Secretary-General, Stories, News, and several resources, including for women and youth.
On the Secretary-General tab, António Guterres, has daily updates on how COVID-19 has impacted many world issues. Specifically, on May 15, 2020, Guterres declared the need for action on mental health during this pandemic. Throughout the report, the Secretary-General stated that we must stand by individuals who are frontline healthcare workers, older people, adolescents and young people, and those with pre-existing mental health conditions (2020). As we may begin to see an increased need for mental health services in the upcoming months, the government must fully fund and expand on aiding these areas, since mental health is an essential part of government responsibilities (Guterres, 2020).
In an effort to increase mental health stability while living through a global health struggle, the United Nations, #CopingWithCOVID, released a webinar series on young people and mental health. Since young people have had many of their social environments like school, sports, and seeing their friends daily taken away from them, this webinar focuses on how to overcome the battle with “socializing” from a distance. The Secretary-General’s Envoy on Youth and UNICEF gives about an hour long tip segment on building stronger connections during COVID19. The webinar began on April 1 and will continue until July 22. Along with video sessions, there is a Q&A on specific topics. This webinar provides a common space for many people who are going through the same issues to come together.
What is ATOP Meaningfulworld Doing?
Since mid-March, ATOP Meaningfulworld has been providing weekly support groups every Thursday at noon, EST. Here are some of our observations of the 3-month long support groups. In each support group there were around a few dozen participants. Participants were 99% women, mostly university graduates or students (90%), majority from United States of America (90%), the remaining from UK, Pakistan, Lebanon, India, Armenia, and Haiti.
The following post-traumatic symptoms were frequently rated extremely high on the emotional thermometer of 0-10, (10 being the most severe): Fear, worry, anxiety, frustration, disappointment, helplessness, sadness, sleep disturbances and nightmares.
Although we cannot change what has happened, the pandemic, we can strive to learn from it. Any crisis brings with it both danger and opportunity. Opportunity is for learning a positive lesson, while danger is when we do not cease the moment, we do not learn from it, and we repeat the same suffering in the next pandemic (Kalayjian, 2018). According to Frankl (1965), there are positive lessons to learn even in the worst, most traumatic situations.
What are the positive lessons to learn? Our support group participants shared the following lessons: “I learned that I could rely on my family,” “I know I could connect with Mother Earth,” “It is a new situation, I am going to learn from it,” “I am grateful that I could breath, and have enough food,” “I am free now to focus on my inner health, to shine my inner light,” and “I am enjoying helping others, as when I help others, I feel less helpless, and can cope with uncertainties.”
Resources for Free Support
Technology is one of the great resources we have in our everyday lives, and our phones offer numerous applications that could help with our mental health. The application, Mindfulness, gives many different meditation sessions for sleep, emotions, relationships, and more. Another application called Jour is a self-care journaling application where you can write down any stressful issues you are going through to let it out. The Jour application also has specific topics and prompts if you do not know how to begin writing. Most self-care applications also offer a daily reminder notification just in case you forget to start your day off with meditation or journaling.
Exercise is a second beneficial resource that is not only essential for physical health, but is also necessary to care for one’s mental health. In particular, yoga has become a popular practice in reducing stress and relieving anxiety. It has also been used to care for various different psychiatric disorders around the world. Yoga practices incorporate mindfulness, which is proven to have many cognitive benefits. It is easy to practice yoga in the comfort of one’s home. On the MeaningfulWorld YouTube channel, we host a series of videos where we provide healing, support and relief through the yoga practice of “Soul Surfing.” The Soul-Surfing practice integrates the physical movement, with deep diaphragmatic breath, color consciousness of each energy center, chakra balancing, and positive affirmations repeated for each movement. In less than 20 minutes, through Soul-Surfing we can align our body, mind, and spirit. These exercises are best to do at the minimum 3-times per week (Kalayjian, 2018). “Exercise in Times of Global Pandemic: Soul Surfing” :https://www.youtube.com/watch?v=nk-aedntLWs” https://www.youtube.com/watch?v=nk-aedntLWs.
Meaningfulworld has also been offering all day workshops to those who wish to study the human nature and learn about integrative self-care practices, peace building, forgiveness, and mindful leadership. These workshops are once a month, http://meaningfulworld.com/.
Additionally, Meaningfulworld has compiled a list of resources, which is posted on our website, and is also offering free therapeutic sessions for those in need. The American Psychological Association’s Trauma Division spearheaded a COVID-19 Task Force, with the partnership of many other divisions, to address the needs of the populations impacted by this virus and its psychological impact. The New York State Psychological Association also has resources. The first author has delivered a recent webinar on the varieties of trauma (Kalayjian, 2020). Additionally, NYSPA has free support phone line and offers a follow up 6-therapy sessions, which are pro bono (DNR, 2020).
Conclusion and Recommendations for Further Research
Based on the review of literature, personal sharing, support group sharing, and other case studies, we conclude that as a human race we are suffering from many negative impacts of the COVID-19 pandemic. We recommend further research to explore the various mental health and psychological challenges of collective trauma before another pandemic irrupts. We also see that when humanity is suffering from mental health issues, these challenges impact the collective psyche of humanity, and extreme emotional outbursts could follow.
Centers for Disease Control and Prevention. (2020). Coronavirus Disease 2019 (COVID-19): Cases in the U.S. CDC. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html.
Centers for Disease Control and Prevention. (2020). New ICD-10-CM code for the 2019 Novel Coronavirus (COVID-19).CDC. https://www.cdc.gov/nchs/data/icd/Announcement-New-ICD-code-for-coronavirus-3-18-2020.pdf.
Duncan, T. K., Weaver, J. L., Zakrison, T. L., Joseph, B., Campbell, B. T., Christmas, A. B., Stewart, R. M., Kuhls, D. A., & Bulger, E. M. (2020). Domestic violence and safe storage of firearms in the COVID-19 era. Annals of surgery,10.1097/SLA.0000000000004088. Advance online publication. https://doi.org/10.1097/SLA.0000000000004088.
Frankl, V. E. (1962). Man’s search for meaning. An introduction to logotherapy. Beacon Press (original publishing 1946).
Gunnell, D., Appleby, L., Arensman, E., Hawton, K., John, A., Kapur, N., … Yip, P. S. (2020). “Suicide risk and prevention during the COVID-19 pandemic.” The Lancet Psychiatry, 7(6), 468–471. https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30171-1/fulltext?utm_source=yahoo&utm_medium=referral&utm_campaign=in-text-link
Harvard Health Publishing. (n.d.). Yoga for anxiety and depression. Harvard. https://www.health.harvard.edu/mind-and-mood/yoga-for-anxiety-and-depression.
Kalayjian, A. (2018). Forget me not: 7 steps for healing our body, mind, spirit, and mother earth. Sojourn Publishing, LLC. Pp 237-249.
Kalayjian, A. (2010). Forgiveness in spite of denial, revisionism, and injustice. In A. Kalayjian, & R. Paloutzian (Eds.)Forgiveness & reconciliation. Springer Publishing.
Kalayjian, A. (2020). What is after COVID-19? Ecological consciousness.
Kalayjian, A. (2020). 12 steps to strengthen immune system. https://youtu.be/WET34N9htNw” https://youtu.be/WET34N9htNw
Kalayjian, A. (2020). Soul-Surfing! 7-steps for healing our body, mind & spirit:
Kalayjian, A. (2020). How to manage fear, anxiety, and distress in times of global pandemic!
APodcast.com. Adrian Sinclair interviews Dr. Kalayjian, “How do we transform crises into opportunity:” https://youtu.be/z7WJaeDN8i8″ https://youtu.be/z7WJaeDN8i8
New York State Psychological Association (2020). Resources phone line for those in need.
Watson, L. & Juman R. (2020, April 22). “Behavioral Health Effects of COVID-19” AMDA on
the Go, PodBean. https://paltc.podbean.com/e/covid-19-effects-on-mental-health/
Ott, H. (2020, April 28). 6 months of coronavirus lockdown could mean 31 million more cases of domestic violence, UN says CBS News. https://www.cbsnews.com/news/domestic-violence-additional-31-million-cases-worldwide/.
Pfefferbaum, B., Boulware, D. R., Klompas, M., Beigel, J. H., & Department of Psychiatry and Behavioral Sciences. (2020, June 3). Mental Health and the Covid-19 Pandemic: NEJM.https://www.nejm.org/doi/full/10.1056/NEJMp2008017
Qiu, J., Shen, B., Zhao, M., Wang, Z., Xie, B., & Xu, Y. (2020, March 6). A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061893/
UN backs global action to end violence against women and girls amid COVID-19 crisis | | UN News. (n.d.). https://news.un.org/en/story/2020/04/1061132.
Watkins, A., Rothfeld, M., Rashbaum, W. K., & Brian. (2020, April 27). Top E.R. Doctor Who Treated Virus Patients Dies by Suicide. NY Times.
World Health Organization (2020). Coronavirus. https://www.who.int/health-topics/coronavirus#tab=tab_1.
Dr. Ani Kalayjian, psychology faculty at Teachers College, Columbia University, John Jay College of Criminal Justice, and at Meaningfulworld, a multicultural and multilingual Psychotherapist, Genocide Prevention Scholar, International Humanitarian Outreach Administrator, Integrative Healer, author, and United Nations Representative. She was awarded Outstanding Psychologist of the Year Award from American Psychological Association (2016, Trauma Division), a Humanitarian Award from the University of Missouri-Columbia (2014), the 2010 ANA Honorary Human Rights Award, the Honorary Doctor of Science degree from Long Island University (2001) recognizing 30 years as a pioneering clinical researcher, professor, humanitarian outreach administrator, community organizer & psycho-spiritual facilitator around the globe and at United Nations. In 2007 she was awarded Columbia University, Teacher College’s Distinguished Alumni of the Year. She is steadfast in her optimism that prevention of human-made trauma and resilience post natural disasters can be realized and nurtured through forgiveness, tolerance, ancestral healing and respect for all humanity and mother earth. She has over 100 published articles in international journals, books, and is an author of Disaster & Mass Trauma, as well as Chief Editor of Forgiveness & Reconciliation: Psychological Pathways to Conflict Transformation and Peace Building (Springer, 2010), Chief Editor of II Volumes on Mass Trauma & Emotional Healing around the World: Rituals and Practices for Resilience and Meaning-Making (Praeger, ABC-CLIO 2010), author of Amazon Bestseller Forget Me Not: 7 steps for Healing our Body, Mind, Spirit, and Mother Earth (2018), author of a meditation CD called “From War To Peace” transforming generational trauma into healing and meaning-making, Soul-Surfing, and 10 films on Meaningfulworld Humanitarian Outreach Programs around the world.
Jasmin Guevarra is a student at Montclair State University double majoring in Medical Humanities & Psychology. She plans to pursue a PhD in Clinical Psychology. She is most interested in doing research on multicultural psychology in order to help others heal despite cultural differences. She also wants to encourage more Asian-Americans to provide more care for their mental health through therapy as it is very stigmatized in Asian culture. She plans on opening her own private practice. She joined MeaningfulWorld as their mission and message aligns with her goals. Through MeaningfulWorld, she wants to expand her knowledge in humanistic and holistic healing, mental health, and also learn about different cultures. She wants to make a difference in her community and the world.
Erin-Nichelle Antona is currently a senior at Montclair State University, finishing her bachelor’s degree with a major in Family Science and Human Development and a minor in Social Work. She is currently a Global Ambassador at Montclair State University, where she is a mentor to international students from different countries and universities. Erin’s past experiences include volunteering at a geriatric agency and working in an inclusive teaching environment with children in a daycare setting in Essex County, NJ. She plans to continue her education in a Master’s program to pursue her passion of becoming a transpersonal psychotherapist and open her own private practice. Erin is a research intern and assistant educational coordinator at the Association for Trauma and Outreach (ATOP): MeaningfulWorld. Erin’s current research interests include racism and emotional intelligence.