How COVID-19 has impacted mental health and future of its treatment

The entrance to the UW medical center located in Montlake, March 6, 2022. (Photo by Lorcan Stokes)

As the world continues to adapt to COVID-19, one aspect of society that has suffered through the entire process of returning to normalcy has been the mental health of millions of people around the globe. According to the World Health Organization, there was a global increase in depression by 27% in just the first year of the pandemic, while anxiety disorders increased by 25%. According to the WHO, these disorders have hit young adults particularly hard, emphasizing individuals aged 20 to 24. Children, as well as teenagers, have suffered similar developments.

According to Dr. Erin Schoenfelder, an assistant professor at the University of Washington's Psychiatry & Behavioral Sciences Department and a clinical psychologist at Seattle Children's Hospital, their psychiatry unit has continuously been seeing children impacted by attention deficit hyperactivity disorder (ADHD).

"There were a lot of families who were likely needing care and needing a diagnosis who didn't seek one out because of lockdown," Schoenfelder said. "Because their child wasn't able to do online schooling, they may have given up on it, and maybe the family didn't feel safe reaching out to resources at that time."

Schoenfelder explains that the nationwide lockdown did cause some parents to seek an ADHD diagnosis for their child when it had previously gone unnoticed.

"We did see a large increase in families where a child had minor attention problems before, and once they were learning at home in front of their parents, parents could see how difficult it was for their child to focus," Schoenfelder said.

Problems with children, diagnosed with ADHD or not, extended beyond short-attention spans in schooling.

"We saw a rise in how severe kids' behavior got. We were getting more families showing up to the emergency room with young kids who were out of control, physically attacking parents, [and] destroying the home," Schoenfelder said. "I do think the pandemic has made those types of behaviors worse."

The UW medicine emergency room has received a constant flow for mental health diagnoses such as ADHD, primarily due to a rise in worsening behavior among children. Pictured on March 6, 2022, a number of cars pull up to the entrance. (Photo: Lorcan Stokes)

As for the reasoning behind this behavior, Schoenfelder highlights multiple factors on why some kids' behavior took such a drastic downturn over the pandemic.

"We got the pandemic [which caused] the loss of school so now that whole environment is gone, and kids don't have that structure, consistency, and that time away," Schoenfelder said. "The time with their parents is just working time."

Schoenfelder explains that parents are under tremendous stress from the pandemic and its impact on them. As they suffer from anxiety, depression, a potential lack of child care, social support, and family isolation, kids suffer those consequences combined with their losses. Hence, parenting and parent-child interactions suffer. Schoenfelder explains these strained relationships continue to suffer despite the easing of restrictions, pointing out that the Seattle Children's hospital psychiatry unit is going through a "mental health tsunami."

"No, everything is not better now," Schoenfeld says on new family dynamics. "I think we are going to be seeing years of impact from this."

The UW medicine emergency room has received a constant flow for mental health diagnoses such as ADHD, March 6, 2022. (Photo: Lorcan Stokes)

Schoenfeld highlights that kids under normal circumstances who would have been undiagnosable increased in symptoms due to the pandemic.

"I do believe we are seeing kids who would have had really mild ADHD and maybe not have to get diagnosed, but the pandemic pushed them into such a hard place that their symptoms have become more severe and problematic," Schoenfeld said.

ADHD is a small part of the current mental illness epidemic.

"The direct mental health of teenagers has been the worst casualty of this pandemic. We are seeing rates unlike ever before of teenagers with suicidal thoughts and making suicide attempts," Schoenfeld said. "I've seen teenagers in my practice who stayed in bed 22 out of 24 hours out of several months of the pandemic."

This deterioration of mental health extended beyond just children and teenagers. No one knows this better than Brent Fisher, a college student who said he had a breakdown in August of 2020. He is still dealing with after-effects.

"I had panic attacks three to four times a day every two weeks. I was getting intrusive thoughts of suicidal ideation that were scaring me," Fisher said. "I was scared to leave the house and was in a paralyzing state of fear."

Instead of coming in person to places such as the Psychiatric unit at UW medical for counseling, much of therapy has been moved online, March 6, 2022. (Photo: Lorcan Stokes)

That was the beginning of his journey to get help.

"I got an official diagnosis of OCD in December of 2020. I found some relief in that diagnosis because I had been questioning if I was ever going to be normal again," Fisher said. "Knowing there are millions of people in the world with this, including people I know, it felt like I could be happy again."

While he still deals with OCD and anxiety daily, he controls it through medication and therapy.

"Trying to find the right cognitive behavioral therapist and getting on the right medication was a huge step," Fisher said. "It took a couple of months, but it worked out on the third try."

Young people, particularly college-aged, have been among the most impacted age groups regarding mental illness due to COVID and lockdown. (Photo: Lorcan Stokes)

Brent contacts his therapist through teletherapy, another aspect of mental health that the pandemic has changed. According to Dr. Benjamin Buck, teletherapy will likely be a "new normal" in the world of counseling and psychiatry. Teletherapy is counseling done over the likes of zoom, FaceTime, or the phone.

"There definitely has been an interest in digital health over the pandemic," Buck said. "This is seen in increased investments in start-ups focused on mental health, new digital health apps, and more visibility for technology supporting mental health."

While unsure if it will take over all forms of therapy, Buck says it's here to stay, at least for quite some time.

"There are all kinds of reasons why people can't get to a clinic. The pandemic kicked that into high gear when we weren't able to meet clients face to face or when it wasn't safe too," Buck said. "I would expect that digital offerings are going to be a part of what mental health providers offer for good now.

COVID has altered the mental health of millions of young people and the treatment of mental illness. Children and young adults who had or have developed mental illnesses during the pandemic could potentially feel the effects of it for years to come, something that no one could have foreseen at the very beginning of the epidemic.