Panic, Abuse, Addiction: The COVID-19 Mental Health Crisis

By Adam Townsend

You've been stuck inside for two months, sheltering from the deadly COVID-19 coronavirus cutting down tens of thousands of Americans. Despite your best efforts to protect yourself, you wake up early one morning with a tightness in your chest and pain as you try to breathe.

You start wondering with growing dread if you somehow caught the coronavirus from a delivery person or a door handle at the grocery store, and the chest pain worsens. You feel light-headed. Breathing is harder, still.

What you’re experiencing sounds like coronavirus symptoms, but they are not from COVID-19 – at least not because you’re infected. It’s because of a panic attack.

The symptoms of a panic attack develop suddenly, without any immediate cause, writes MedicineNet author Roxanne Dryden-Edwards, MD. They may include physical and emotional symptoms like:

  • racing or pounding heartbeat (palpitations);
  • chest pains;
  • stomach upset;
  • dizziness, lightheadedness, nausea;
  • hyperventilation;
  • difficulty breathing, a sense of feeling smothered;
  • a choking sensation;
  • hand tingling or numbness;
  • hot flashes/sweating or cold flashes/chills;
  • trembling and shaking;
  • dreamlike sensations or perceptual distortions like a feeling of detachment;
  • intense fear of terror, a sense that something unimaginably terrible is about to occur and one is powerless to prevent it;
  • a need to escape;
  • fear of dying.

Anxiety, depression, substance abuse and domestic violence all are on the rise as the coronavirus’ global assault grinds into a sixth month.

Further straining the mental health system are abusers who drink heavily or use drugs and attack their spouses and children. Fear, unemployment, and increased substance abuse creates more and worse abusers and victims even in the best of times.

It’s too early for scholarly examination to get an accurate picture of the mental health, addiction and domestic violence problems exacerbated by the pandemic. But domestic violence hotlines worldwide have seen huge spikes in calls and web visits, and alcohol sales have skyrocketed according to multiple reports in the popular press.

The Psychology Community Scrambles to Adapt

The American Psychological Association (APA) in mid-March, soon after state-by-state lockdowns started, relaxed rules about telehealth counseling, or therapy via video conference.

Though videoconferencing technology is widespread and easily accessible, typical platforms like Zoom and Skype aren’t deemed secure enough to comply with stringent health privacy rules outlined by the health data privacy law HIPAA. But in March, the Department of Health and Human Services (DHHS) freed therapists to use these and other consumer tools to treat their clients using existing tools.

“(DHHS) will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency,” the agency stated in a release.

The Medicaid and Medicare offices have also relaxed rules on billing for telehealth sessions, the APA states.

Meanwhile, the APA’s research foundation is ramping up grants for researchers and clinicians who want to study the impact of shelter-in-place orders and general pandemic panic on mental health, substance abuse, and domestic violence.

COVID-19 Sheltering Spikes Partner and Child Abuse

The Substance Abuse and Mental Health Services Administration assessed the situation early in the crisis in a policy guidance paper:

“COVID-19 has caused major economic devastation, disconnected many from community resources and support systems, and created widespread uncertainty and panic. Such conditions may stimulate violence in families where it didn’t exist before and worsen situations in homes where mistreatment and violence has been a problem.”

Caroline Bradbury-Jones, RN, PhD, and Louise Ishams, PhD, acknowledge the strict social distancing orders have been necessary and successful to a degree in slowing the rate of infection and preserving hospital capabilities. But in an editorial in the international Clinical Journal of Nursing, they plead with governments to take additional measures to protect people for whom home is no shelter.

“This pandemic creates a paradox as regards staying safe at home,” they write. “Stringent restrictions on movement shut off avenues of escape, help-seeking and ways of coping for victim–survivors. Restrictive measures are also likely to play into the hands of people who abuse through tactics of control, surveillance and coercion.”

The editorial begs governments to keep money flowing to agencies that deal with the fallout from domestic violence and volunteer organizations that offer shelter or other resources to abused people.

“It also means finding new solutions, including increasing capacity for helpline services and running targeted campaigns, alongside specialist services, about discrete ways that victim-survivors can contact the emergency services without alerting their abuser,” the article states.

What if I’m in Treatment for Opioid Use?

Before the COVID-19 coronavirus pandemic, heroin and synthetic opioids were stacking U.S. morgues full of dead Americans, and indications suggest people addicted to substances aren’t faring well during the coronavirus pandemic.

Alcohol sales boomed in the opening weeks of the pandemic (meaning off-premise sales; bar and restaurant alcohol sales plummeted as those establishments fell under closure orders), according to the Nielsen Company.

Opioid use is illegal outside medical settings, so there aren’t any clear numbers about increases in abuse, but substance problems go hand-in-hand with emotional disturbance, such as getting laid off from your job amid worries you or your family might die of a terrifying viral disease.

The DHHS and Drug Enforcement Administration relaxed restrictions on prescribing buprenorphine, a drug used in medication-assisted therapy for opioid addiction, via telehealth sessions.

“Limited access to health care places people with addiction at greater risk for many illnesses, but if hospitals and clinics are pushed to their capacity, it could be that people with addiction—who are already stigmatized and underserved by the healthcare system—will experience even greater barriers to treatment for COVID-19,” states the National Institute on Drug Abuse.

How Do You Seek Mental Health Help During the Pandemic?

The most important step you can take in any of these situations – panic or depression; out-of-control drug or alcohol use; or attacks by an intimate partner or parent – is to seek help.

Here is a list of resources with staff and volunteers available to help you (24-7, in most cases):

  • National Domestic Violence Hotline
    1-800-799-7233 or TTY 1-800-787-3224 or text LOVEIS to 22522
  • Disaster Distress Helpline (US Substance Abuse and Mental Health Administration)
    Call 1-800-985-5990 or text TalkWithUs to 66746
  • National Suicide Prevention Lifeline
    Call 800-273-8255 or Chat with Lifeline
  • Crisis Textline
    Text TALK to 741741
  • Veterans Crisis Line (VA)
    Call 800-273-8255 or text 838255

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