Mental Health Crisis compounded by COVID-19 Pandemic

The Centers for Disease Control (CDC) has published a review of the prevalence of “Mental Health, Substance Use, and Suicidal Ideation” during the week of June 24-30 that came out on August 14. It is, as expected, a dismal picture. We all know that we’re feeling anxious about things.

The people suffering the most are young adults aged 18-24 — 75% of them have “at least one mental or behavioral condition.” That is, they feel anxious or depressed, or they are drinking heavily, or having other ugly feelings and doing other ugly things. Worst of all, about a quarter of them reported “suicidal ideation”– they had thoughts of harming themselves or wished they were dead.

Of course, people who already had problems are suffering even more, but that’s to be expected. The others who are, surprisingly, deeply affected, are those who did not receive a high school diploma (66%) and unpaid adult caregivers (67%); most of the rest of the subcategories have about a 50% positive response rate to the questions about feeling bad or doing “bad” things to cope. Unpaid adult caregivers also reported “suicidal ideation” at a 30% rate.

About a quarter to 30% of all adults report anxiety or depression symptoms, three to four times the rate that gave that report pre-pandemic. 13% stated that they were using substances to cope with the effects of stressors (whether that is fear of infection, job loss, or the death of a relative varies, of course.) 11% of all adults reported feeling suicidal this June.

These data were summarized in a post on Medpage Today also dated August 14; this is a quick and easy read compared to the Morbidity and Mortality Weekly Report (MMWR) linked here and in the first paragraph. Here are a couple of caveats that will help you to digest this information.

First, “suicidal ideation” is not the same as risk for suicide. About half of all people who commit suicide would not have reported suicidal ideation if they were asked prior to doing the deed.

There is a combination of factors that causes people to kill themselves, and they are poorly captured by the thoughts that they have beforehand that are expressed in the phrase “suicidal ideation.” Even specialists don’t think that half of all suicides were actually “mentally ill” before they did it.

We do not know exactly what prompts these people to kill themselves. It appears to be an addition of an “adjustment disorder” (a reaction to something that happens to you, such as losing a job or being yelled at) to something called “akathisia” (literally, the inability to sit still, a kind of restlessness that seems to provoke sudden, thoughtless actions.)

Akathisia can be brought on by drugs such as certain antidepressants like so-called SSRIs (don’t ask what this acronym means, please. OK, it’s “selective serotonin reuptake inhibitors”) It can be calmed by certain other drugs like propranolol, a drug used for high blood pressure called a “beta blocker” (which stops the action of adrenaline.)

Akathisia can also be caused by a person’s reaction to some things that happen, even the thing we just called an “adjustment disorder.” This makes it very difficult to deal with, although it’s the sort of thing that, once you’ve seen it and identified it, you will recognize it immediately the next time.

The second problem I need to talk about is the fact that the suicide rate in this country has gone up by about 50% in the last 20 years. You can look up yearly suicide rates through the CDC’s web sites. The point is that we’ve had a worsening problem for years even before the pandemic, and psychiatrists are very worried about it.

So, bottom line, the US has had mental health problems for years — it seems to have been reducing our life expectancy even pre-pandemic — and the virus is only making it worse.

Please be gentle with one another, try to get together and help each other to deal with this disaster, and tell your children that you know they are hurting even if you can’t do much about it right now. If worse comes to worst, here’s the National Suicide Prevention Lifeline: 1-800-273-8255.