Creating art had always been a respite for Pattie Archuleta.
Diagnosed with depression and anxiety in her 30s, Archuleta channeled her feelings into creativity. Using found objects — usually discarded materials with a non-art function — the Catonsville resident would piece together collages and mosaics.
There are “a lot of outside factors that impact … my own ability to navigate my mental health,” Archuleta said. “After holding it together for so long, you just have to fall apart so you can put the pieces back together.”
That’s the thought process behind her mosaics, she said: “These broken pieces that have come apart and then come back together again in a really beautiful way.”
As Archuleta raised her son and engrossed herself in her work at Maryland Coalition of Families, her creative outlet fell by the wayside, she said. Since the coronavirus outbreak began sweeping through the U.S. at the end of February, Archuleta has found solace in her artwork again.
“You go through it just hoping for the best, but knowing there’s going to be loss,” Archuleta said. “Great loss.”
The novel COVID-19 virus has combined such numerous mental health stressors that psychologists say the pandemic is inflicting trauma on an unprecedented global scale.
The diagnostic criteria for trauma in the Diagnostic and Statistical Manual of Mental Disorders, used by the American Psychiatric Association, are "exposure to actual or threat of death, serious injury [and] sexual violence,” said Dr. Bethany Brand, a Towson University professor and psychologist specializing in trauma treatment.
“Clearly, people are being exposed right now to actual and threat of death,” Brand said. “That is one possibility with COVID.”
Collective anxiety over the fear of losing a loved one or contracting the illness is compounded by the reality of millions rapidly losing their jobs and a volatile economy with no clear end in sight. As Marylanders adjust to Gov. Larry Hogan’s stay-at-home orders, residents are also losing “a respite for life stressors,” Brand said.
Human connection helps “people normally feel settled or connected,” Brand said. “And now we can’t do that.”
Those with pre-existing physical and mental illnesses and substance abuse problems, those who have lost their jobs and those whose work puts them in the throes of the pandemic are most vulnerable to the emotional distress the virus is causing, Brand said.
Despite the added stress, therapy patients are canceling sessions and new patient referrals have dropped, said Dr. Julie Bindeman, who runs a private practice in Rockville.
The reason for that is economic uncertainty and the fear or reality of losing work and insurance coverage, Bindeman said. Using the 2008 recession as a precedent, Bindeman said she expects “a huge influx” to return as mental health professionals explore ways to work with insurance companies to lower deductibles and offer discounted fee-for-service rates.
Pete Fitzpatrick is used to working 50-hour weeks as a nurse with a pediatric transport team at a D.C. hospital. Now, working 60 to 70 hours a week has become typical.
Chronic stress “comes with the job,” he said. “Working in pediatrics, it is sometimes extraordinarily sad. You’re in close contact with a lot of the worst things you’ll ever see in the world. But that’s like our norm, and this is adding on top of that.”
The Catonsville resident said his anxiety is threefold: He worries about the anticipated surge of COVID-19 patients, keeping the staff of 50 clinicians he supervises safe, and about what will happen if he contracts the virus. Taking time off work, he said, would only exacerbate those concerns.
“I’m not so worried for my own health reasons … I’m worried I’m gonna get sick and get put out of the fight,” he said.
That anxiety can manifest in myriad ways. It tends to cause problems with sleep, “with feeling safe in their daily lives,” which can lead to irritability and increased emotional reactivity, Brand said. Reports of domestic abuse will likely rise amid the pandemic, she added.
Some may have trouble finding motivation to even get out of bed. Others might glom onto media coverage and ruminate obsessively, Brand said.
The fear can lead to muscle tension, stomach upset and, with a lack of exercise and restless sleep, can impair one’s immune system, she said.
How to cope
To manage the stress, psychologists recommend creating rituals to maintain a sense of stability, said Dr. Bruce Herman, director of health services and the counseling center at the University of Maryland, Baltimore County.
“Finding things that give you a sense of meaning, a sense of normalcy ... all those things are going to be especially important,” Herman said.
For those working at home, Brand recommends taking breaks throughout the day to work on something creative or do a soothing activity like deep-breathing exercises. Making time to video chat with friends can alleviate the feeling of isolation as residents are sequestered in their homes. Having a creative outlet like cooking, sewing or listening to music, and feeling a sense of control can also offer some respite, she said.
For Brand, that outlet has been gardening. “To make something beautiful and alive in my yard was incredibly important,” she said. Fitzpatrick, to decompress, works on a sprawling Lego city with his son.
For Archuleta, assisting others in dealing with their own mental health needs has helped.
“I have the skills to navigate [emotional distress], and I also have the skills to help other people navigate it, which is important to me,” she said. “That’s something that makes me feel really empowered, is empowering others.”
Psychologists also recommend unplugging from social media and limiting the time they spend watching or reading the news.
“It’s about finding a balance between keeping yourself informed and keeping yourself safe and healthy without being overwhelmed,” Herman said.
Fitzpatrick, a self-described news junkie, said he’s limited his media consumption to an hour a day.
He’s found comfort, he said, in the support of his friends and neighbors who check in on him or have offered to go grocery shopping for his family of five.
“It’s just been illuminating,” he said. “if there’s an upside to this, it’s that.”