The COVID-19 pandemic has compounded people's stress levels in a multitude of ways.
Not only do people fear contracting the coronavirus, but business closures have placed many families in a financial bind. And school shutdowns and social distancing guidelines have left many people physically separated from their families and friends.
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Coping strategies that focus on self-care and social support – like seeking help when you need it, offering assistance to others and choosing safe ways to have fun – can help people maintain their mental health, Erina MacGeorge, a Penn State University professor of communication arts and sciences, told PhillyVoice.
Such coping strategies were associated with better mental health during the early days of the COVID-19 pandemic in the U.S., according to a study conducted by MacGeorge and her colleagues. And they can help people cope as the pandemic continues to disrupt everyday life.
Social support involves having a network of family and friends to turn to when facing a crisis, MacGeorge said. It could be someone that offers comfort, provides advice, talks through a problem or even just brings a meal. And research has shown that the perception of having social support helps people cope more than any particular action.
Offering to help someone else also provides a positive impact on mental health, she added.
"It comes down to how you see yourself," MacGeorge said. "When receiving help, feelings of dependency may undercut the value of the help you are receiving while offering support may contribute more to a positive self concept."
Forward-focused coping strategies like maintaining healthy routines — eating right, exercising and spending time outdoors — and focusing on future goals also improve mental health, she added.
MacGeorge gave a personal example of how she and her boyfriend are now actively planning a trip to run a portion of the Appalachian Trail.
"Before the pandemic, we had a casual desire to do it, but now we are purchasing equipment and going on longer hikes to prepare," MacGeorge said. "We even have a specific date in mind for the trip."
Maintaining a consistent schedule was especially crucial in the early days of the pandemic when people were stuck in their homes, the study found. But even now, when many people have returned to work and school in some capacity, sticking to a schedule is important, MacGeorge said.
"Schedule things you want to do and things you have to do as best you can," she suggested.
Social strain, which refers to the negative impact of someone making demands, giving criticism or simply getting on your nerves, was the strongest and most consistent predictor of mental health, according to the study's findings.
"Negative emotional experiences stay with us longer and have more of a impact on us," MacGeorge said. "Limiting these types of interactions is important, but may be difficult if you are sheltering in place with the person. It can really start to wear on you, especially if you have limited options to get away."
Following the national recommendations for protecting oneself from COVID-19, like hand-washing, social distancing and masking also eased feelings of anxiety, MacGeorge said.
Younger people going through big life transitions, like graduating high school or college and finding a job, and people with pre-existing health conditions were more likely to have negative mental health outcomes. So were people of color navigating COVID-19 and racial injustice and people under economic strain because of the pandemic, she said.
Levels of stress, anxiety and depression were highest at the beginning of the study period, the end of April. By the study's late-May endpoint, some states were starting to reopen. Stress levels were lower, a finding that contradicts what other research has shown – that mental health issues have continued to grow amid the pandemic.
Experts have warned that the mental health crisis continues and more interventions and prevention efforts are needed.
A Centers for Disease Control and Prevention report found that many young adults were having suicidal thoughts and turning to substance abuse during the pandemic. Forty percent of adults between the ages of 25 and 44 had an anxiety or depressive disorder.
MacGeorge agreed that the mental health effects of the pandemic are cumulative, suggesting that the timing of their survey might be why their findings differed.
"The pandemic had not been going on very long at that point," she said. "Many states were just starting to 'reopen,' and there was a temporary flattening of the COVID-19 illness and death curve at that time.
"There is reason to believe that the mental health impacts of the continuing pandemic will be stronger than they appeared in our study in May, especially for people who have lost loved ones, who are now out of work, or who have suffered racial prejudice and discrimination."
She added that their study also took place before the police killing of George Floyd prompted civil unrest throughout the country and the increased tensions of the upcoming presidential election.
Their findings were published earlier this month in the International Journal of Environmental Research and Public Health.
The researchers recruited participants between the ages of 18 and 90 for the study. Participants were asked to complete surveys at three points in time between April 20 and May 22. A total of 442 participants participated in all three surveys.
They were asked about symptoms of depression and anxiety, how they cope with traumatic events, and how much they feel the pandemic is affecting them financially, physically, socially and mentally. They also were asked about coping strategies and whether they were adhering to public health recommendations.