April 15, 2020 | Loma Linda, California, United States | By:  Carlos Fayard, associate professor of psychiatry at Loma Linda University

My wife Elba and I took a short walk around our neighborhood while keeping a healthy dose of “social distancing” from the few others that also ventured into what appears is a very different world. Just a short four weeks ago, we were in San Diego for a lovely time of rest. We then flew to Argentina to celebrate my mother’s 100th year birthday, and it seems that as we were up in the air, the entire world turned upside down. We were the last group of passengers to get through without being asked to quarantine. As we were preparing my mother’s birthday, we learned that it was advised that we leave the country. Just a few hours later we found ourselves in a return flight surrounded by people donning face masks and getting screened upon arrival. And that was only the beginning.

How has your life changed? For most, we have to learn to live with the fear of contracting this ferocious virus while having to adjust to one of the most precious human need: Closeness with family and friends. There are others who struggle beyond that. Our daughter, who is a medical doctor training in psychiatry at Loma Linda Hospital, told us that there many desperate people arriving to the emergency room considering suicide. The cumulative impact of job losses, not being able to pay rent, searching for a place to live and symptoms that mimic COVID-19 pushed some of the most vulnerable over the edge.

What may your mental health look like after the pandemic? Well, it is already tough as it is. A poll conducted by the highly respected Kaiser Family Foundation found that the levels of stress affecting the people in the United States jumped from 32% in early March to 45% by the end of the month. From previous disasters we know that the real and lasting emotional impact becomes more evident after the event is over. It is reported that China, now emerging from the pandemic, has seen a significant spike in divorces. A rippling effect on emotional problems is likely to ensue.

While no one is immune to emotional distress, who might be more vulnerable? The World Health Organization has identified the groups below as populations at a higher risk.

You may wonder, for instance, why would women or healthcare workers be more vulnerable. For women, some countries are reporting an increased level of domestic violence while in isolation. Health care workers are witnessing horrifying scenes and, on top of that, have become the “new lepers” – people see them as potential carriers of COVID–19 and therefore avoid them, creating even more isolation.

How would you know if your current distress may turn into something of concern?

  • You are in one of the population groups above and have conditions influencing vulnerability
  • Your emotional pain and suffering do not seem to abate or go away
  • You try to return to your regular routine (e.g. work productivity and social activity) but can’t (e.g. don’t have the energy to do it)
  • Other complications start to show up (e.g. addictive behaviors, suicidal thoughts, lethargy, less motivation, painful loneliness)

Naturally, how you experience the emotional toll from the pandemic may be different from what is suggested above. Common reactions can include:

  • Grief over the loss of loved ones, material losses, loss of faith, loss of a sense of meaning
  • Fear of dying
  • Feelings of loneliness, abandonment or being forgotten
  • Anger because the losses could have been prevented if those in authority would have done something differently, or anger with whoever may have passed on the virus

How can you protect your own mental health even if isolated?

  • Stay connected with your family, friends, neighbors and church family
  • Engage in healthy activities, like exercise, a good sleep routine, eat nutritious food
  • Manage the news. Too much can be very detrimental. Perhaps you have seen how, behind the news anchors, images of the virus float around. News organizations know that fear can create more viewers. Don’t be trapped into that.
  • Don’t remain passive. Not only try to maintain your regular routine at home, but seek and join interactive Sabbath School classes where you can comment. Watch the many wonderful preachers that are reaching out in many ways. If there is singing, sing with all your heart, like when you sing in the shower.
  • Focus on God’s promises. For instance, Psalm 91. I suggest you do it in this way:
    • Read it once through, but don’t rush, let the rich images in it come alive and the words of comfort sink in your mind and in your heart.
    • Pause on verse 1 and imagine yourself resting in the protective shadow of the Lord. Remember a time you were outside under the sun and how it felt to find some shade and rest there. Place yourself there, and like Israel, let the shadow of God be upon you
    • You may choose to focus on similar images on verse 4. Let your imagination capture the goodness and the power of God surrounding you and your loved ones
    • Understand that protection is not the same as not being under attack. In fact, we need protection because we are under severe assault (vs. 5, 6, 7, 12,13 and 15)
    • When was the last time you thought of your guardian angel? Imagine your own angel lifting you up (v. 12)
    • Focus on hope (v. 14), cultivate trust (vs. 14-16)
    • You can trust only those you know well. Focus on Jesus (John 15). Be like Mary (Luke 10: 38-42)

If it is hard for you to control your worrying, try the recommendations drawn from Matthew 6 at this link

Help is available through many Christian counselors who are available online. Reach out. There is no fear, there is no shame. Remember that even Jesus himself cried out when he was suffering (Matthew 27:46).

One of the most difficult situations this pandemic may generate, is a sense of despair for those who, for multiple reasons, may find themselves thinking that life is not worth living. While they will need immediate treatment, which you should urge, you may find a way to minister to them as well.

How you may minister to those in distress?

  • Create a safe and private atmosphere for the person to share thoughts.
  • Use a series of questions where any answer naturally leads to another question.

For example, if the person has expressed suicidal ideas:

  • Do not judge the person for being suicidal.
  • Offer to talk with the person alone or with other people of their choice

Start with the present: “How do you feel?”

Acknowledge the person’s feelings: “You look sad/ upset. I want to ask you a few questions about it”.

“How do you see your future? “

“What are your hopes for the future? “

“Some people with similar problems have told me that they felt life was not worth living. Do you go to sleep wishing that you might not wake up in the morning?”

“Do you think about hurting yourself?”

“Have you made any plans to end your life? If so, how are you planning to do it?”

“Do you have the means to end your life? Have you considered when to do it?”

“Have you ever attempted suicide?”

If the person has expressed suicidal ideas:

  • Maintain a calm and supportive attitude
  • Do not make false promises
  • Share that the Lord has known suffering first hand (Hebrews 2:18; 4:15-16; 1 Peter 2:21). He knows what it feels to find yourself in a hopeless place (Matthew 27:46)
  • Invite the person to consider seeking comfort from God, as it may also be how this person learns how to comfort others (2 Corinthians 1:3-7)
  • As you encourage the person to seek professional help, offer to stay in touch on a regular basis. You are not to take this up on your own, but having regular and predictable contact, just to listen, may provide the support the person may need.
  • If the person indicates a clear intent to take their life, have a plan and means to carry it out:
    • Stay on the line with them while you have someone call the authorities to meet the person in distress

The pandemic will be over. Hopefully your life will go back to normal. Will you be able to look back on this time as a series of moments that strengthened your faith, made you more compassionate and generous, and willing to lend a helping hand to others?

If your emotional life does not go back to normal. Know that you remain under the tender gaze of your heavenly Father, and that there is help for you. Your church is becoming more attuned to the emotional needs of her members and the communities she serves. Seek the help you need.

May your prayers for all of us lead us to know that “God is our refuge and strength, an ever-present help in trouble. Therefore, we will not fear” (Psalms 46: 1-2).

Carlos Fayard, PhD, Associate Professor of Psychiatry at Loma Linda University School of Medicine. He directs the WHO Collaborating Center in the Department of Psychiatry and is the author of “Christian Principles for the Practice of Counseling and Psychotherapy.

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