Colleen, who grew up in the United States and now lives abroad, suffered from an extended illness in 2019. She recovered before the onset of the COVID-19 pandemic, but the pandemic triggered memories of her own illness and aftershocks of extreme mental health anxiety. She had been treated for anxiety before, but now she found herself an ocean away from her family and unable to turn to friends for support.
“That point was when I realized, wow, I’m crying in a fetal position on the floor because I’m afraid to leave my house and not get the virus,” Colleen says. Her closest friends also struggled with their mental health early in the pandemic and could not provide the support system she sorely needed, so Colleen decided to seek out professional help.
In the country she newly called home, Colleen believed for a long time that she didn’t have access to therapy. She did, however, eventually find a therapist whom she has been seeing throughout the pandemic.
Even so, accessibility poses barriers for many in urgent need of mental health treatment. American lives have become saturated with news of suicide and drug overdose deaths during the pandemic. Suicide deaths, in particular, may have risen among people of color in the past year.
Alex was no stranger to isolation. The summer after she graduated from college in 2019, Alex found herself alone in a new city with few friends. The depression she had lived with for years worsened.
“I would just sit in my apartment and wait for the day to be over,” she says.
Ultimately, Alex found a job and began to seek out friendships, routines, and hobbies that made life outside work meaningful and sustainable.
“And then the pandemic hit, and I couldn’t see friends anymore. I no longer had a job. I no longer had a routine. So it was kind of like I was back to square one,” she continues.
The loneliness of isolation in a pandemic tested her coping mechanisms like nothing before. Once again, she found herself sitting at home waiting for the day to end so she could go to sleep.
Alex and Colleen are not alone in their worsening mental health. Research has long supported a connection between isolation and damage to mental health. Loneliness and isolation can worsen depression, increase stress, and impair executive function. One recent study links the loneliness of social distancing to increasing mental health problems among young adults, and another suggests that countries with less robust coronavirus-response measures may have seen greater increases in anxiety and depression. Under these conditions, many find it difficult to motivate themselves to complete everyday tasks.
“An object in motion stays in motion, but an object at rest stays at rest,” Alex says of the challenge to find motivation while isolated.
Because of the extraordinary toll the pandemic has taken on people who previously struggled with mental illness, some medical professionals called for vaccine distribution to prioritize people with mental illness. In fact, recent data shows that people with severe mental illness – schizophrenia, bipolar disorder, major depressive disorder, and “any mental illness that causes severe functional impairment” – are at higher risk for acute illness and death from COVID-19.
Few states explicitly included mental illness in priority groups, and those who did made it challenging to determine which diagnoses qualified – and raised questions of accessibility to obtaining a formal diagnosis. Regardless of prior eligibility, the Biden administration mandated that all adults over 16 be made eligible for vaccination beginning April 19.
Normalcy may prove unattainable for many in the post-vaccine world, but vaccination is a tangible step toward improving mental health for people who have struggled with social isolation. For Alex, it means her days have meaning again. With the promise of seeing friends in person, she has shifted her focus to rebuilding stamina for social and professional interactions.
The vaccine rollout has not reached Colleen overseas yet, so she may not receive her first dose for several months. “It is hard to see people getting vaccinated and not know when that’s going to happen for me,” she says. For now, Colleen is taking it day by day and maintaining hope that receiving the Covid-19 vaccine will put an end to her sometimes incapacitating anxiety.
Even so, vaccination cannot be the end of the conversation. For people who struggled with mental illness prior to the pandemic, two doses of a vaccine will not eradicate underlying mental health issues.
“I feel like there’s going to be a lot of uncertainty just in my mental health, my belief in myself, and in my stability,” Alex says of life after the pandemic.
With the right resources and greater accessibility to diagnoses, treatment, and education, it is possible to imagine a world that does not make us choose between mental and physical health. As the conversations around the importance of mental health evolve, the vaccine can act as a jumping-off point for a deeper discussion of preventative measures and treatment.
“Other people actually now have a deep understanding of what I’ve been through, the feelings of isolation and hopelessness for the future and uncertainty,” Alex says. “These are all things I’ve experienced before and now other people have experienced them, too, so it’s a lot easier to express and explain.”
NOTE: names have been changed to protect the subjects' identities