SIDNEY — Since the first reports of COVID-19 in the U.S. in January 2020, a nation coping with COVID-19 is nearing its second year, and the type of stresses placed upon Americans — particularly young people — have only intensified.
In April 2020, the death toll from COVID-19 surpassed that of the Vietnam War, and as a nation we are enduring a trauma from it. Much like the young soldiers returning from war, COVID-19 has caused PTSD symptoms, substance abuse problems, and thoughts of suicide to emerge. By the end of June, the exact number had nearly doubled the national average of 20 percent of adults living with mental illness, when it reached 41 percent of Americans, according to a web-based survey of nearly 10,000 adults conducted by the Center’s for Disease Control. The study showed that 18- to 24-year-olds were bearing the brunt of this disease’s mental health toll and were the second highest group (after unpaid adult caregivers) to admit suicidal thoughts.
What is COVID-induced PTSD?
“COVID-19 has put a magnifying glass on issues of depression, anxiety, and PTSD,” said Mary Jean Carpenter, a licensed independent social worker with a supervisor designation (LISW/S) and owner of Journey 4 Self in Sidney, which focuses on treating PTSD for individuals, couples, and families.
“We can’t stay at a prolonged heightened level of fear. There’s a breaking point that comes with the continual low, but elevated situational awareness that has arisen from this long bout with COVID-19. Additionally, for some, the sudden death of a family member or having personally survived a serious case of SARS-COV-2 infection can push someone past their breaking point. In both cases, that’s when PTSD happens,” said Carpenter.
“For those already suffering from these problems, their coping mechanisms have had to change,” said Carpenter. “Individuals suffering from depression are often encouraged to spend time with friends and family, but when we have to worry about who we are around and who has been vaccinated, including family members at gatherings, that makes it more difficult to do. Individuals suffering with PTSD have not been able to rely on regular environmental feedback because facial cues from others around them are blocked while they are wearing a mask.”
“When we can’t process a traumatic event and put it away, it manifests itself through reoccurring thoughts and initiates nightmares, and we call this situation PTSD,” said Carpenter.
Children suffer from COVID-induced PTSD
“Many people have a misconception that PTSD is an adult condition, but PTSD affects kids too. Children can be misdiagnosed as having ADHD because PTSD symptoms often mimic those of ADHD. If they have been put on ADHD medications, and the problems continue, it could be PTSD. PTSD treatment could be as simple as working with a therapist to reprocess a traumatic event in their life using a technique called Eye Movement Desensitization and Reprocessing (EMDR) therapy,” said Carpenter.
According to the definition provided by the American Psychological Association, EMDR is “a structured therapy that encourages the patient to briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation (typically eye movements), which is associated with a reduction in the vividness and emotion associated with the trauma memories.”
“COVID has functioned like a ‘pressure cooker,’ intensifying pressures on kids. Children face pressures from a lot of different directions — in the community, at school, and at home,” said Carpenter. “Events are occurring around them are like ripples on a pond, so that a child can become overwhelmed and have difficulty expressing their emotions. That’s when child therapists, like Anne Case at Journey 4 Self can intervene,” said Carpenter.
Before coming to Journey 4 Self, Case worked in schools during the pandemic.
“I saw kids struggling with 6-foot mandates and the spacing of days for in-school attendance. For example, a child may have to face a bully without their supportive friend because the friend might be scheduled for a different set of days,” said Case.
“Key indicators that teachers and school counselors recognize when a child may need therapy include delays in social-emotional and academic areas, increased incidents of bullying or being bullied, random outbursts, and inward-directed issues involving self-harm, like cutting and self-medicating through alcohol and drugs,” said Carpenter.
“Parents may notice that when their kids are at home they are withdrawing or trying to escape by spending hours in their rooms on their electronics (YouTube, Tic-Tok, video games, etc.), and not spending time with family and friends. Some of that is preventative but it also can lead to depression,” said Case.
Case implements a technique during child therapy called “Zones of Regulation,” a framework developed by Leah Kuypers to divide emotional states into four color-codes: blue (sad, sick, tired, bored), green (ready to go, focused, content), yellow (starting to lose control, silly/wiggly, frustrated/annoyed), and red (lost control, angry/aggressive, elated or excited). She helps the child determine what zone they are in and then uses the correct tools to deal with that situation, which might include helping a child know when to implement deep breathing exercises or to separate themselves from a stressful situation by leaving the room.
Parents also need to be trained by the therapist in these methods so they can engage in helping their child self-regulate.
“Parents are the key to making their child’s mental health a priority,” said Carpenter. ‘Parent therapy’ is an opportunity to work one-on-one focusing on individual issues in the home, such as instilling structure or modifying unrealistic expectations. This therapy helps parents know the best strategies to support the therapy they are receiving through conversations at home.”
Knowing when and how to seek treatment is essential.
Carpenter indicated that “while the school system is sometimes the source of referrals to a therapist, about 25 percent of our referrals come from a doctor’s office. It’s important to emphasize that parents can call directly — a medical referral is not needed from a family physician for insurance to cover a therapy visit. Telehealth and teletherapy, which has really taken off, is particularly recommended for teens and young adults and is covered by insurance.”
COVID-19 drives youth to suicide
“What I’ve seen in my practice are preteens and teens aged 11-16 who have been struggling with anxiety and depression, both of which are tied to an increased rate of suicide,” said Emily Sherwood, a licensed professional counselor (LPC), at Reclaim Counseling in Sidney.
”Out of 15 of my youth clients who experienced suicidal ideations, nine were actively suicidal. When we looked into the cause, it was an overwhelming sense of loss. They’re experiencing grief over the loss of ‘connectedness’ with parents, friends, and peers because they cannot engage in their normal social routines during COVID-19, as well as enduring a breakdown of the family dynamic driven by adult stressors like job loss or household income decline,” said Sherwood. “Essentially, they are unable to adapt their coping skills to a ‘new normal’ during the extended duration of the pandemic and are being pushed to their breaking point.”
According to Sherwood, some of the warning signs that a young person may be considering suicide include social withdrawal by pulling away, declined effort in favorite activities, isolation instead of being around others, mood changes (more sad, depressed, or on edge); or any form of self-harm, including the use of alcohol, drugs, or cutting.
There is a real misconception about how and why self-harm leads to suicide, Sherwood explained. “People begin to feel numb when they are overwhelmed and can no longer process their emotions. They are, in reality, trying self-harming to feel something to overcome that numbness. Eventually, they figure out that the self-harming is not working and that escalates into thoughts of suicide. Some viewed suicide as an escape and then researched a plan on the internet about how to carry it out.”
“Suicide is never anyone’s first option. It’s a last resort,” says Sherwood. “It’s a misconception that talking about suicide might bring it about; it is just the opposite. Talking about suicide openly helps to prevent it.”
In her therapy sessions, Sherwood employs three primary therapy modalities to treat suicidal young people: cognitive behavioral therapy (changing distorted and negative thinking that leads to automatic thought processes which become internalized into moods and emotions, such as thinking, “This is never going to end”), dialectal behavioral therapy (creating a “mindful awareness” of what is going on around you verses what is imagined to be happening that creates uncomfortable feelings like a racing heart or difficulty breathing), and person-centered approach (empathizing and validating emotions by essentially saying “I hear you and I understand”).
Sherwood says these strategies help her clients find the escape they are looking for from their sense of helplessness or haplessness that leads them to a place where they are able to recognize and acknowledge the progress that they are making that is taking their life, step-by-step, in a positive direction. They can begin to self-regulate their negative self-talking, especially after they begin to hear supportive words from their parents at home that help to cancel out that negativity. Finally, the young person begins to acknowledge their self-worth and that they have a family who is listening and loves them.
For help, residents of Shelby, Darke, and Miami counties can reach the Tricounty Board’s local crisis hotline 24/7 by calling 800-351-7347 or by texting “4hope” to 741 741.