Specific Mental Health Conditions

Specific Mental Health Conditions Summary

The stress associated with the evolving social disruptions and health-related threats caused by the coronavirus (COVID-19) pandemic can be particularly challenging for individuals with pre-existing mental health conditions. For example, uncertainty and the threat of infection can exacerbate pre-existing anxiety and worry; the need to minimize disease transmission can amplify contamination fears among those with OCD; and the potential disruption of social connections may contribute to loneliness and isolation that can compound the challenges for those struggling with depression.

The resources below provide a range of expert-recommended strategies that may be useful for individuals who are dealing with, or at risk for, mental health conditions. In addition to the general self-care/coping strategies described in the prior section, these include specific tips for individuals with existing mental health conditions, including recognizing increased risk, maintaining clinical contact where possible, ensuring adequate medication supply, adapting skills learned in treatment (e.g., exposure) for unique circumstances, and reaching out for professional help as needed.

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In this guide:

• General Resources
• Anxiety
• Eating Disorders
• Substance Use

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Resources

General

Resource: COVID-19 Information & Resources
From: National Alliance on Mental Illness (NAMI)

Key points:

• Helpline numbers for accessing support for coronavirus-related distress
  • NAMI helpline: 800-950-NAMI (6264) - Monday-Friday 10 am-6 pm EST
  • SAMHSA crisis/disaster helpline: (800) 985-5990 - 24/7 all year
• Answers and tips for specific mental health concerns, e.g., anxiety, quarantine, health care access, business assistance, grief/loss, homelessness, loved ones who are incarcerated, etc.
• Links to virtual communities for emotional and mental health support

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Resource: Helping Patients Concerned about Coronavirus: A Guide for Psychiatrists
From: Center for the Study of Traumatic Stress

Highlights:

• Individual differences may be observed among patients with prior mental health conditions—some may remain stable while others may experience heightened distress during an outbreak. Higher-risk patients include those with delusions, obsessive-compulsive thoughts/behaviors or a history of trauma
• Recommendations for psychiatrists working with these patients include:
  1. Acknowledging concerns and uncertainty
  2. Sharing timely and accurate medical knowledge
  3. Working with patients on a plan to reduce stress and maintain healthy behaviors and
  4. Sustaining clinical contact where possible and ensuring adequate medication supply

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Anxiety

Resource: Coronavirus Anxiety - Helpful Expert Tips and Resources
From: Anxiety & Depression Association of America

Key points:

• Official resources from ADAA
• News articles with expert commentary on anxiety management and impact (e.g., What Coronavirus Fears Are Doing To People With Anxiety Disorders)
• Virtual exposure and response prevention sessions ($50/session) for patients with OCD via: https://lp.treatmyocd.com/adaa
• Other links to WHO, CDC and NCPTSD resources

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Resource: COVID-19 and OCD
From: International OCD Foundation

Highlights:

• Recommendations for individuals with OCD include:
  1. Acknowledging feelings
  2. Staying informed but setting a defined time limit for media without needing to learn everything
  3. Following public health guidelines for hygiene and disinfection without going beyond, e.g., excessive hand-washing
  4. Engaging in healthy lifestyle habits
  5. Talking to your OCD treatment team, or reaching out for treatment if needed and
  6. Staying socially connected

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Eating Disorders

Resource: Eating Disorders During the Coronavirus (COVID-19) Pandemic 
From: Verywell Mind

Key points: 

• Specific challenges for those who have eating disorders include: changes in treatment; interrupted access to usual sources of emotional support; heightened uncertainty; stressors around buying groceries and potential food shortages
• Coping strategies include:
  • Accepting and recognizing your feelings, and knowing when to reach out for help, including online therapy
  • Staying connected to your support network and enjoyable activities
  • Planning regular meals and snacks to stay nourished and satisfied
  • Practicing self-compassion
  • Practicing new coping skills and ways of thinking about self

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Resource: Managing an Eating Disorder During the Coronavirus Crisis 
From: McLean Hospital

Key points: 

• Recommendations include:
  • Creating a new routine and planning ahead, e.g., making a grocery list or researching where to get delivery/takeout meals 
  • Accessing virtual groups for healthy eating support
  • Staying connected to social support network

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Substance Use

Resource: Stress and Addiction During the COVID-19 Pandemic
From: McLean Hospital

Key points: 

• Webinar from Cathy Milliken, program director of McLean’s Borden Cottage (a Signature Addiction Recovery Program), discusses how to identify self-defeating behaviors, determine behaviors that may become addictive (especially related to drugs or alcohol) and learn coping strategies for managing challenging circumstances and emotions

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Resource: COVID-19: Implications for Individuals with Substance Use Disorders
From: National Institute on Drug Abuse

Key points: 

• Recorded webinar on coping with COVID-19 and substance use disorders, by NIDA director Dr. Nora Volkow

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Resource: COVID-19 Behavioral Health Substance Use Factsheet
From: Network of Care Massachusetts

Key points: 

• Factsheet with a compilation of virtual support groups and hotlines for substance use and recovery, and resources for accessing care and treatment during this time.

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If you have comments or would like to suggest an addition to the guide, contact: Karmel Choi, PhD and Jordan W. Smoller, MD, ScD.