Panic Attacks And Night Terrors: The Mental Health Toll Of Coronavirus

March was supposed to be a time of relief for Karin Barbee. The 47-year-old English professor hoped her divorce would be finalized, her house would be on the market and that she’d be finding somewhere new to live in Adrian, Michigan, with her two kids, 13 and 9. 

Instead, since the coronavirus outbreak has reshaped her life over the past few weeks, she regularly wakes up in the middle of the night and has a panic attack. Barbee stands at her sink feeling short of breath while her heart races. Her thoughts fall like dominoes: Will the house even sell in this market? Will she be able to pay off her credit card debt? Will she still have a job next semester? Will her kids be OK?

“It just feels like this constant level of anxiety that’s just kind of buzzing in me all the time,” she said. “I’m feeling like it’s never-ending, you know, like it’s just going to go on forever.”

The coronavirus outbreak has forced every American to radically change the way they live. Many service workers are out of jobs, with no idea when they will have a paycheck again, while others are working from home indefinitely. Almost everyone is more isolated, limiting social contact and hunkering down indoors to slow the virus’s spread. The upheaval of people’s routines, social lives and in some cases, livelihoods, is enough to make anyone feel stressed and overwhelmed ― especially when there’s no end date. But it creates even more serious challenges for those with mental health conditions such as anxiety, depression or post-traumatic stress disorder.

Mental health experts worry that as weeks at home turn into months, more Americans could begin to have issues ranging from depressive episodes and panic attacks to suicidal thoughts.

“My concern is how this will accumulate over time and how people will cope,” said Jonathan Kanter, the director of the University of Washington’s Center for the Science of Social Connection. “Social isolation and loneliness increases the risk of suicidality.”

The negative effects of isolation have been well documented by doctors. Loneliness is linked to premature death, heart disease, mental health and addiction issues. Of course, it’s not a given that living more secluded lives will make us lonely ― in 2020, we can sit in our living rooms and video chat with family and friends anywhere in the world. But this doesn’t replace spending time together in person, and those with mental illnesses are more susceptible to bouts of anxiety and depression the more isolated they feel, according to psychologists.

Since last Friday, 15% of people messaging the Crisis Text Line, which connects people to counselors, have mentioned the coronavirus, and 80% of their texts describe feeling anxious, according to company data. On social media, there are many threads about people’s mental health struggles. “Anyone else been waking up in the middle of the night to have a nice big panic attack?” tweeted feminist writer Jessica Valenti. “I had my first Coronavirus cry on Thursday,” a woman responded.

Being isolated exacerbates mental health issues. Instead of reading during a commute or blowing off steam at a bar, people are spending more time in their own heads, especially if they live alone. Those with depression or anxiety tend to have negative thought patterns, which can snowball if they don’t get perspective from others, said Dr. Margot Levin, a New York-based psychologist. If someone is worried about a paycheck, their concerns can easily turn into a full-blown panic about the future without someone around to calm them down.

It’s also easy to become depressed when the usual markers of a successful day, such as going to work and feeling productive, don’t exist anymore, said Kanter. People feel untethered, and can easily slip into fatalistic thinking. A recent study from Chinese psychologists found that one month into the coronavirus outbreak, those who stopped working suffered from the worst health conditions and mental distress.

That’s been the case for Jekyra Hoffman, 27, who felt so depressed on Monday that she spent hours on her couch, unable to get up. The single mother of two relies on her job doing customer service for a medical device company to stay busy and distracted from traumatic thoughts.

But since her employer asked people to start working from home last week, which Hoffman can’t do because she doesn’t own a laptop, she’s been stuck in her one-bedroom apartment with her 9- and 7-year-old children. She spends time worrying that all the progress she’s made escaping an abusive relationship, finding a shelter to live in, and getting a job to support her family is starting to unravel.

Hoffman says being in the house “gives me too much time to think.”

“If I keep myself busy, I don’t allow the thoughts to really take over and get depressed,” she said. “Sitting here, it’s like a cloud.”

Community provides a sense of safety, according to Kanter. He says socializing helps to “regulate our bodies and stay calm.”

Without going into the office and seeing his colleagues in person, Nick Hennen has been on edge. The 49-year-old media relations adviser has developed some paranoid behavior, such as triple-locking his door or wondering if the virus can get through his windows (he also has respiratory issues that could be life-threatening if he gets the virus, and describes himself as a “germophobe”). His PTSD, which normally doesn’t act up, has been triggered. Hennen is now having more regular night terrors about the time he was attacked and sexually assaulted as a kid, and only slept a few hours each night last week.

“I suppose it’s sort of just the unknown and being alone with my thoughts for that long ― what’s going to happen?” he said, adding that he lives by himself but has been FaceTiming with friends to stave off loneliness and stay optimistic.

David Thuo, a 24-year-old student in Kenya with bipolar disorder, said being around people helps regulate his mood swings. One night in 2017, he became convinced that he was going to die, but his friends helped to “neutralize the anxiety and paranoia.” Now that his classes are online and his internship has been put on hold, Thuo worries he might become depressed or manic and be unable to see people if he needs help.

But physical isolation doesn’t need to mean social isolation, according to Dr. Heidi Kar, a psychologist at the Education Development Center. She says phone calls and video chats can still make people feel connected and that many doctors are doing telehealth appointments.  A support system is crucial for people’s mental health, says Kanter, citing studies about how those with family support are less likely to develop PTSD after natural disasters.

In addition to sleeping, eating well and creating a routine, Kanter said it’s important for people to limit their news intake, which affects their mental state.

Barbee, the professor in the midst of a divorce, says she’s constantly opening new tabs about the coronavirus, which make her feel even more anxious. “I’m just worrying about stuff that I can’t even control,” she said. “Wall Street, I cannot control. You know, whether there’s toilet paper in the grocery ― I can’t control any of this.”

Instead of scrolling through endless articles, Kanter suggests logging off and helping people, like an elderly neighbor who can’t get groceries or an overworked parent who needs their dog walked. He’s worried that if people don’t start developing healthy habits early on, the prolonged isolation will start to fray their mental health.

“I’m concerned about someone living alone who has just lost their primary source of social interaction at work,” he said. “I’m also concerned about people who were already marginalized in our society. They are feeling more of a hit right now than others.”

If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HOME to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.