At a time where South Carolina health providers are trying to manage COVID-19 patient loads, mental health experts are raising concerns about front-line workers' rising stress levels and their overall well-being.
“You can’t help someone else until you help yourself," said Dr. Sarah Coker, a psychiatrist with Roper St. Francis Healthcare.
Over the past few weeks, South Carolina has recorded thousands of new coronavirus cases. At the same time, the state's hospitalizations for the virus have tripled.
Internationally, the pandemic has placed increased pressure on front-line health care workers and pushed many to report feelings of excessive stress.
In a study of more than 1,000 health providers in China by the Journal of the American Medical Association in March, 71 percent reported experiencing psychological distress. Half of them reported dealing with depression.
Alyssa Rheingold, a professor and clinical psychiatrist with the Medical University of South Carolina's Department of Psychiatry and Behavioral Sciences, said that early in the pandemic there was a lot of anxiety from health care workers about what to expect with the virus.
With South Carolina seeing a spike in cases, Rheingold sees that anxiety shifting a lot to chronic fatigue, which can eventually lead to problems including depression. Front-line workers are finding themselves in extended periods of anxiety and being on guard.
Rheingold argues workers have to be intentional about taking care of themselves because of this, especially considering how long the pandemic could potentially last.
“This is a marathon, not a sprint," she said.
According to the American Psychiatric Nurses Association, some of the clear red flags for excessive stress are trouble with sleeping, irritability, difficulty concentrating and rapid heart rate.
With providers dealing with managing patients during a pandemic while addressing their own personal fears with the virus, some may be experiencing acute stress disorder. If that intense level of stress persists for 30 days, the association believes workers should consider the possibility of post-traumatic stress disorder.
This all feeds into the association's argument there is an increased risk of a second pandemic of mental health problems among American health providers and communities. Coker agrees.
Long term, she sees there being an increased risk of burnout and potential increase in the suicide rate among health professionals.
One of the best things experts believe providers can do for themselves in this new normal is be mindful of their mental health and their social connections.
For a lot of health providers who work directly with COVID-19 patients, Tari Dilks, the president of the American Psychiatric Nurses Association, said she has heard stories of them coming home and immediately taking all of their clothes off in the garage and hopping in the shower before they even make time for social interactions.
“They do that day after day," she said.
Some are quarantining from their families all together because of their daily exposure to the virus, Coker said.
If they aren't able to physically connect with someone, Dilks encourages workers to try reaching out to people virtually since social connections are vitally important. Her mother has a list of people she routinely calls to check up on, so that's one step health providers can take.
Nurses in particular also have a bad habit of getting into a deep focus and not taking breaks. Experts agree that they especially have to be mindful of taking those much needed pauses throughout the day to help manage stress.
Most health providers were working in stressful situations even before the pandemic. While certain coping mechanisms may have worked prior to the coronavirus, Rheingold said, they may not be working now with social distancing.
"Sometimes it might be about learning other strategies," she said.
If a worker hasn't reached a dire level of stress, then it may be OK to reach out to family member or friend for support. They also can make attempts to exercise more and start implementing relaxation practices.
But if they get to point where the stress is so severe that they are losing sleep and having actual dysfunction in their lives, then Coker believes they should seek professional help.
A lot of hospitals will usually offer access to mental health resources to their staff, she said. The S.C. Department of Mental Health offers resources online through its website.
The Substance Abuse and Mental Health Services Administration also has a distress helpline that people can take advantage during the pandemic by calling 1-800-985-5990 or texting "TalkWithUs" to 66746.