Episode 01: What COVID-19 Has Done To Our Mental Health
In the first episode of South of Fine, we discuss the mental health repercussions of COVID-19 — and why we are unprepared to treat all those who will be psychologically affected by the pandemic. Our guests for this episode include Katherine Pannel, DO, Medical Director, Right Track Medical Group, and Taryn Cooper, MA, Coordinator of Best Practices, Right Track Medical Group. Listen now below, or anywhere you get your podcasts.
EPISODE TRANSCRIPT
Welcome to South of Fine, a podcast from Right Track Medical Group, dedicated to de-stigmatizing mental health in the south through genuine conversation about the challenges that we all face every day. For more information, please visit our website, righttrackmedical.com\SouthofFine. While we hope you enjoy listening to our podcast, please remember that this is not a substitute for professional diagnosis or for the treatment of any mental health condition.
Rhes Low, Host:
Hey guys, thanks for joining us for the first episode of South of Fine. I'm your host, Rhes Low, and while I'm not the least bit qualified to provide advice on mental health, I have spent 20 years of my life studying human nature as an actor and writer. I love the exploration of how life's ups and downs, large or small, can influence the mind. Things like physical, such as ailments, handicap, surgery, or our families, culture, all of these can affect our mental health in a positive or a negative way. Or sometimes both. And here I get to pick the brains of actual mental health professionals that can help me, and you, get a better understanding of all of this.
Low:
In regard to tragedy, or just simple daily struggles, as southerners, we always like to say things like, ‘you got to pull yourself up by your bootstraps’ or just ‘be strong’, or, one of my favorites, ‘just muscle through it.’ But sometimes that just doesn't work.
When our team first started dreaming up this podcast, our goal was to discuss just that, a wide range of mental health issues folks struggle with on a daily basis while confronting the economic and cultural barriers that keep many of us, especially in the south, from actually seeking help. However, the world has changed dramatically since we first began planning this thing. COVID-19 has created a new normal, like it or not. It has become plain to see that this pandemic is taking a toll, not only on our physical safety, but even more so our mental wellbeing.
According to a recent study by the Kaiser Family Foundation, nearly 50% of adults say coronavirus has negatively affected them mentally. Individuals who might otherwise describe themselves as mentally healthy are now dealing with feelings of anxiety and stress and massive depression, while those were the existing conditions are frankly just getting worse.
Low:
Our thoughts are now dominated by concerns for the safety of ourselves and, of course, our loved ones. We've got the stress of homeschooling. I know that one firsthand, I've got four kids at home. The loneliness that we experienced or we are experiencing for those of us that are still in isolation. And then there's social distancing. At the beginning of all this, my father passed away, and we had to have a funeral. And a lot of it almost got overshadowed by how do we social distance at a funeral. This was before everything was shut down of course. The grief of what we've had to miss or give up, think about all those high school and college seniors that you know. They missed out on not only the pomp and circumstance of graduation, but also, more importantly probably, the social celebration with their friends throughout the last semester of college or high school, ever.
And now they're entering a job market that is basically just a mess. And then, as adults, we fear for our jobs. Just the uncertainty of everything. No one has a clear view of the future, or can even make an educated guess because things change so dramatically from day to day. And now, as things are opening up, that presents us with a whole new level of concern and uncertainty. New highs and lows. So like we all say these days, we're pivoting. Our first episodes will delve into the mental health crisis that COVID-19 is creating. And we're starting with the level set, an even playing field. A sort of state of the state of mental health in the time of COVID.
Our guests today are Dr. Katherine Pannel, Medical Director of Right Track Medical Group, and Taryn Cooper, Coordinator of Best Practices at Right Track Medical Group. They are joining us remotely from Right Track Medical Group's office in Oxford, Mississippi. Katherine and Taryn, thank you guys so much for being here with us.
Dr. Katherine Pannel, Medical Director of Right Track Medical Group:
Thanks for having me.
Taryn Cooper, Coordinator of Best Practices at Right Track Medical Group:
Yeah, thank you.
Low:
Absolutely. We're excited. I think that we want to begin this discussion with a little bit of context. Before COVID-19 was a term in all of our vocabularies, how would you have described, this is to either of you, how would you have described the state of mental health in the United States, and in particular the south?
Dr. Pannel:
I think if you can sum it up into one word, I would say abysmal.
Cooper:
Yeah. We know that nearly one in five adults live with mental illness and that's nearly 20%. And so most of those people, I mean less than half of those people are actually receiving services for their mental health.
Low:
Does it have to do with economic and cultural stigma?
Dr. Pannel:
In the south there's a huge cultural stigma. I think even as a kid, I kind of recognized that, I know my grandmother, she would take Valium and she would always say that it was for her inner ear. She was dizzy. But there was no doubt that she was taking it for her anxiety. She was a stay-at-home mom with children and she was taking it for anxiety. But I look back and laugh now, but it is a little bit sad that she was fearful to admit that she was having anxiety. And she even was too scared to admit it to her primary care physician at that time. She would just always say that it was her inner ear. We know she didn't have any problems with her ears.
Low:
And that's related to like postpartum depression. People didn't talk about that for years in the south.
Dr. Pannel:
That's right.
Low:
And maybe why we enjoy our cocktails in the south.
Cooper:
Yeah.
Low:
So moving on to what we're in now. How would you describe the state of mental health now in the midst of COVID?
Cooper:
Yeah, just from what I'm hearing, people are not doing well. And if you've been listening to the news at all, they've been talking a lot about just predicting there to be increases of post-traumatic stress disorder (PTSD) from all of this. And I believe that that's going to be true. People with anxiety and depression have elevated levels of anxiety and depression right now, and really what is happening in our country is traumatic. And I think those people who maybe were coping with anxiety or depression in various ways, a lot of those coping mechanisms have actually been taken away because so many of us are having to social distance right now.
Dr. Pannel:
Yeah. I think even at one time in the State of Tennessee, there were actually more cases of suicide than there were actually cases of COVID. We have seen that there has actually been an increase in suicide rates, up to 40% right now.
Low:
Oh my gosh. The coping mechanisms is an interesting topic to me in that I don’t think most of us are equipped or have coping mechanisms. As I said in the beginning, as an actor and a writer, I studied human nature for years, and I’m very open about my faults. Not that I’m the healthiest person in the world, but on the whole, does the population have an understanding of what a coping mechanism is.
Dr. Pannel:
I don't know that they realize some of the positive things that they do are coping mechanisms, but I think you can definitely realize and it's obvious when they are not there. That's when you start struggling. And this whole pandemic has put coping skills on the forefront because some of our coping skills that we normally do, that are healthy, that we may not realize are coping skills, we can't do right now because we are socially distancing and we're isolating. Going out with friends, spending time with friends, that is a healthy coping mechanism and we can't do that right now.
Low:
Yeah. Great. Go ahead, Taryn.
Cooper:
Yeah, I would say too, we might, like Dr. Katherine Pannel said, we might not know what a coping mechanism is or be able to label it, but we're definitely doing some of those things. Even the negative coping mechanisms. We're potentially drinking more, potentially eating more, binge watching Netflix, doing anything to help us feel better right now, or cope with the changes that are taking place.
Low:
Yeah, absolutely.
Dr. Pannel:
Yeah. Now I see several posts on Facebook with a lot of, especially, women saying that they have now gained the COVID 15. It's no longer the freshman 15, it's the COVID 15.
Cooper:
I've seen that too. Yeah.
Low:
I was Zooming with some old friends the other day and the bulk of the conversation was about how we'd all put on a COVID 25. So do you guys think that the country's mental health care system is prepared to deal with all of this long-term, the long-term effects that we're discussing?
Dr. Pannel:
No. No. Back to your very first question when you asked me the state of the mental health care system in our country, and I gave you the word abysmal. We were in a healthcare crisis before this began. There are lack of good, adequate, quality outpatient treatment facilities. I know in Mississippi alone, we have a federal lawsuit that basically they have said, "Mississippi, get it together. Your outpatient services are not what they should be. We've been giving you money and they're still not there. And y'all are over hospitalizing patients way too much." They've given us a timeframe. They slapped us with a fine. I don't know how much clearer it can be that Mississippi's mental health care system is in shambles. And we've got to fix it now because the services are only going to exponentially be needed more because of this pandemic.
Low:
Yeah. I'm sorry. Go ahead, Taryn.
Cooper:
I was just going to add, I heard a stat that said 60% of US counties don't even have a single practicing psychiatrist. So that means people who live in those counties, they're having to drive outside of their counties to even get any help, have an assessment done.
Dr. Pannel:
Every single Monday, I drive one and a half to two hours, one way, to go to Winona, Mississippi, one of the most rural places in Mississippi, just to provide psychiatric services there. Because there's not enough in Mississippi, there are just not enough of us.
Low:
What was that stat again, Taryn?
Cooper:
Sixty percent of U.S. counties.
Low:
Oh my gosh.
Dr. Pannel:
Even more in Mississippi. I bet we're on the higher end of that.
Low:
Katherine, do you think that, and you may not want to answer this and if you do answer it and it's political we'll cut it out, but do you think that outside of what we've already discussed, the economic and cultural stigma, like what is causing Mississippi to be so far behind in that sense?
Dr. Pannel:
I think mental health care, because of the stigma and because people are scared of mental illness. They're scared of people that have it, they're scared of if they will get it. And that's all because of lack of education. We get fearful of things that we don't understand or that we don't have education about. And I think we're just behind. I think even in the legislature, it just kind of gets overlooked because it makes us uncomfortable to think about it. It gives us fear because we don't have an understanding of it. So we definitely have a big game of catch up to play here in Mississippi.
Low:
I still have a stigma as a man from the south. Like, ‘No, I can do it. I can fix this myself. I don't need to go talk to anybody. I'm good. Or let me push it down.’ I'm recognizing I'm pushing it down, but in recognizing that's unhealthy, but guess what? I'm pushing it down.
Cooper:
Exactly.
Low:
Yeah. Good point. So on an individual level, how is COVID-19 affecting people?
Cooper:
I'm a marriage and family therapist in training. I'm looking at families and I'm noticing that families are a lot more irritable. There's higher anxiety within the home right now because families aren't used to spending as much time together as they currently are. This is all just part of a normal part of being around each other more and adjusting. But if we don't have those positive coping mechanisms like we were talking about earlier, I think we're going to see a lot more families lashing out at each other, a lot more conflict. I'm just thinking about what this is going to do to relationships moving forward. And then I'm thinking about the families too, who those environments for them are already toxic and they're stuck with those family members. I mean, people who have, they're in domestic violence situations or abusive homes. I'm thinking about kids who, really, the only outlet for them is to go to school every day and they can't do that right now. So we're going to see kids coming out of this who are really going to have some PTSD from being home and not having those positive figures in their lives.
Dr. Pannel:
I feel like I'm the Debbie Downer of this podcast right now but we've already started seeing an increase in domestic violence. And that is going all the way from children to the elderly. Think about caregivers that are stuck with their elderly parents that they're the 100% caregiver all the time. They don't have an outlet. And Taryn's right, it just increases stress and it really brings out the unhealthy coping skills. And unfortunately, we're just seeing a really drastic increase in domestic violence, unfortunately.
Low:
I think the long-term mental health situation we're looking at is a secondary crisis.
Dr. Pannel:
Yeah. I think that we are finally at the peak, if not a little over the peak, we're flattening now this whole COVID pandemic. And we would say that we're on the other side of it. I think we can safely agree that we are on the other side of the pandemic. But we are just at the beginning of a mental health pandemic. We have not reached that surge and we've got to prepare for it.
Low:
How do we prepare for that? Is that too broad of a question?
Dr. Pannel:
Go ahead, Taryn.
Cooper:
Thank you. I was going to say, for the mental health professionals out there, I think just knowing that it's coming is helpful. I think a lot of us have already started to take action to prepare ourselves by offering telehealth so that we can kind of reduce the number people who are coming after the fact, but we can get to people now from their own homes. And as long as we can do that, we can attempt to make it a little bit easier for us in the future.
Dr. Pannel
Yeah. And that's where things like this podcast really come into play. Going ahead and educating the population about things like healthy coping mechanisms or where they can get access to mental health care, putting those things all into place right now and really just getting up there and educating the public is how we're going to prepare for it. That's where the COVID pandemic really hit us hard, we weren't prepared. It was fast. It hit us hard. We didn't know what to do. We were unprepared. But we know that this is this coming as far as mental health pandemic and we can start preparing now.
Low:
Yes, absolutely. That's great guys. So moving on to grief, how is the grief over what has changed and what we have lost? Not necessarily the people but our way of life, our events, et cetera. How is that adding to our mental health struggle? We may have discussed that a little bit, but more in depth, I think, is what we'd like to hear.
Cooper:
We see people are struggling with creating new rituals and routines around their day to day lives. And I think that's where the grief really sets in. Kids were used to getting up and going to school every day, mom and dad or whoever would pick them up and then they would maybe spend some time together in the evening. But right now we don't have that structure and so we almost lose sense of time. How many of us are like, "I don't even know what day it is anymore because I'm not getting up and doing my normal day to day thing or going to work or taking the kids to school." And so those big events in life that are marked by the everyday, but then the seasons of life, we're missing those.
Cooper:
And we see grief in big events like graduation. We see grief in even just high school proms. How many girls are excited about picking up that prom dress and going to prom? We've heard about events that kids have, they were introduced to their freshman year of high school and now they're seniors and now they don't get to do that. And so those stepping stones, which are like rites of passage for some of these people, we're missing out on those things. And there's definitely grief anytime something in our life changes like that.
Low:
The rites of passage thing is how we pinpoint where are we see growth in our lives. And that pinpoint is off. Once again, I said in the beginning, I'm not a medical professional, so I use pinpoint. Sorry guys. From a personal standpoint, my father passed away at the very beginning of this. And my cousin's wife said, ‘Most of the time when things like this happen, you have a death, you feel like the world stops but it keeps moving on. And in this instance, the world actually stopped.’ And so now that things are opening back up, we're stepping back out into the world and real life is hitting us again and all of a sudden the reality of this death is hitting. More so than it has before because we really, not ignore it, but we could pretend it wasn't there because no one was coming and telling us, ‘Hey, how are you doing? Here's some food.’ Doing that southern thing, you know what I mean? You guys are in such an important position going forward through this thing.
Low:
You guys mentioned that there were probably be a lot of PTSD coming out of this. Can we elaborate on that a little bit?
Dr. Pannel:
We could probably do a whole podcast on PTSD because it's going to affect everyone from healthcare workers to the general population, for different reasons. I have a patient that actually recovered from COVID, and he has legitimate PTSD that he is scared that he is going to get another round of this. He was healthy before he got COVID, no underlying conditions, he was a runner. He came to me with anxiety because he would go for a run, and even if he went three miles and got short of breath, which would probably be normal given that he was in the hospital, he was deconditioned, he thinks he's getting COVID again. So it affects those that have had COVID, those that have seen loved ones with COVID.
Dr. Pannel:
Then you look at the healthcare workers who have treated and they've seen people die from COVID. The general population who was facing the social isolation and depression they felt from that, now we're hearing of a second surge, a second wave, and we're all of a sudden panicking, are we going to have to go through this again? And it brings up all those feelings again. I think it's going to affect everybody differently, but I think, in some shape or form, PTSD is very prevalent.
Cooper:
Yeah. And just to add to that, I think that people are going to show signs of PTSD just from even just the government not knowing how to respond. Not to make this too political or anything, but this threw everybody off. We didn't expect it. And so of course, our government didn't necessarily know how to respond to it. I've heard from people who are like, "I don't know if I can trust my government anymore," or, ‘I don't know if I agree with what they're doing or they're doing this over here in this part of the world.’ I just think that it's affected our ability to trust each other.
Dr. Pannel:
Just a response, a blanket response, for all of that is just ensuring comforting them and letting them know that, because we've already gone through a first wave of this, the experts, the physicians, the government, we all know so much more about this now that if that second wave is going to come, we are so much more prepared. And I think that is just a very important thing to continue to like harp on and really drive home because it provides comfort for anxiety, knowing that we're so much more prepared. This is not going to be the surprise that it was starting in March.
Cooper:
Exactly.
Low:
Great. So let's wrap this up guys. Taryn, let me start with you. I'm going to do a two part question, but I want both of you guys to answer this, please. So going forward, how can individuals take care of their mental health during this pandemic. And if they need help and aren't sure where to turn, where do you recommend they start?
Cooper:
Because we've lost so many of those connections, I would say the best way to take care of your mental health right now is to attempt to stay as connected as possible. That might mean that we have to be a little more creative, but there's a lot of really great technology out there that can help us do that. Or as we're starting to kind of come out of this and we can go out in public again, what does it look like to, from a safe distance, reconnect with those people that are really important in our lives, or call someone up on the phone. As humans we were made for connection. And that connection is actually what helps us build resiliency when stressful things occur. When we get sick, we're stronger and we're more resilient when we have people around us.
And so, I would just ask people to ask themselves who are those people for you. Who are those people that you know you can turn to, who will be there if you pick up the phone and you need to call. Who are those people? That's really important.
And then secondly, if you don't know where to turn or you don't have those people in your life, there are a lot of really competent professionals out there, and there are a lot of resources. And so even just doing a quick Google search, you can find providers online, you can go to our website. I'm sure you're going to have resources available through this podcast. Reach out to a professional who can help connect you to the right people. There are great support groups out there. You might be going through something that other people in the community are going through. Maybe we can connect you with one of those support groups. But that connection is really key.
Low:
Great.
Dr. Pannel:
Just to add to those. Those were great options and great suggestions. But one way that we can sort of prepare now to get things in place, I think, really harping healthy coping mechanisms. We all get anxious with change and lack of control, and that is what this whole pandemic has been. Nothing but changed from day to day, week to week. Things that we can't control. We're essentially right now controlled by what the government tells us we can and can't do. But focus on what you can control, that gives you comfort. Control your diet, eat healthy, stay hydrated, exercise. Not only exercise to keep yourself healthy, but to help your mental health. Focus on things that you really can control to reduce anxiety.
And as far as where you can go to get help, I know it can get very complicated, whether you have a certain kind insurance, if you don't have insurance, do you have Medicare? Who takes what? I mean it can become overwhelming. I think one of the best things that we have is NAMI, the National Alliance of Mental Illness. Go ahead and reach out at 1-800-950-NAMI. You can tell them what insurance you have or if you don't have insurance, and that can put you directly in contact with services to help you.
Low:
Awesome. Guys, this has been quite an honor, especially after listening to all that you guys have to say. And so everybody, remember if you find yourself struggling with mental health, do not be afraid to reach out for help. As we've discussed today, your mental health is huge. It matters tremendously. Thank you guys for being here. Katherine, Taryn, you guys are awesome. Appreciate it.
Dr. Pannel:
Thank you.
Cooper:
Thank you. It was fun.
Low:
All right guys, that's it. I'm out. But I look forward to continuing this conversation with you all in future episodes of South of Fine. Please come back.
If you have questions about mental health and the COVID-19 pandemic that you'd like our providers to answer in a future episode, please email southoffine@righttrackmedical.com. And if you'd like more information about Right Track Medical Group or the South of Fine podcast, please visit righttrackmedical.com.
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