Chances are the final weeks of 2020 look markedly different than what you would've predicted on the first day of this year. With COVID-19 case and death counts on the rise and hospitals continuing to fill up, many are grappling with the ways that the unchecked coronavirus has sabotaged their daily lives, their economic stability and their time-honored traditions at the end of a year where shared celebration and community may feel more important than ever before.
More than a million people in the U.S. are also estimated to be facing their first holiday season without a loved one who has died from the disease.
Regardless of your circumstances, it's likely that this moment is impacting your mental health in one way or another. In an American Psychological Association poll from late October, 62 percent of adults reported that they felt "more anxious" than they did at the same time last year.
One major driver of that anxiety? The pervasive uncertainty of living through a pandemic. We've been dealing with the same answerless questions for months: When will we be able to feel safe spending time with the people we care about, but don't live with? Will in-person work and school ever resume a more normal tempo? How long will we have to wear masks and stay vigilant?
"All of those things are literally big, fat question marks. And people struggle with that because we're not sure how long it'll last and, inevitably, that creates anxiety and worry," Louisville-based licensed psychologist Kevin Chapman explained.
Pair those question marks with the the shorter days and colder weather in many parts of the country, the fear of contracting COVID-19 during the worst chapter of the pandemic so far, among plenty of other concerns, and you've got a recipe for not just anxiety, but a host of other conditions like depression and obsessive-compulsive disorder (OCD).
Here are some tips to help you manage your mental health and even celebrate the season during this difficult time, as well as resources to turn to if you or a loved one needs a hand.
Ask for help
The demand for therapy and other behavioral health interventions has skyrocketed this year as more and more people have sought treatment for new or existing mental health conditions. However, the pandemic also has pushed many patients and providers to take advantage of technological tools like telehealth that can help them connect from a distance.
If you're having a difficult time finding an available therapist in your area, broaden your search to include locations you normally wouldn't consider if you were looking to see someone in person, especially if you're in need of support right now. Given the volume of people seeking care, you might need to shop around for available providers or add yourself to a wait list if you find someone you want to schedule an appointment with, who is booked up for the time being.
For those covered by health insurance, you can consult your insurance company for a list of in-network providers. But if you don't have coverage, or you can't afford the out-of-pocket expenses associated with therapy, search for providers who offer their patients the option of a sliding scale or reduced fee.
Regardless of your insurance status, you can also check out self-help books like the ones on this list from the Association for Behavioral and Cognitive Therapies or consult PsyberGuide, a website that, according to the Anxiety and Depression Association of America, "provides accurate and reliable information about digital products [like smartphone apps] designed to address" mental health issues.
San Diego-based psychotherapist Cecille Ahrens also recommends reaching out to your doctor or a psychiatrist if you want to know more about prescription-based mental health treatments like anti-depressants. She emphasized that there's "a time and place" for those medications, and that they may be the first step some people need to take before addressing other facets of their mental health.
If you're interested in a therapy setting that focuses on COVID-19-related experiences like the loss of a loved one or the experience of being a "long hauler" — someone with lasting symptoms of the disease — look for any local organizations that are providing that kind of service. If there aren't any in your area, consider whether technology can help you join a group that's farther away.
Even with this range of digital options, many people may not have the time or internet access necessary to take advantage of them. In those cases, it's important to lean on trusted friends or family if you're able to do so. You can also seek help through free hotlines like the one operated by the National Alliance on Mental Health, or by texting the 24-hour Crisis Text Line to get connected with a counselor in real-time.
Make time for self-care
Plenty of people might feel that they haven't had the luxury of taking a step back from the chaos of this year to ask themselves how they are actually doing right now. Although 2020 has brought fear, uncertainty and loss of balance, Moe Brown, an Atlanta-based licensed marriage and family therapist, argues that it's also presented a challenge or, in some cases, opportunity.
Sometimes, he said, the desire to "just get through" a difficult experience can lead us to gloss over deeper problems. But he invites those who are struggling to consider questions like "What is it that I really need?" and "What would connecting with myself look like?" and to pursue those answers for the remainder of the pandemic.
Taking care of yourself is just as important as ever, though it may feel inaccessible to those who are having a hard time keeping up with life's many demands in this moment. If that's your experience, Brown recommends reaching out to your support system and doing your best to add some "structure" to your days to "create a little less chaos" when you can. Maintaining a routine can be difficult, but zeroing in on what self-care looks like for you is a good place to start.
Getting enough sleep, eating nutritious food and exercising regularly are the cornerstones of that care. Ahrens also recommends being aware about how much and what kinds of media you're consuming, and avoiding screens entirely when you need a reset. You can also look into mindfulness techniques to help you manage your thoughts and feelings when you're feeling overwhelmed. The most important thing, she said, is committing to self-care in the first place.
"You have to really make room for it," Ahrens said. "You have to prioritize self-care the way you prioritize other things in your life. It can't be like the last thing you do."
Schedule your social life
Connecting with people is crucially important, even when you're following strict social distancing measures. One of the main ways humans experience positive emotion, Chapman noted, is through the company of others.
"As long as it's a positive interaction, that's absolutely something that I not only suggest people do regularly, but I would go as far as they schedule a daily," Chapman recommended. That could be a walk, a phone call, an online support group, a session with a therapist, or any other type of pandemic-safe interaction.
It's possible, though, that right now you may be feeling less motivated to connect after months of repeating the same types of pandemic interaction. It can simply be difficult to find joy given the limitations of the pandemic and all of its stressors, noted Sarah Hagerty, a postdoctoral scholar at Stanford University School of Medicine.
And yet Hagerty recommends doing your best to pursue social outlets anyway, while keeping in mind that the results may surprise you. Putting behavior ahead of feelings can be "really helpful" sometimes, she said.
"Even if you don't feel like going for that walk safely outside, or even if you don't feel like taking that Zoom catch-up call with your friends or family, [know] that it's important to do it anyway and that it likely will end up making you feel better despite the fact that you didn't anticipate that it would," Hagerty said.
Embrace new traditions
Throughout the year, Long Island-based licensed psychologist Regine Galanti has helped patients of different religions cope with the cancelation of in-person, communal holiday celebrations.
It's normal to feel sadness and frustration when much-anticipated family events are canceled or modified in the name of public health, Galanti said. But getting stuck in that mindset won't change the situation. Once you've processed those feelings, Galanti stressed that you then have the opportunity to instead find new ways to make your holidays special.
"The families who I see who navigated things most successfully started new traditions," Galanti said. "They didn't dwell on what they couldn't have. Instead they focused on, 'What can I do here? How can I make this good for my immediate family, for my bubble, for myself?'"
If you've decided to celebrate your holiday with your immediate household or a social pod where everyone is on the same page about safety, take some time to brainstorm different ideas for making this year's unusual celebration one to remember. That goes for gift giving, too.
Millions of Americans have been impacted by the economic fallout caused by the pandemic, and countless families are struggling to afford basic necessities — let alone store-bought presents — this year. Ahrens recommends coming up with gift ideas that aim to "enrich" someone's life but don't involve spending money.
"The challenge is, 'How else can I celebrate this person? What do I know about them? Can I make them something? Can I write them the most beautiful card and thank them for all these things they've done for me over the years?'" Ahrens said. "It can really be a lot more fulfilling, if you think about it."
Take time to reflect on this year
The end of the year is a time for reflection on what we've experienced as individuals and as a society over the last 12 months. With its host of different hardships, it's likely that each of us has lost something meaningful this year.
Brown advises "giving yourself the grace" to grieve those losses — whether that's a way of life, an experience, a relationship or a loved one — and remember that you're not alone.
"I would just want people to know that it's OK to cry, to mourn the past, to really sit with how things have changed, to sit with how they might be different than what our dreams were for the world," he said. "There have been so many things that have happened that have pulled the rug out from under us."
Hagerty co-authored a paper earlier this year about how people may react to this shared pandemic experience based on "brain styles," or ways of thinking. She noted that some people often have a hard time identifying "bright spots" when they reflect on the past, a tendency that could understandably be exacerbated this year. But she emphasized the importance of doing your best to identify "kernels" of "joy and gratitude" whether you're looking back on your year, or even simply your day.
It's "reasonable," Hagerty said, that you may not have yet given yourself the time or space to engage in this kind of reflection, especially given the pressing "needs and threats and responsibilities" that have been placed upon all of us this year. But she added that it's "OK to be proud" of yourself for making it through those challenges.
The last several months have "made everything so different, and there's been so much to adapt to," Hagerty said. Having gotten through those moments "like all of us have — that's something to think of with a sense of pride and resilience."
The following list of resources combines resources recommended by the professionals consulated for this story, along with those curated by NewsHour.
Resources you can turn to for help
- The Anxiety and Depression Association of America offers guidance regarding how to screen yourself for mental health concerns and find low-cost treatment, among other services.
- The Association for Behavioral and Cognitive Therapies offers a list of self-help books and ways to connect with a therapist who specializes in Cognitive Behavioral Therapy (CBT).
- Psyberguide offers a list of digital mental health resources and apps that have been reviewed by professionals.
- The National Suicide Prevention Lifeline offers support for those who are grappling with suicidal thoughts.
- PFLAG offers members of the LGBTQ community a list of hotlines and other resources related to crisis intervention and suicide prevention.
- The National Domestic Abuse Hotline offers help for victims of domestic abuse.
- The Substance Abuse and Mental Health Services Administration helps connect patients with treatment for substance abuse and behavioral health.
- If you are facing eviction or struggling to pay rent due to the pandemic, consult the National Low Income Housing Coalition's page on state and local rental assistance.
Correction: Sarah Hagerty's name was misspelled in an earlier version of this story. We regret the error.