Her speech quickens and her heart races as Sarah talks about the spread of COVID-19 and how it could affect her brother, whose medical history makes him more vulnerable to infection.
Sarah, a Norman resident who asked that her last name not be used, has depression that is brought on by stress. According to her journal, she has been anxious and fighting insomnia for weeks – signs that her depression has returned.
“I’ve been in the house for five days now and I’m so keyed up,” Sarah said. “I’m trying not to let myself spiral.”
Increasing closures and restrictions in response to the coronavirus can be triggers for anyone with mental illness. Oklahoma counselors and therapists are anticipating a flood of scenarios like Sarah’s in the coming weeks and months.
State and federal officials are recommending, and in some cases ordering, social distancing and isolation as a way to slow the spreading infection. But for people fighting depression, anxiety or other mental illness, isolation can be more frightening than the virus.
This week’s government response to the pandemic – the governor declared a state of emergency and schools closed statewide – spurred an uptick in calls to the National Alliance on Mental Illness’ Oklahoma hotline.
One caller, an Oklahoma City-area woman in her 50s, has battled depression for years. She finally had it under control, recounted James Bost, the group’s executive director, but those familiar feelings of fear and sadness returned this week amid the announcements.
These calls are likely to increase the longer people are cooped up at home, Bost said.
“We’re already seeing people calling in repeatedly for check-ins,” he said. “Isolation and distancing can negatively impact folks with mental health concerns and, frankly, we’re all concerned, so it’s completely warranted.”
Following local and state recommendations, the alliance halted support groups and face-to-face appointments. Bost said employees are working remotely answering calls, connecting callers to clinicians by phone and providing other online resources.
The Oklahoma Department of Mental Health and Substance Abuse Services is still accepting patients at state treatment facilities. Interim Commissioner Carrie Slatton-Hodges said patients’ temperatures are being checked as a precaution.
Increased substance abuse is also a concern as some turn to drugs or alcohol as a coping mechanism for stress or loneliness, she said. Online resources can provide a substitute for group meetings, and members of groups are being encouraged to increase contact with one another until in-person meetings resume.
The department is increasing access to video conferencing and telecommunication and encouraging people to check on family and friends daily by phone or online.
Cara McCarty, a licensed professional counselor in Oklahoma City, said COVID-19 has been at the center of all of her sessions this week.
Weekly trips to the grocery store for toothpaste and shampoo are part of the routine that keeps anxiety at bay for one of McCarty’s clients, an Oklahoma City woman in her 20s. But those feelings of comfort turned to panic when she saw empty shelves and purchasing limits across the store this weekend, McCarty said.
“It made her feel like she wasn’t prepared or didn’t know enough about what was going on,” McCarty said. “She felt backed into a corner, and that can be overwhelming. I think a lot of people are feeling that way right now.”
McCarty hasn’t booked any new patients since the outbreak started but said after things calm down, she expects a wave of calls from people who experienced trauma or emotional distress.
Betty Carter hasn’t seen her husband, Bill, since Thursday. The couple has been married for 54 years and this is their longest separation since he returned from Vietnam. And it’s not by choice.
Carter moved her husband into Fairmont Skilled Nursing and Therapy center in Spencer about 10 months ago. His dementia became too advanced for Carter to continue caring for him, and she visits five days a week.
Last week the nursing home closed to visitors. And while Carter said she supports the decision to protect residents, she is afraid her husband may not remember her by the time the ban is lifted.
“It felt like they kidnapped him,” Carter said. “I know that’s not true. I know why they restrict visitors and I understand all that and I want them to do that, but emotionally it’s very difficult.”
Edmond resident Kate Luber has been hearing about a special birthday for months. Luber’s sister, Sarah Reynolds, has cerebral palsy and has the intellect of a child, Luber said.
“Her birthday is the biggest, most important event of the year,” Luber said. “She gets so excited about it that we actually have a rule that she’s not allowed to talk about her birthday until after Christmas because otherwise she would talk about it all day every day.”
Sarah turns 44 on March 18 and, for the first time, her family will not be there to celebrate with her. She lives in a group home in Okarche that is closed to visitors for now.
When Reynolds found out there would be no visitors on her birthday, “it was a meltdown,” Luber said.
“It’s more difficult for her, and for a lot of people like her right now,” Luber said.
Luber posted on social media this week asking friends to mail cards to her sister in an effort to cheer her up on her big day.
Mike Brose, CEO of the Mental Health Association, said the agency is receiving a lot of questions about the virus and calls from people who just want to talk to someone because they’re more isolated than normal.
Even people who don’t suffer from mental illness are concerned, and that will increase as more restrictions and cancellations are enacted, he said.
Wedding ceremonies are postponed. High school sports tournaments and proms are cancelled. Delayed milestones are causing distress and disappointment across the world. But some mental health care providers are hopeful that something good will result from these common threads.
“This might lead to a greater understanding or compassion for people with mental illness because we can all relate on some level right now,” said Bost, of the mental illness alliance. “Maybe we could come away from this saying, ‘Wow, these folks are feeling this every day,’ so maybe that could increase our levels of support and remove some of the stigma that keeps people from receiving a diagnosis and treatment early on. That could greatly reduce and mitigate some of our mental health issues overall.”
Correction: James Bost’s name was incorrectly spelled in an earlier version of the story.