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Michelle Obama Reveals Struggle with “Low-Grade Depression”

Michelle Obama Reveals Struggle with “Low-Grade Depression”

Civil unrest, COVID-19 and economic strain are fueling a mental health crisis. Know the signs and how to get help.

Updated on August 10, 2020 at 11:30am EST.

Michelle Obama revealed that she’s dealing with "some form of low-grade depression" resulting from the lockdown restrictions imposed during the COVID-19 pandemic as well as racial and political tensions in the United States. The former First Lady revealed her personal struggles on August 6 during an episode of her podcast.

Obama admits she’s having trouble sleeping and waking up during the night due to ongoing worries. She adds that she’s been less active and has felt a “heaviness.”

"Spiritually, these are not ... fulfilling times," Obama said. 

Research shows Michelle Obama isn’t alone.

Job losses, social isolation, virtual working and schooling—not to mention fears about the coronavirus itself—have all combined over the past few months to create the perfect storm for a mental health crisis.

The civil unrest that has erupted across the United States in response to enduring racial injustice and political controversy related to the upcoming presidential elections has added even more emotional strain. Experts warn the psychological toll of these crises could worsen in the weeks and months to come. 

“There’s a lot of added stress,” says Asim A. Shah, MD, chief of psychiatry at Houston’s Ben Taub Hospital and professor and executive vice chair of the Menninger department of psychiatry at Baylor College of Medicine.

“There are many factors that make this disaster one-of-a-kind,” adds Dr. Shah, “and we’re going to see a lot of depression, PTSD and anxiety. A hundred thousand people have died, and that’s not the end of it. This will have long, drawn-out consequences.”

The emergency department at Ben Taub alone has seen a nearly 25 percent increase in psychiatric cases, says Shah, with anxiety, depression and suicidal ideation among the major issues involved. That jibes with national data, which shows people are struggling with anxiety and depression.

U.S. Census Bureau survey data released on May 20 suggests the pandemic has taken a mental health toll on Americans, with nearly 30 percent of adults reporting symptoms of anxiety disorder or depression.  

Of those polled, 19 percent felt down more than half the days or nearly every day of the week. Around 21 percent said they have little interest or pleasure in doing things most of the time.

Fear of the unknown
Generally, disasters can lead to post traumatic stress, anxiety, depression and other psychological symptoms. Due to their unpredictable nature, victims are often left in a state of shock. But when compared to other recent tragedies that spawned widespread mental health issues—including the September 11, 2001 attacks as well as Hurricane Katrina and Hurricane Harvey—the COVID-19 pandemic has one key difference: Prolonged uncertainty.

“This is an ongoing disaster, and there’s no end date to it,” Shah says. “There’s a lot of fear of unknowns.” This uncertainty can trigger the most anxiety and depression since people don’t even fully know what they are facing, he explains.

Maybe you’re afraid you’ll become infected with SARS-CoV-2—the virus that causes COVID-19—and develop a serious case, or that you’ll pass the infection on to a vulnerable loved one. Some people may mourn the loss of their pre-pandemic life or worry about falling behind on paying bills after losing their job. Others fear not being able to see friends or loved ones for many more weeks, even months.

Meanwhile, economists are predicting a slow economic recovery, which means the financial strain and uncertainty associated with this health crisis may linger for some time.

As coronavirus cases continue to climb in many parts of the country, rising depression and anxiety will likely follow in lockstep—at least until new infections and death rates drop and there is some clarity about when an effective vaccine will be available, says Shah.

Pandemic risk tolerance varies
While some Americans are returning to work and adapting to a new normal of social distancing, others are still sticking close to home for a variety of reasons, ranging from job loss to fears about infection.

An April 2020 paper published in JAMA Psychiatry suggests that with the prolonged personal and financial stress that’s expected, “the potential for adverse outcomes on suicide risk is high.”

This may be particularly true for those who were already dealing with depression and anxiety before the pandemic gripped the world, according to Shah.

During prior disasters, people with preexisting mental illness, anxiety and depression were among the first ones to be affected because their threshold for problems was already low, he explains. Many people already taking medicine had to up their doses, while others who had successfully weaned themselves off depression medication had to resume their treatment, Shah notes.

Other people who may be particularly vulnerable to anxiety and depression as the COVID-19 pandemic wears on include:

Those with substance abuse problems. When isolated at home during a challenging time, it may be easier for those with a drug or alcohol dependency to slip back into old, unhealthy behaviors. “We need to keep watch over those people,” Shah says. “It can be a slippery slope.”

Children and teens. If not monitored, kids can slide into depression just as easily as adults. Children younger than 5 years old shouldn’t be exposed to upsetting images on the news. Unlike adults, their brains don’t understand that the same image shown repeatedly is the same event. Instead, they think an incident happens again and again, which can be traumatic. Older kids should be informed in manageable doses and in an age-appropriate manner. “Don’t hide things,” says Shah. “They’re curious. Try to explain things to them.”

First responders. Many healthcare workers on the front lines of the pandemic are at high risk for exposure to SARS-CoV-2, which can be understandably anxiety-provoking. Recognizing first responders through small actions—thanking them when you see them in public, for instance—can make a real difference. “A few words of empathy go a long way,” Shah says.

Older people. Because of the isolation the new coronavirus has imposed on us, older people—many of whom may live alone—are vulnerable to loneliness and depression. Think about your elderly neighbors, Shah says. Check in on them, offer to buy their groceries for them or pick up their medications. Regular Zoom or FaceTime calls with grandparents can also help lift their spirits and keep anxiety and depression at bay.

Recognizing the warning signs
It’s normal to feel occasional anxiety, even in normal times. So, it would not be surprising if someone was struggling with stress or worries during a global health crisis. High levels of stress and anxiety that become debilitating or interfere with daily activities aren’t healthy.

For others, persistent feelings of sadness, irritability and hopelessness could signal depression. Other symptoms of depression may include:

  • Feelings of guilt or helplessness
  • Loss of interest in once enjoyable activities
  • Lack of energy or fatigue
  • Restlessness
  • Trouble focusing or problems with memory and decision-making
  • Changes in sleep habits or appetite
  • Aches, pains or digestive problems with an unknown cause
  • Thoughts of self-harm or suicide

The intensity and frequency of these symptoms varies from one person to the next. By definition, people with depression typically struggle with some or all of these symptoms most of the time for at least two weeks.

Don’t hesitate to seek help
Mental health concerns, including anxiety and depression, are treatable with either medication, talk or behavioral therapy or a combination of the two.

If you or someone you care about need counseling as the crisis unfolds, don’t let worries about infection and the need for social distancing prevent you from seeking support from a mental health professional.

By taking advantage of telemedicine, most people with Wi-Fi and a smartphone, tablet or computer can “see” a healthcare provider virtually for medical advice and keep follow up visits without leaving their home.

Telemedicine includes mental health care. In fact, teletherapy, or virtual therapy sessions, has emerged as a vital resource for a growing number of people during these uncertain times.

Whether you would be reaching out to a provider for the first time to help manage pandemic-related issues or you’re already under the care of a therapist or psychiatrist, ask if teletherapy is a possibility for you.

Medically reviewed in June 2020.

Sources:
U.S. Census Bureau. “Weekly Census Bureau Survey Provides Timely Info on Households During COVID-19 Pandemic.”
N Makwana. “Disaster and its impact on mental health: A narrative review.” Journal of Family Medicine and Primary Care. 2019;8(10):3090‐3095. Published 2019 Oct 31.
The Federal Reserve. “Current Economic Issues May 13, 2020.”
MA Reger, IH Stanley, TE Joiner. “Suicide Mortality and Coronavirus Disease 2019—A Perfect Storm?” JAMA Psychiatry. Published online April 10, 2020.
U.S. National Institutes of Mental Health. “Depression.”
E Whaibeh, H Mahmoud, H Naal. “Telemental Health in the Context of a Pandemic: the COVID-19 Experience [published online ahead of print, 2020 Apr 2].” Current Treatment Options in Psychiatry. 2020.
X Zhou, CL Snoswell, LE Harding, et al. “The Role of Telehealth in Reducing the Mental Health Burden from COVID-19.” Telemedicine and e-Health. Vol. 26, No. 4. 2020 April 16.

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