Exactly one year ago, the World Health Organization (WHO) declared the coronavirus a global pandemic. In following months, millions of people around the world contracted the disease, and more than 2.5 million people were killed by the virus; more than 500,000 of those deaths were in the United States alone.
At the same time, measures to try to slow the spread of the virus transformed the world: Lockdowns and quarantines became routine, office buildings sat empty, and major milestones were canceled or put on hold. Millions mourned losses big and small.
It's no surprise that these major changes had a serious impact on the country's collective mental health. The American Psychological Association (APA) released their annual "Stress in America" survey, measuring responses from more than 3,000 adults about their stress levels over the past year.
The survey revealed a "secondary health crisis" and found that in addition to difficulties managing stressors and dealing with grief and trauma, people were reporting their physical health was also declining. Many respondents said they had experienced an undesired weight change, were drinking more alcohol to cope with stress, and were not getting an appropriate amount of sleep.
"People are really reporting that they are engaging in some pretty significant unhealthy coping behaviors," said Vaile Wright, a clinical psychologist and the senior director of health care innovation at the APA. "... I think we're seeing a pattern, and unhealthy coping behaviors that could really lead to some negative physical and mental health consequences."
According to the APA survey, young adults were most likely to report changes in their mental health due to the pandemic: 46% of Generation Z, adults between the ages of 18 and 23, said that their mental health had worsened, and 65% of respondents in that age group said they have felt "very lonely" amid the pandemic. About 62% of millennial adults, the next-oldest age group, said that they felt the same, though just 31% of millennials said that they felt their mental health had worsened.
Wright said that it's normal for the "youngest adults" to "always report the highest levels of stress and negative impact on their mental health" in the study, but this year has brought unique challenges.
"For a lot of younger adults, this is probably the first, if not the biggest, adversity that they've ever faced," Wright said. "When you think about, developmentally, what should be happening when you're younger, it should be about developing autonomy and your own sense of identity away from your family, and not everybody can do that right now. Coupled on top of the loss of milestones like graduations, and putting off starting school or going to college, and the (potential) actual loss of loved ones, it's a combination of all these factors that make it really challenging for Gen Z right now."
Wright said that for many, the "anniversary" of the pandemic could be particularly difficult to grapple with.
"We know from literature and research and trauma on (post traumatic stress disorder) that anniversaries can be a real trigger for people, and I think that is what you're seeing right now, where it's overwhelming," Wright said. "I hear people talk about how they feel like they've lost a year, and we certainly have had a lot of lots as individuals ... I think there is a real period of reflection and some grieving."
How can you manage your mental health right now?
As social media feeds remind us of what life looked like before the pandemic and people talk about everything they've seen change this year, experts recommend checking in with yourself and setting appropriate boundaries.
"One of the most important pieces here is to find ways to process all that this past year has done to us and for us," said Jessica Stern, a clinical psychologist at NYU Langone Health. "It's ushered in a lot of hopelessness and confusion, and for a lot of people if not almost all people, there was this sense of feeling like there was a standstill, and we felt stuck or like we didn't know when we would be able to proceed with 'regularly scheduled programming.' I think processing what that has been like is important."
Dr. K. Luan Phan, chair of the department of psychiatry and behavioral health at the Ohio State University Wexner Medical Center in Columbus, said that many people may be experiencing something like grief.
"We have an opportunity to revisit those things that we lost this past year, and it's almost akin to coming out of a grieving process," Pham said. "Depending on whether you lost a loved one, a job, ties with friends, the opportunity to attend a family reunion or wedding, those things were real, tangible losses that we felt both on a health front but also on a social front."
Stern said that one of the best things people can do for themselves right now is "take a step back" and "reflect" on what the past year has changed, and think about what things you might be able to control or change going forward while also trying to accept that some things can't be controlled.
"What can be really helpful is to figure out what you as an individual need in order to process that anniversary or this series of anniversaries for you," Stern said.
Stern said that people should "make space for the fact that we all have different feelings on different days," and understand that mixed feelings are a pretty normal experience for many. It can also help to set boundaries, like limiting the amount of time you'll spend on social media or avoiding features that show memories from previous years.
As more people gain access to vaccines, will our mental health improve?
While the APA study measured people's stress responses over the past year, the experts interviewed said that the progression of the vaccine rollout could also affect people's mental health for the better.
Stern said that as the rollout expands, it's giving people a "sense of hope" and the "opportunity to carefully and cautiously reclaim a sense of (being) one step closer to freedom," but those emotions can be "overwhelming" after a year of being on pause.
"I think what can be helpful is to look around in your life and see what was it that changed that you feel like you want to re-engage with at once," Stern said. "Finding small moments of connection with things that you lost previously or had to cut out of your life can be helpful. ... There's definitely a lot of hope with the vaccinations."
Wright added that it can be helpful for people to acknowledge that just because vaccinations are happening, the stress of the pandemic won't just disappear.
"We do need to acknowledge our stress, because if we don't acknowledge it, we can't address it," Wright said. "Acknowledging that 'This is really stressful, it's been really stressful, it's going to stay stressful for a bit' allows you to identify some solutions."
Phan said that people should feel comfortable setting boundaries and only engaging in activities that they think are safe, even as the pandemic appears to improve.
"There's going to be a range of possibilities," he said, comparing it to the Roaring '20s that followed the 1918 flu epidemic. "Some people might feel the need to go gangbusters and full force back into the way it used to be and some people will be very hesitant to do so, and there'll be a big range in between. Acknowledge that you don't have to do it all at once."