That feeling you have might be situational depression

Even in the middle of the unprecedented situation caused by the COVID-19 pandemic, experts say people can reach out for help.
/ Source: TODAY
By Meghan Holohan

The COVID-19 pandemic has trapped most people in their homes and little things, like getting dressed and showering, seem less important now. Some people might lack motivation and interest in things they once loved, sleep more, become more irritable or battle insomnia. While these feelings and behaviors could be normal reactions to stress, they also could be a symptom of a more serious mental health issue.

The Centers for Disease Control and Prevention and Census Bureau recently released data from mid-May 2020 that found roughly 28% of adults in the U.S. reported symptoms of an anxiety disorder and 24% said they experienced symptoms of depressive disorder in the last seven days. These rates are considerably higher than last year: A similar survey from April-June 2019 found that 8% of U.S. adults reported symptoms of an anxiety disorder and 6.5% reported symptoms of depressive disorder.

NBC News correspondent Miguel Almaguer reported this week that prescriptions for anti-anxiety medications are up by 34% from mid-February to mid-March and antidepressant prescriptions increased by 18% according to Express Scripts, a pharmacy benefit company.

It's clear that the coronavirus pandemic is having an impact on mental health in the U.S. Here is what a few experts want people to know about navigating this difficult time.

What’s situational depression?

Some people might be experiencing what’s known colloquially as situational depression or what clinicians refer to as adjustment disorder. It’s a type of depression that occurs in someone for the first time after they experience a stressful or tragic event, such as the loss of a job, the death of a loved one, divorce or any other unpleasant experience.

“Everyone feels sadness. It’s a natural human emotional,” Scott Lewis, director of inpatient units at UPMC Western Psychiatric Hospital in Pittsburgh, told TODAY. “(Situational depression is) typically short-term due to these specific changes in your environment and it’s just struggling with those changes.”

Adjustment disorder and major depressive disorder share similarities.

“To a large extent most clinical depression is situational because it usually develops at times in people's lives when something's not going well,” Dr. Michael Thase, a professor of psychiatry at Penn Medicine in Philadelphia, told TODAY. “The things that normally… make us the bluest are things that affect our sense of self-esteem, like our ability to earn money and to do things that are important.”

Feelings of insecurity and being disconnected from worthwhile pursuits are incredibly common right now as people face unemployment and a sluggish economy. Many worry that they could catch the coronavirus and social distancing keeps people away from friends and family. People are isolated from activities and loved ones, losing some natural coping mechanisms.

“There’s so much complexity and insecurity to this stressor,” Sophie Lazarus, a psychologist at the Ohio State University Wexner Medical Center in Columbus, told TODAY. “I've gotten a chance to talk to so many people and almost everyone that I talked with is having some level of difficulty coping.”

Signs of depression and how to ease them:

Symptoms of adjustment disorder include:

  • Lethargy
  • Trouble concentrating
  • Feeling sad
  • Being more tearful
  • Withdrawing from loved ones
  • Avoiding enjoyable interests and activities

Symptoms of major depression include:

  • Depressed mood
  • Constant irritability
  • Significant reduction in pleasurable activities
  • Major weight loss or weight gain
  • Feelings of worthlessness
  • Thinking of death, suicide or harming one’s self

What you can do:

For many, getting regular exercise, eating healthy foods, keeping a regular schedule, engaging in fun activities and chatting with friends and family help ease the symptoms of adjustment disorder. In some cases time and relying on coping mechanisms causes it to disappear.

“The person just naturally recovers from the life event due to their own resilience,” Lewis said. “But it doesn’t happen unless you’re actively trying to resolve that, really actively pushing someone to get out and be active or talking to a loved one or a counselor.”

But the symptoms can evolve or reoccur and that’s why experts encourage people to seek help. Psychotherapy and medication effectively treat both adjustment disorder and depression. Cognitive behavioral therapy is often considered one of the best treatments for it.

“Accepting that you are struggling with this is part of the process,” Thase said. “But you shouldn’t just accept that this is inevitable and that you should suffer because there may be things that you can do on your own or with help."

Even some less intense treatments, such as self-help books, apps, prayer or meditation, can help.

“It can be making sure you’re getting enough sleep or making an effort to talk to one or two friends or changing the way we consume news,” Lazarus said. “It can be learning to challenge and be more critical of our (negative) thoughts and more purposefully integrating positive or pleasant experiences.”

But when symptoms feel as if they’re outside one’s control it is important to seek help — especially if it's impacting one’s ability to work and care for themselves.

“When we are functioning poorly at work and that's becoming a threat to our livelihood, that is way more cause for concern,” Lazarus said. “Even though it may be normal and understandable right now that level of stress may just be not be (healthy).”