I Didn’t Think I “Needed” Therapy—Then COVID-19 Happened

It’s 2:30 a.m. on a Monday morning and I’ve just relocated from my bed to the couch, trying to stifle my tears so I don’t disturb my husband. I’ve already let my boss know I need the day off tomorrow to monitor my unexpectedly sick partner’s COVID-like symptoms to see if they are worth a call (or worse, a visit) to the doctor. Though my brain is telling me it’s just the flu, a constant COVID-19 news cycle and some symptom-Googling are enough to spike my already sky-high anxiety.

At this point, we’re entering week eight of self-isolation during the COVID-19 pandemic and I am one of the lucky ones. I’ve managed to hang onto my full-time job and while my additional freelance work has significantly slowed, I’m still earning a nine-to-five paycheque. I have shelter and access to food and even a backyard. I’m self-isolating with my husband, whom I love, and our two adorable cats. I’m aware of my privilege every day, but have never felt it more keenly than I do now when so many have lost so much. But, for the first time in my adult life, I’m also recognizing I could use some help managing my mental health.

It’s not that I had fully mastered managing my mental health prior to what can only be described as my (first?) quarantine breaking point. I have, and do, struggle, most notably with anxiety that often has no outlet, and burnout from failing to pause when I feel run down. But when it comes to feeling low or anxious, I’ve often been able to turn it around through prioritizing screen-free time alone, spending time outside, counting my blessings and coming up with a plan. Regaining my perspective and a sense of control through action has always been something that has helped me out of those lower periods (that, and comfort food), but I know this doesn’t come easily to everyone. So, while I understand the benefits of therapy and have seen the positive effects of it on so many of my peers, I’ve never felt bad enough for long enough to seek it out myself. 

Which brings me to 2:30 a.m. on May 4 when a cocktail of sadness, anger, guilt, helplessness and fear are rolling around my brain and in my chest, making it impossible to sleep (though apparently not impossible to write, even though I am exhausted). And despite the truly terrible week I’ve had (another story for another time; just know that a husband showing COVID-like symptoms truly was the straw that broke the camel’s back), I know I can’t be the only one wondering whether talking to someone—preferably, someone impartial with credentials—might help ease some of the non-diagnosed anxiety currently bearing down on me. At this point, I know it certainly couldn’t hurt.

Of course, I’m not alone. Most of us are generally reporting more stress and anxiety with more perceived barriers to treatment and care without in-person appointments. According to Dr. Donna Ferguson, a clinical psychologist at the Centre for Addiction and Mental Health (CAMH), those who regularly attended therapy pre-pandemic may have halted sessions in the hopes that in-person meetings can soon take place, resulting in a disruption to care. And for those of us who have never been to therapy before, starting now can feel completely overwhelming—with everything going on, where does one even start? With no real end to the pandemic in sight—and no idea of what our new normal will look like—even those of us who felt pretty strong mental health-wise are learning just how much can be chipped away under the right (or in this case, the wrong) circumstances. 

Once I knew I would be researching and writing this story, I checked in on my friends and peers on Instagram, asking a series of questions to learn more about how everyone was doing. Unsurprisingly, 95% of those who answered acknowledged that COVID has increased their stress and anxiety. Despite that, only 50% of those folks have sought out mental health support, whether in the form of online therapy, digital apps or wellness practices like meditation. Up until a few weeks ago, this was me as well.

The truth is, most of us are struggling and for myriad reasons. The good news? You’re not alone and your mental health challenges are completely understandable, whatever they may be. And don’t just take my word for it. I spoke to Dr. Ferguson, as well as Dr. Sabeena Chopra, psychiatrist at Stella’s Place, a support centre for young adults in need of mental health assistance, to understand why so many of us are struggling and, more importantly, what can be done to help manage it.

Your typical coping mechanisms are harder to do now

We all have our coping mechanisms to handle stressful situations. And some of us have been prescribed methods or homework, such as trying to be more social and reaching out to friends and colleagues, as part of the behavioural arm of Cognitive Behavioural Therapy. According to CAMH, CBT is a method of practicing skills and strategies for managing mental health that is often used solo or in conjunction with medication for a range of mental health concerns. It’s practical and problem-focused and can include things like activity scheduling for diagnoses like depression. Unsurprisingly, activity-scheduling is difficult when your city is on lockdown. 

While some of us are naturally more solitary creatures, many are not. In fact, many of us rely on socializing—going to a workout class, getting dinner with friends, spending time with our families and congregating outdoors—as antidotes to the stresses we face. While some of these activities are slowly becoming more accessible as provinces begin to relax social distancing rules, for almost three months (and counting, for some of us), they were impossible without great risk. But the truth is, even your replacement coping mechanisms (yes, I’m looking at you sourdough bread and TikTok) may not be providing the relief you’re hoping for. “If you’re having normal ups and downs, things like gardening and baking can be good coping tactics. Walking, exercising—these can be enough for some people, and they all can support your mental health,” says Dr. Ferguson. “But, I’m not sure it would be enough for somebody who is really struggling.” 

Don’t be afraid to seek out external help, like virtual therapy or a mental health app like the ones listed at the end of this story, if alphabetizing your bookshelf isn’t cutting it. Many of us need more support than the delicious, distracting pursuit of the perfect banana bread to feel better—and that’s completely understandable given that your normal coping strategies have likely been upended.

Smaller, usually more manageable, stressors are now amplified

“It would be reasonable to say that everyone’s stress level is amplified,” says Dr. Chopra. “The already existing challenges that individuals are facing are likely amplified as well.” That means that whatever stressors or mental health challenges you were dealing with pre-COVID likely weren’t made any better with the addition of a global pandemic. While a tough week at work is always frustrating, add a dose of job insecurity and an economic downturn and the leap from frustration to panic becomes smaller. And if even the most minor problems feel like they’re hard to handle, that’s because they are made bigger thanks to the magnifying glass that is COVID-19. Focus is key here—as well as recognizing what is in your control and what is beyond it. There’s a lot that is out of our control right now, but if you’re still working, you can focus on your job or (hopefully) ask for that day off should you need it. If you’re currently laid off or furloughed from work, keep reading. 

Your entire life and schedule has changed

For many of us, work gives structure to our days and weeks. Although not universally true, most of us know our work schedules; they are predictable in some way, and we organize our lives around them. But for many of us, our work schedules have changed dramatically, along with our work settings—or they’ve been eliminated entirely. “Our bodies like to know when they are going to be fed and when they’re going to sleep, that stabilizes the nervous system,” says Dr. Chopra. “Now more than ever I encourage people to try to establish some sort of routine. It sounds very basic, but it’s also a foundation of staying well.” Of course, this is easier said than done when you have no work and no social plans. Start small with some examples from Dr. Ferguson: Get up at the same time every morning or set work hours if you’re adjusting to work-from-home life. Go for a walk at the same time every day. Budget alone time for yourself, if it’s possible in a full house, or social time with a friendly video call if you’re alone. But remember to not be too hard on yourself if maintaining a routine is difficult, especially if you’re reeling under the anxiety of losing your job. If it adds another layer of pressure, scale it back until you feel well enough to try a routine again.

The uncertainty of this moment is overwhelming

Uncertainty was the biggest reason people felt stress in my informal Instagram poll, and this was true for me as well. After I cancelled or put all my spring and summer plans on the back burner (which included a years-in-the-making trip and several personal and professional milestones I was hoping to accomplish, not to mention all the smaller social events I was greatly looking forward to), I was lost. I love my plans. I tend to them like so many of my Instagram follows tend to their gardens. And it wasn’t so much the plans that I lost—if the worst thing that happened to me was that I needed to cancel a vacation, then I’m in much better shape than most—but rather the volume. Everything was cancelled with no notion of when it might come back. “If there’s a single stress or a couple of stresses that are short term, most of us can manage that—but COVID is a disruption to routine, financial stress, social isolation, health insecurity and your safety is compromised, and it’s been prolonged,” says Dr. Chopra. “The unknown: When is this going to end? How is this going to be? What are things going to look like? These questions weigh on people. And the degree of uncertainty we are facing today is enormous.” That includes the medical uncertainty as well as we continue to learn more about the virus itself and as we prepare for what many are calling an inevitable second wave. It’s this uncertainty that is my own biggest trigger. 

So, what can you do to manage your mental health right now?

Any of these reasons on their own is enough to reach out for mental health support, and most of us are coping with several of them. There is help, even from a distance. “There are actually increasing resources for people who are having a hard time with mental health,” says Dr. Chopra. Therapy is being offered virtually (though it’s important to acknowledge the limitations of virtual meetings which can include access to a computer and a reliable internet connection and, especially now, a quiet, private and undisturbed place to actually have that meeting). “People are accommodating with virtual,” says Dr. Ferguson. “It’s good to reach out, and not to wait, to do it sooner rather than later. Be proactive so you can start that process and feel like you’re getting on top of the issues.” The cost of therapy is, of course, also a barrier for so many people. Increasingly, there are virtual therapies and apps being offered for free. “If people can get even a bit of support during this time while they’re dealing with a lot of stress, I think it will help,” says Dr. Chopra. This is backed up by my informal Instagram poll—82% who sought out mental health support noted that it had helped them. 

Shortly after my husband’s COVID-19 test came back negative, I had my first virtual therapy session. As you might expect, it did not solve all my COVID-related concerns. My uncertainty lingers and I’m still dealing with a lot of the things that were present in the lead up to my middle-of-the-night sob sesh. But, I can’t deny how helpful it was to speak to someone who acknowledged that I was struggling and that I had every reason to feel how I was feeling. The simple recognition of the burdens that I was carrying was an immense support I didn’t know I needed until I realized I couldn’t carry any more.

And much to my surprise, therapy (and more specifically, online therapy) was much less awkward than I anticipated. It didn’t take much to get me talking in my first session, and just listing off the things that were weighing on me helped. In my second session, more work was done relating to ~feelings~ which I did find more awkward as a first-time patient. Sitting in my feelings is new to me (my trusty compartmentalization tactic doesn’t tend to allow for much emotional time). But, the awkwardness was mine and had more to do with my own hangups about composure than it did about virtual therapy (or therapy at all). Despite my obvious discomfort, it still felt like I was doing important work to understand my own emotional impulses, and more importantly, how I could learn to move through them better, without just placing them in a box to be dealt with later—like, ahem, in the middle of the night.

It may sound a bit cliché, but it’s also been proven over and over again as this global pandemic touches all of us in some way: “We’re all in this together, and we can’t forget that,” says Dr. Ferguson. “We need to remember to lean on each other for support.” In isolation and with distance, it can be hard to remember the simple notion that leaning on each other is incredibly helpful.

As we get closer and closer to a “new normal” (whatever that ends up meaning), I’m hoping my own version of this future includes taking more honest stock of my own mental health needs, and perhaps continued therapy visits (virtual or IRL). I’m hoping the next time something shakes me—whether it’s that tough work week, or a family illness or, yes, even another pandemic—I’m better able to handle it before I find myself crying uncontrollably on the couch in the dead of night. Or at the very least, that if I need to cry, that’s OK, too. I hope I remember that there are people I can lean on, if I need to.

Here are some mental health resources across Canada:  

• If you are in crisis and need immediate support, dial 911 or head to Wellness Together Canada for crisis numbers.
• Check out a comprehensive list of where to find free and accessible mental health care across Canada here.
• “Tolerance for Uncertainty: A COVID-19 Workbook” includes healthy coping ideas with templates, information about emotional awareness and mindfulness practices.
• For app-based mental health support, try MindBeacon Stronger Minds, a free resource to all Canadians that has workbooks and information informed by evidence-based strategies and psychology to help alleviate stress due to COVID-19. Others apps to check out include MindShiftCBT, ClearFear and Moodpath.
• The Canadian Mental Health Association has tips to manage mental health during COVID-19 and offers support through its BounceBack program.