Coronavirus has disrupted every aspect of our society, including individuals, communities, businesses and government. People’s reactions to these disruptions can be adaptive or maladaptive.
Physical isolation, widespread job loss, limited resources for testing and treatment of the virus, and the illness and deaths of friends and family cause emotional distress in even the most resilient of us. But the response is maladaptive and harmful for some people. Coronaphobia, an emerging phobia specific to the virus, is described as a maladaptive reaction to the virus.
Up to one in four Americans are suffering from this new diagnosis, according to recent studies. The psychologic impact of coronavirus is affecting both the general population and people with pre-existing mental health problems. This global pandemic is causing fear, anxiety, and distress in our friends, family, peers, patients and perhaps in ourselves. Unfortunately, our mental health system, which was unprepared for substantial pre-COVID mental health needs, is unlikely to be prepared to respond to the new mental health needs of coronaphobia.
How do we diagnose coronaphobia?
Coronaphobia is currently considered an adjustment disorder. For many of us non-psychology clinicians, diagnosing adjustment disorders is somewhat confusing since there is a lack of valid and reliable screening modalities for these disorders.
Binge TV watching, purchasing unusual quantities of Lysol, having a few more cocktails each week, boredom, and feeling somewhat nervous are not really maladaptive behaviors. Some signs associated with corornaphobia include:
- phobic anxiety
- new onset insomnia
- obsessive behaviors
- avoidance reaction
- suicidal ideation
Superficially many of these “signs” seem somewhat normal considering this formidable, potentially deadly disease, but for people with coronaphobia, the response is maladaptive and harmful.
The impact on society
The virus is also having a disproportionate effect on people suffering with Alzheimer’s, disabilities, eating disorders, autism, depression, substance abuse and other pre-existing mental health conditions. Children are also more likely to develop stress disorders with the disruptions in education and social interactions as well as secondary to significant changes in household dynamics. Parents frequently underestimate their children’s distress and physicians need to encourage open discussion regarding children’s reactions and concerns.
People who have contracted the disease and those at higher risk of the disease are also more vulnerable to mental health conditions. There is a psychological toll on low income individuals without access to personal protective equipment whose jobs require face to face contact (transportation, food supply, janitorial services etc.) as well as frontline health care workers. These essential workers are experiencing increased and stressful workloads while being exposed to the virus.
Clinicians should be cognizant of these vulnerable populations and screen for mental health problems exacerbated or caused by the pandemic. After assessing patients for mental health changes due to coronavirus, what can physicians advise patients and caregivers?
Some patients with obvious significant depression or anxiety and maladaptive behaviors will need referral for mental health evaluation and care. Fortunately, psychiatric support services have become remote during COVID and this has helped with accessibility.
Patients with mild psychosocial stress may be relieved to hear from a physician that their reaction, such as mild anxiety, is common during a devastating period such as a pandemic.
Physicians can offer suggestions of stress management and wellness techniques that enhance coping such as maintaining daily routines, exercising, limiting exposure to pandemicrelated news, and learning relaxation techniques. Social and mental health services should be provided to patients in need of psychosocial support