How Are You? A Critical Question—Especially During the Pandemic

^{By: Yvette C. Terrie, BS Pharm, RPh, Consultant Pharmacist}

We say the three simple words, “How are you?” several times a day as we go about our daily lives and as we interact with our family members, friends, colleagues, patients, and neighbors. These days it is a critical question for our fellow human beings as we continue to live through the ongoing COVID-19 pandemic. The CDC indicates that anxiety disorders and depressive disorders increased substantially in the US during April 2020 to June 2020 compared to the same time frame in 2019.¹ In addition to the stress and uncertainty of the pandemic, the unrest in our country and world adds more stress and anxiety to our lives. It is very concerning to read about and hear firsthand about the soaring rates of depression and anxiety during these times. In conversations with other healthcare providers (HCPs), many are experiencing extreme amounts of stress since the dawn of the pandemic for several reasons. For example, many HCPs are overworked due to the pandemic, many are encountering patients who are frustrated because of the pandemic and many have seen elevated morbidity and mortality rates due to the virus and an influx of patients presenting with exacerbated conditions such as CHF, renal failure, diabetes, cancer etc. Many of these exacerbations were the result of delays in diagnosis and treatment because their patients were fearful of getting COVID-19 and did not seek medical attention until the symptoms worsened. In a recent conversation with a nurse, she mentioned that she was seeing an upsurge of cases of substance abuse (alcohol and drug overdoses), depression and anxiety. For patients and society as a whole, the uncertainty and stresses stem from various factors including physical health, financial woes and mental health.

To date, the health care system does not really know the true impact of the pandemic on society, but effects are gradually being revealed and it is imperative that health care professionals do their best to identify and address the effects. According to a survey conducted by the CDC, which was published on August 14, 2020, the pandemic is having a considerable impact on the mental health of Americans.¹ The survey revealed the following information of those surveyed:

• An estimated 40% of US adults reported struggling with mental health or substance use.
• 31% have symptoms associated with depression and anxiety
• 13% initiated or increased substance use.
• 26% are experiencing trauma/stressor related disorder symptoms (PTSD like symptoms)
• 11% seriously considered suicide.
• More than 50% of essential workers reported at least one adverse mental or behavioral health symptoms and 22% reported suicidal thoughts.
• Symptoms of a COVID-related trauma and stressor-related disorder and increased substance use were more prevalent among essential workers than nonessential workers
• The survey also indicated that 75% of respondents 18-24 years reported at least one adverse mental or behavioral health symptom and serious suicidal ideation among this age group was 25%.¹

The sobering results from this recent CDC survey have clearly shed light on the need to assess the impact of this pandemic on mental health as well as the impact of the disruptions to life as we once knew it and the ongoing uncertainties. I hope that we all understand the detrimental effects that the pandemic has had on mental health and acknowledge that everyone has experienced some degree of mental stress. The other day, I held the door open for an elderly woman and she seemed surprised at the gesture. She said, “Thank you so much for your kindness!” I responded, “No problem! Ma’am, the only way we are going to get through this pandemic is together and we need to be kind to one another.” and she simply responded with, “Amen to that, my dear!”

As pharmacists, we need to seize every possible opportunity to ask our patients the simple question, “How are you?” and truly listen to them. I think you will be amazed at how valuable those words are especially during the pandemic. As one of the most accessible healthcare providers, pharmacists should encourage those experiencing mental health issues to seek help from their primary healthcare provider and remind them that they are not alone and that resources are available to support them. We can also direct them to the CDC resources for handling stress during the pandemic such as https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html or Mental Health America at https://mhanational.org/covid19

Recently, I read an inspiring quote and it said the author was unknown, but it read, “Kindness is a wonderful way to let another struggling soul know that there is still love in this world.” During these challenging times, it is indispensable. Let us all aspire to be sources of hope for those around us and remember to take care of ourselves and our loved ones because sometimes the best medicine is empathy and compassion for others.

Yvette C. Terrie, Consultant Pharmacist, Medical Writer and creator of A Pharmacist’s Perspective (https://apharmacistsperspective.blogspot.com/).

Reference:

1. Czeisler MÉ , Lane RI, Petrosky E, et al. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1049–1057. DOI: https://dx.doi.org/10.15585/mmwr.mm6932a1.