Pandemic Aftershocks

A counseling professor examines the mental health impacts of the COVID-19 pandemic.

Assistant Professor Alyson Pompeo-Fargnoli, Ph.D., is a nationally certified counselor and a licensed professional counselor. In April, the peer-reviewed journal Psychosomatics rush published an article, “The Mental Health Impact of the COVID-19 Crisis: The Battle Ahead for Inpatient Survivors,” that she coauthored with her husband, Anthony Fargnoli, Ph.D., associate director of research and development at the New York University Langone Medical Center. We asked Professor Pompeo-Fargnoli how the COVID-19 crisis affects the mental health of different groups, and how healthcare professionals can prepare for this “second tidal wave” from the pandemic.

Is the COVID-19 crisis different from previous health crises like the H1-N1 “Swine Flu” or Ebola?

COVID-19 has received much more media attention than H1-N1 or Ebola, which logged similar death tolls and statistics. Of the three, COVID-19 is the unknown super-spreader, thus inducing more fear. This current crisis also forced much of the industrialized world into various states of quarantine, imposing new challenges to an already stressful pandemic situation. While appropriate caution is necessary because there are still some unknowns regarding the symptoms, transmission, and treatment of the virus, the fear of the general population can be equally debilitating regarding mental health.

How is COVID-19 different from or similar to a non-disease related crisis like the Great Recession of 2007–08?

The similarity is the anxiety driven from the fear of the unknown, and daily updates with sudden changes in mental health status. However, the magnitude of the fear has been reported as greater with a pandemic for a variety of reasons. For example, much of the fear around COVID-19 is a rapid loss of life and tragedy. Furthermore, this fear is experienced amongst a lack of social support. In financial ruin, the pain is real, in some cases equal; however, people have access to their social and family networks. 

Speaking of social and family networks, what are the mental health impacts of things like quarantine and social distancing for those who don’t have COVID-19?

In general, people thrive from social interactions, yet times of quarantine can prohibit this. People may feel lonely and at a loss for the support systems that they previously depended on. In addition, the concerns and fears of COVID-19 may cause fear and worry, changes in sleeping and/or eating, increased drug and alcohol use, and other negative coping mechanisms. All of these things may ultimately result in mental health issues like depression and anxiety. Individuals that already have existing mental health problems are at a greater risk during these times of high stress and reduced support.

Can you address the mental health impact of potential bias and stigma against those who test positive for COVID-19?

When people fear something that they do not fully understand, stigma often results. People may also stigmatize certain groups because of misplaced anger for a situation, such as the COVID-19 crisis. Unfortunately, those that have tested positive for COVID-19 may be at the receiving end of this stigma, which can have mental health impacts such as feelings of isolation and abandonment and even depression. It’s important to realize that stigma hurts everyone, and that prior pandemics have shown that stigma negatively impacts efforts to test and treat people.

How does the mental health impact of the COVID-19 crisis differ for adults and children?

For children, having a dependable daily structure is important, as it signals safety, and contributes to healthy emotional and psychological development. The COVID-19 crisis has caused schools to close, and this has greatly impacted the daily structure for children in that they have been forced from the classroom to homeschooling. Children are also greatly impacted by the stress felt by their parents and guardians. As COVID-19 has placed mental health strains on adults, many children have felt their strain secondhand. Many adults have lost their jobs during this crisis, and this not only causes an immediate financial challenge, but can also call a person’s sense of self and purpose into question. Adults will also have concerns over the safety and health of their family, and uncertainty about the future.

I feel it’s also important to mention the specific college student population.1 The greatest mental health concern that we see with this group is anxiety. The uncertainty and transition during this time can exacerbate this anxiety. Furthermore, college student development often includes building social relationships and determining a sense of self—two things that the quarantine makes even more challenging.

What are the effects of social media during a pandemic like this?

I think social media just adds to the fear. Between the public media and social media, there’s constant talk about this, so people can’t really get away from it. In the journal article I mentioned doing some yoga, meditation, cognitive therapy—some things that can assist in reducing anxiety and reframing negative thoughts. But if the media is constantly throwing it at us, it doesn’t really give our emotional health a chance to re-center, and that can be very detrimental for anxiety and even depression. So people want to just be cautious to not utilize those resources in a way that adds to their fear, anxiety, and depression.

Are there any positive effects of social media during the pandemic?

It can be a great way to keep in touch with family and friends and your support system. We know that one of the reasons why people often struggle with mental health disorders is because they don’t have good support systems. That was one of my concerns during all of this: That here are people that either already have mental health problems, or they’re on the verge of having them, and what was holding them together was having support systems—and now that’s lost. So if they can use social media to have that social support, to not feel isolation, and not feel like they have to deal with this all alone, that’s great.

Are there any positive mental health effects from the COVID-19 crisis in general?

While some individuals deal with mental health issues that are very much medically and physically based, there are some mental health conditions that are brought on by, or worsened by, the way a person thinks about their situation. For instance, some counseling approaches focus on changing one’s cognitions to result in more positive feelings and behaviors. Therefore, as much as possible, individuals might try to view this crisis more as an “opportunity” to do things like spend more time with in-home family members. For example, homeschool their children to include cultural heritage and their own talents; connect with friends and family via phone and the internet; and find new healthy coping strategies like meditation and yoga. Even spending more time with the family pet can elicit some joy right now—and we know that at least the pets themselves are finding some real happiness in all of this extra time that the family is home!

What’s next for your work?

One of my colleagues in the School of Education, Dr. Cathy Wong, and I submitted another article on COVID and the stress and anxiety of parents who now have to homeschool their children, and possibly work from home, as well as juggle the health and safety of their family, financial worries, and more. For example: What are some things that they’re dealing with? What are some tools to help them during that time? The hope is that this article will assist parents and teachers in how to best help students during this challenging time—both from an educational and mental health perspective.

1 For Monmouth students who may be struggling with mental health issues, Counseling and Psychological Services at Monmouth University, located on the 3rd floor of the Student Center, is a free resource to all undergraduate and graduate students. The office’s phone number is 732-571–7517.