Community Mental Health and Wellness Coalition

Seasonal strain: Dealing with the winter blues

There’s no question that the pandemic has spiked everyone’s stress level. Millions of people have lost jobs. Parents are struggling to balance work lives with kids’ remote learning. Many have been stuck inside their homes for months, away from loved ones. And on top of all of that, coronavirus cases and deaths continue to increase every day.

According to local mental health experts, this upcoming winter will bring a whole new layer of stress.

While many have been able to safely do activities outdoors during the summer and fall, “in the cold months people tend to stay inside more,” says Varinia Garcia Anderson, a licensed professional counselor at The Women’s Initiative. “People can’t get out…and that’s a lot of pressure on the system of your well-being.”

Being stuck inside can have a significant impact on mood and behavior, even in normal winters, explains Anderson. It can decrease motivation and energy, making it challenging to get anything done, as well as increase feelings of loneliness and isolation.

Winter also means fewer hours of daylight, which has real consequences for mental health. Sunlight triggers the release of mood-boosting serotonin in the brain, meaning short, dark days are hard for everyone, says licensed clinical social worker Eboni Bugg, who practices in the Charlottesville area.

To get through this stressful season, Bugg encourages everyone to safely spend time outside as much as possible during the day, which helps the body to produce vitamin D, boosting our mood and immune system.

For people of color, getting sun may not be enough to maintain healthy vitamin D levels, explains Bugg.

“For Black and brown people, I encourage folks to check with their physician and check their vitamin D level,” she says. “Because our melanin protects us from the sun, it also limits our capacity to manufacture vitamin D in our skin.”

When it’s not possible to go outside, it’s important to find ways to exercise every day, which naturally helps fight depression.

Regularly indulging in activities “that make you feel good” can also help to relieve winter stress, such as listening to music, reading, cooking, and watching movies, says Anderson.

Though it can be difficult during this time, try to “maintain hope [by] cultivating a practice of gratitude,” adds licensed clinical social worker Joanna Jennings. “Really think about the small things in life that bring you joy or peace, sometimes even writing them out.”

Getting a pet can help too. “Finding something else to care about sometimes can really refocus your energy,” says Bugg.

Most importantly, people should prioritize staying connected with family and friends, and being there for each other through this difficult winter, say all three therapists.

“COVID has really increased disconnection amongst us, but there are still ways we can facilitate connections that are safe,” says Jennings.

Keeping in touch is also the best way to support a family member or friend who is under a lot of stress. That might mean a regularly scheduled phone or video chat, or a socially distanced activity together, preferably outdoors.

“For people who have a loved one who may be suffering, sometimes the concern is that you have to be an expert [and] help them fix it,” says Bugg. “The reality is that most people really just need someone to see them, listen without judgment, and love them unconditionally.”

Of course, these simple practices might not be enough to relieve stress or other mental health struggles.

According to mental health experts, you may be in need of professional help if you experience drastic changes in appetite, sleeping patterns, and energy levels for more than two weeks. Overwhelming anxiety and sadness, feelings of withdrawal, and acts of self-harm are also major causes for concern.

“If a person is really noticing a change…it’s never too early to reach out to a professional,” Jennings stresses. “Oftentimes we are able to catch something early and put supports in place to prevent it from escalating to a serious mental health condition, or to the point of a crisis.”

Free and affordable mental health care is available through multiple community providers, including Region Ten, The Women’s Initiative, Charlottesville Free Clinic, On Our Own, Central Virginia Clinicians of Color Network, and Partner for Mental Health.

The Community Mental Health and Wellness Coalition—a network of health organizations in Charlottesville and the surrounding counties—will also be offering no-cost support groups and events online during the holiday season.

“There are people who are really here to support those who need help, [regardless] of money,” says Anderson. “You are not alone.”

Desperate: Drug overdoses increase locally since onset of the pandemic

By Claudia Gohn

From April 1 to July 31 of this year, emergency teams responded to 27 opioid overdoses in Charlottesville—a 200 percent increase in cases compared to the same time frame in 2019, reports the Charlottesville Fire Department. Health professionals believe the stress of the pandemic is one factor responsible for the increase.

Other areas in the state are struggling with similar problems. Arlington County police issued a warning last week after five people died from drug overdoses in August. In Roanoke, police responded to twice as many fatal drug overdose calls this spring as they did in all of 2019, reports The Washington Post. And NPR reports that nationwide, overdoses are up 18 percent since the pandemic began.

The local increase in opioid overdose calls comes despite an overall decrease in the amount of emergency calls this year, says Lucas Lyons, the Charlottesville Fire Department’s systems performance analyst. Total emergency calls in the city were down 23 percent in the period from April to July 2020, compared to the same months in 2019.

“In general, 9-1-1 calls are down because of people’s fear of the pandemic and not entering the medical system,” says the Community Mental Health and Wellness Coalition’s Rebecca Kendall. “But there is an increase in Charlottesville in calls for overdose despite that.”

Virginia Leavell, chief of the Charlottesville-Albemarle Rescue Squad’s board of directors and director of Addiction Allies, a treatment center for people with opioid use disorder, attributes this increase to the isolation and decreased access to in-person recovery services many have experienced during the pandemic. “I think when we are looking at why there is some increase, it’s somewhat predictable, right?” Leavell says. “We’ve taken away the support structure and we’ve added a whole lot of stress.”

Leslie Fitzgerald, care coordinator for Region Ten’s office-based opioid treatment program, echoes Leavell. “The isolation, the increased depression and anxiety has led to increased use,” she says.

As a result, treatment and recovery services for people with substance use disorder remain vital. In March, C-VILLE covered how recovery groups, such as Alcoholics Anonymous and Narcotics Anonymous, have transitioned online during the pandemic. Similarly, some treatment and recovery services for those with opioid use disorder have shifted online.

“It’s not the same level of support that you would have if somebody was coming into the office, honestly,” Leavell says of the virtual options. “And it makes things like urine drug screening more difficult, as well.”

But Leavell also says that telehealth services have made it possible to see new patients. This spring, enrollment in Addiction Allies’ intensive outpatient program has tripled. “Which I think speaks to both the increased stress and the increased use [of substances] during this time, but also the importance of the telehealth service delivery in order to reach people who are having transportation issues [and] childcare issues,” she says. “Everything is easier if you can access treatment from your home.”

The OBOT program has retained almost all the individuals under its care during the pandemic, says Fitzgerald. A central component of the program is medication-assisted treatment, where drugs such as methadone, buprenorphine, and naltrexone may be used to reduce dependency.

This medication-assisted treatment can be done via telehealth, Fitzgerald says, and prescriptions are sent to the patient’s pharmacy of choice or delivered by Region Ten if necessary.

Leavell says that medication-assisted treatment through telehealth, though not ideal, is safe. “When we’re talking about opioid use disorder, it is a very, very uncomfortable withdrawal,” she says. “However, it is unlikely to be lethal and the transition from using opioids to moving into medication-assisted treatment, such as the use of buprenorphine is typically fairly smooth.”

Other services combating the opioid crisis have also been impacted by the pandemic, and Region Ten offers free opioid reversal training classes, which have been moved online, and participants now receive Narcan through the mail.

Leavell emphasizes that, given the emotional and financial strain of the pandemic, it’s especially important to be aware of the causes of opioid addiction. “There’s a misconception that addiction couldn’t happen to someone like me or my family. And the reality is that it can absolutely affect anyone. It is just a matter of being prescribed an opioid and becoming physically dependent,” she says. “And if we’ve been fortunate enough not to experience that, I think we have responsibility to help those who have through no fault of their own, through making those resources accessible and being willing to talk about it.”

Correction, 8/19/20: Virginia Leavell is the chief of CARS, not the president, and buprenorphine, not Narcan, is used for medication-assisted treatment.