A Therapist Answers: How Does COVID-19 Affect People With Mental Illness?

这COVID-19 pandemic迫使美国人民面对一系列压力源— job loss, isolation, and economic uncertainty — all at once. This abrupt change will undoubtedly have a significant impact on the mental health of the average person but will likely be particularly hard on those with preexisting mental health conditions. In fact, a recent survey-based研究被接受美国精神病学杂志on April 14发现在中国锁定期间，超过20％的患有先前心理健康状况的受访者感到他们的症状恶化。作为治疗师，这告诉我什么？我们 - 治疗师，家人和朋友 - 应该为某些人准备额外的帮助做好准备。这是vwin德赢app苹果大流行可能会影响最常见的精神疾病，以及应对它们的一些技巧。

Everyone is worried about germs at the moment. The fear of getting sick with COVID-19 is a lot for the average person to cope with, but it’s even trickier for someone who is predisposed to obsessive (intrusive and unwanted) thoughts or compulsions (irresistible urges). Obsessions over germs and the compulsion to clean are already among the most common features of obsessive-compulsive disorder (OCD), so it’s no surprise that many患有强迫症的人想知道他们目前对消毒的冲动是正常的还是诊断的结果。（（1) If attempts to clean less cause significant anxiety, if you are having physical problems like cracked skin due to washing too much, or if you are consistently getting into arguments with your loved ones over cleanliness, the behavior is likely a result of your OCD and not a healthy adaptation to the times.

如何应付

这best way to deal with OCD is to allow yourself to feel uncomfortable while not giving in to your urges. (Easier said than done, I know.) Obviously, some increase in handwashing and cleaning is necessary during this time, so it is a little complicated to know which behaviors to give up and which to keep. Talk to a trusted friend, family member, or healthcare provider if you need help figuring out which behaviors are unhealthy. If you feel comfortable, ask a partner or roommate to help keep you accountable in not giving in to your urges. If you are not able to see your mental health provider often due to the pandemic, explore other tools: Some of my clients have found it helpful to use the support features available through the appnocd在会议之间。

Learn More About Obsessive-Compulsive Disorder

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有许多焦虑类型。这most common form is广泛性焦虑症（GAD），这是过分且持续担心的生活的各个方面，通常包括健康，人际关系和财务状况（所有这些都可能受到这一大流行的负面影响）。除了增加现有的烦恼外，由于涉及多少不确定性，因此对于患有GAD的人来说，这一大流行还很难。什么时候结束？会回来吗？我会生病吗？我会失业吗？以我的经验，让GAD的人通过反省最坏情况并不断为其计划来应对这种不确定性。这是压力且疲惫的，通常会导致身体健康症状，例如胃痛或头痛，睡眠麻烦以及处于边缘的感觉。

如何应付

For starters, empower yourself. Think of a time you had a setback and handled it as a reminder that, although you may not be able to anticipate everything that happens in life, you will probably be able to handle stressors as they come up. Next, shift your focus of worry to what you can control instead what you cannot. For example, if you are worried about your finances, shift your focus from “Will I lose my job?” (which you cannot control) to “Let me make a budget and spend my money wisely” (which you can control).

如果您仍在担心无法控制的事情，请每天计划5到10分钟，以“担心时间”。当思想在白天弹出时，提醒自己要等到担心时间关注它们。然后，在担心的时间里，将所有的烦恼写在纸上。我做了许多练习的人最终意识到他们一直都在担心同样的事情，并且通过预留时间真正专注于他们，有些人甚至对同样的旧烦恼感到无聊。

当您想到忧虑想法弹出时，所有这些练习都会更容易。这使您可以处理忧虑的火车接近时，而不是被它带走。如果您是正念的新手，建议您尝试一个免费的冥想应用程序，例如我的生活要么aguided meditation播客，例如塔拉·布拉奇（Tara Brach）。

Learn More About Anxiety Disorders

有关的：关于如何处理焦虑的12个问题

Post-traumatic stress disorder（（PTSD) is a mental health condition triggered by experiencing or witnessing a terrifying event. Symptoms include trouble sleeping, unwanted thoughts of the event, severe anxiety, and flashbacks.患有PTSD的人被认为具有更大的压力反应（通常称为“战斗，飞行或冻结”）。日常生活可能会使PTSD患者筋疲力尽，因为他们不断感到自己受到威胁，尽管没有真正的威胁。在大流行期间，这尤其有问题，因为威胁似乎无处不在，甚至是杂货店。除此之外，取决于造成PTSD的创伤，该大流行的其他特征（例如死亡的报道，隔离或可能的生存罪恶感（内gui，您健康而其他人都患有严重患病）也可能会夸大PTSD症状。

如何应付

如果您感到最近的事件触发，请与值得信赖的亲人或您的心理健康提供者联系。注意触发症状的原因。例如，如果新闻限制了您每天观看和阅读一次的数量，则几分钟，这足以需要知道的更新。确保您参与自我护理including exercise, eat three nutritious meals daily, and make time for hobbies you can do from home or while social distancing.

Learn More About PTSD

仅此大流行的压力和担忧就会导致抑郁发作，以低情绪，对活动的兴趣很小，自我价值感，自我价值低，疲劳，注意力减弱，睡眠不安，食欲不振或经常性思想，对活动的感觉很少，感受感受，感情疲劳，疲劳感下来。死亡。对于以前从未经历过抑郁症并且在患有重度抑郁症病史（MDD）的人更有可能的人来说，这是正确的，其特征是五个或更多的抑郁症状，为期两周或更长时间。由于我在容易发生抑郁症的客户的经验中，情绪遵循行为。实际上，一个普遍treatment for major depressive disorder是行为激活，通过让一个人奖励事物来治疗抑郁症，例如与朋友接触，锻炼，在自然界中度过时间或完成工作项目。人们更加孤立且能力较低的事实可能导致抑郁症。

如何应付

您可以使用“焦虑”部分中列出的相同技术来试图管理压力。vwin app此外，请坚持健康的例行程序，尤其是近似您感到满意的活动的活动。这可能需要一些创造力。例如，如果您曾经在健身房锻炼，现在不能去那里，仍然可以花时间锻炼。如果您错过体育课，请尝试在线健身课。如果您是社交人，请通过Zoom主持早午餐或开胃菜。

Learn More About Depression

有关的：研究表明，吸烟增加了抑郁症和精神分裂症的风险。

People with躁郁症经历抑郁发作（如上所述）和躁狂发作，这些发作是由极端的幸福或易怒，缺乏睡眠，能量增加和活动增加的划分。这种大流行可能会以相同的方式恶化双极抑郁症，使单极抑郁症（也称为MDD，如上所述）。明显的压力类似地导致躁狂症状。此外，如果患有双相情感障碍的人会由于大流行而大大改变其例程，尤其是如果他们睡得很少，他们就有躁狂发作的风险。

如何应付

Routine! Routine! Routine! Try your best to stick to a routine, especially going to bed and waking up at about the same time. Avoid behaviors that can interfere with sleep before bed, like reading news updates on your phone. Avoid using substances, like alcohol, to help with sleep or manage stress, as those can lead to mania in people with bipolar disorder.

了解有关躁郁症的更多信息

在整个大流行中，酒类商店被认为是必不可少的，尽管许多企业遭受了苦难，但据估计，与去年这一时期相比，酒类销售额增长了55％。（（2）很明显，无论是否饮酒障碍，人们都在使用更多的酒精 - 以及其他物质，例如marijuana- 打击这种大流行并呆在家里的压力和无聊。

People who misuse substances, defined by an inability to control use and having substance-related health or social problems, may be using more substances than usual, and people who are sober may be struggling to maintain sobriety. Whether you have been diagnosed with an alcohol use disorder or not, it is important to be mindful of how much you are drinking because alcohol can cause sleep problems, lead to depression, worsen anxiety, and over the long term, have health consequences, such as increasing the risk of a number of cancers.

如何应付

如果您担心使用物质可能会出现问题，或者您的朋友或家人不断告诉您可能是有问题的，则应尝试停止使用一段时间。如果您在没有实质的情况下变得易怒或焦虑，并且不使用努力，则可能需要医疗保健提供者的支持。如果您想戒酒并体验戒断症状，​​请与您的医疗保健提供者联系，作为戒酒can be fatal. If you are currently sober and struggling, keep in mind what helped you achieve sobriety. Whatever coping skills you used previously, try to continue. Reach out to a loved one for support. In a time of isolation, it may also be helpful to reach out to a community, like Alcoholics Anonymous or The Tribe (a free online wellness community with a number of peer-to-peer support groups, including one for addiction).

有不同形式的饮食，例如厌食，，，，贪食症，，，，和binge eating. In my experience treating people with饮食失调，，，，having a sense of control is a common theme. Many people are struggling now with the lack of control we have over what is happening, how it is being handled, and how long the situation will last. Someone with an eating disorder may experience a worsening of symptoms in an attempt to gain back some control. Additionally, a person prone to binge eating may be turning to food to cope with stress.

如何应付

练习接受自己和无法控制的事情可能有助于防止症状恶化。这并不意味着您决定不改变自己或处境的任何事情；这只是意味着您正在允许目前的时刻，因为它是没有判断力的。如果您遇到的饮食失调恶化，请与您的辅导员接触或精神科医生。

了解有关饮食失调的更多信息

People diagnosed withattention deficit hyperactivity disorder（ADHD）可能在注意力，专注，计划，静止和冲动控制方面遇到麻烦。对于某些人来说，这种新的在家上班或上学的方式可能会有所帮助，使他们可以在自己的时间内做事并休息一下。对于其他人来说，缺乏结构可能会使注意力问题恶化，并导致拖延和生产力。

如何应付

If you are struggling to stay focused, create a schedule and to-do list each night for the following day. Include time for meals, work, and downtime. Scheduling downtime will allow you to indulge a bit throughout the day without wasting too much time talking on the phone or scrolling through social media. Also, be specific. For example, instead of writing "Do work,” actually write the items you want to accomplish. Many people find it helpful to schedule a challenging or boring task before something fun or relaxing, like a meal or a planned phone call with a friend. This provides a little incentive to get through the task.

Keep in mind that the medications commonly used to治疗多动症- 刺激剂，例如哌醋甲酯（Adderall要么利他林） - 会使焦虑恶化。因此，如果您患有多动症，并且由于Covid-19而感到比平时更担心或焦虑，那么您应该与提供者谈论这些新的或恶化的感觉。

了解有关多动症的更多信息

精神分裂症和delusional disorders both have the presence of delusions (beliefs that are firmly maintained though they go against facts or norms) as a common feature. These disorders are not as common as the other disorders listed here, but they, too, can be easily exacerbated during the pandemic. Some people may become convinced they have contracted COVID-19 even if there is no evidence supporting this. Additionally, just searching the news or social media, you can see a number of conspiracy theories that have arisen since the start of the COVID-19 pandemic. Further, the effects the pandemic is having on the availability of common household products and medical supplies (such as masks) can lead to mistrust of one another and authorities. All of these can be challenging for someone who is already prone to suspicion.

如何应付

通常，有妄想的人没有意识到这一点。如果您担心自己喜欢的人，请尝试理解。坚定地告诉他们他们错了，这将行不通，可能会导致他们感到更受威胁。如果您担心妄想思想正在干扰他们的行为，请帮助他们与提供者寻求帮助。如果有即将出现的安全问题，请致电911。

Learn More About Schizophrenia

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Not only can the COVID-19 pandemic worsen symptoms of various mental illnesses, it can also make it more difficult for people to get the care they need. For example, many patients do not want to go to clinics or offices to get care out of fear of getting sick. If you are worried about this, ask your mental health provider about virtual visits (called远程医疗）。理想情况下，这是通过视频和音频进行的。但是，如果您的心理健康提供者没有设置此设置，或者对您来说太棘手了，请询问简单电话的可能性。

与您的提供者讨论症状的任何恶化。现在，许多医院挤满了可能有COVID-19的人，与您的提供商一起工作很重要，需要期待潜在的危机，希望在医院之外进行管理。vwin app当然，如果您感到不安全，则可能有必要去医院。如果可以的话，请致电您的提供者，他们可能能够帮助您选择一家人拥挤的医院或医院，该医院的心理健康危机区域与身体病患者分开。

除了担心获得护理的机会外，有些人还担心使用他们的药物。鉴于在其他国家 /地区制造了药物中使用的某些成分，因此随着各国处理大流行，药物的供应可能会破坏。尽管没有常用的精神病药物，例如选择性5-羟色胺再摄取抑制剂，，，，have yet to be in short supply, if you are stressed about the availability of your medication, ask your doctor about a 90-day supply of medication instead of a 30-day supply.