Feeling “Off” Lately? 5 signs it’s time to reach out for help

Man sleeping to cope with anxiety, sadness and other grief.

If you’re feeling a little “off” during the global pandemic, you’re not alone! But how do you know when those feelings are cause for concern? We help you identify the signs.

According to a recent poll by KFF, 45 percent of U.S. adults say COVID-19 has hurt their mental health.

“Increased anxiety, sadness, and even grief is normal during these trying times,” says Dr. John Koutras, a clinical assistant professor of psychiatry at the University of Vermont Medical Center and a medical director at Blue Cross Blue Shield of Vermont. “It’s not unusual to be feeling a little ‘off.’”

Fear, uncertainty, and disruptions to our routines are some common sources of pandemic stress. “Physical distancing,” which reduces the spread of the virus, can also increase feelings of isolation and sadness.

To help stay balanced throughout the stress of the pandemic, experts recommend making time every day for wellness activities like:

  • Movement and outdoor activity
  • Regular sleep, ideally 7-9 hours per night
  • Healthy meals that include plenty of vegetables, fruits, and other whole foods
  • Relaxation techniques like mindful breathing or meditation such as loving-kindness meditation
  • Social connection with other people

“It’s crucial to make healthy choices and to maintain a sense of social connection during this time,” says Dr. Koutras. “Our relationships are a source of collective strength.”  

Dr. Koutras says it is especially important for people with a history of depression, anxiety, substance use disorders or other mental health conditions to maintain their personal wellness routines and continue with existing treatment during times of increased stress.

When to seek help

If you have been experiencing any of the following five signs, please reach out to your health care provider:

  1. Newfound difficulty concentrating on everyday tasks or leisure activities, which persists from day to day and continues throughout the day
  2. A persistent change in your sleep pattern for 2 weeks, with either difficulty falling asleep, or waking up much earlier than you intended
  3. A persistent decrease in appetite for 2 weeks, often resulting in weight loss
  4. A feeling that you are using too much alcohol and/or cannabis, or someone telling you to cut back on your use
  5. Repeated or persistent hopeless thoughts about living your life

Some thoughts and feelings require even quicker action.

“If you are having thoughts of self-harm, reach out to someone you trust and contact your healthcare provider as soon as possible,” says Dr. Koutras. “And if you are considering acting on these thoughts, don’t wait— contact your provider to let them know and go to the emergency room.”

Special considerations for health care workers and other frontline personnel

Health care workers and other frontline personnel are at high risk of experiencing pandemic-related mental health distress. Increased threat of exposure to infection and long hours under difficult working conditions are just a few of the added stressors that this group is facing. Those who have lost patients or co-workers to Covid-19 may also be grieving for those who have passed.

If you are a health care worker or another person on the front lines, it is especially important to reach out to your colleagues for shared support and take steps to actively maintain your wellness as you get through this difficult time.

Acute Stress Disorder and PTSD

Those who care for critically ill or dying COVID-19 patients or who have contracted the virus while on the job may also develop post-traumatic stress disorder or acute stress disorder.

Acute and post-traumatic stress disorders occur when exposure to the threat of death or risk of serious harm causes a disruption in your “fight or flight” response.

Contact your health care provider if you have been exposed to the threat of death or risk of serious harm during COVID-19 (such as caring for critically ill patients or contracting COVID-19 yourself), and are experiencing most of the following signs/symptoms for at least 3 days:

  • Experiencing intrusive memories or nightmares
  • Avoiding activities, people, places, or thoughts that trigger memories or fear related to the event
  • Persistent feelings of being scared or more easily startled
  • Experiencing negative changes in thinking or mood
  • New irritable behavior and angry outbursts or experiencing other new physical and emotional disruptions

And remember, if you are diagnosed with an acute stress disorder, this does not imply that you will develop post-traumatic stress disorder, but it is important to get the support you need. There are evidence-based treatments available that can help. 

Resources for Help

If you or a loved one has persistent feelings of hopelessness, don’t wait to reach out for help. You are not alone.

  • Crisis Text Line: Text “VT” to 741741 (available for any kind of crisis, 24/7)
  • Dial 211 to be connected to mental health services in your area
  • The National Suicide Prevention Lifeline is available 24/7 at 800-273-8255
  • Vermont Peer Support Line is available 24/7. Call or text 833-888-2557
  • If you have questions about any of these or other programs, email the Vermont Department of Mental Health at AHS.DMHCOVID19Info@vermont.gov.