Some doctors are starting to see major psychological effects of the coronavirus pandemic lockdown as patients cope with months of isolation, job loss and life changes.
Doctors in the Baton Rouge area are reporting an increase of patients with weight gain, anxiety and depression, alcohol use and sexual dysfunction as the prolonged stresses of the virus impact even those who have not been diagnosed with COVID-19.
Vicki Munson, a Baton Rouge General primary care physician with a clinic in Zachary, said patients who have never before reported mental health concerns have been presenting with anxiety about their current situation. Many have an increase in blood sugar and blood pressure, weight gain resulting from a combination of eating poorly and many gyms being closed, or exacerbation of chronic conditions.
“It’s a vicious cycle,” she said.
Gov. John Bel Edwards issued a statewide stay-at-home order March 22. Though the state has slowly loosened restrictions, businesses, schools, houses of worship and other places are not back to their pre-coronavirus operations.
Social distancing measures and mask-wearing are still strongly encouraged, and many Louisianians have been living their new normal for more than three months now.
During that time, a lot of patients avoided doctors’ offices for minor medical issues or annual physicals, said Ochsner physician Chad Braden, who’s begun seeing almost as many patients as prior to the pandemic at his office at The Grove in Baton Rouge. He’s been seeing the same anxiety and depression as other doctors in the area.
“It’s not just because of fear of the pandemic, it’s all the changes in people’s lives; they’ve been living with them for a while now,” he said. “A lot of folks who would come in with one or two problems now have 10 concerns mostly related to how they’re living now.”
People are having difficulties sleeping, staying motivated to work out while gyms are closed and have been eating poorly for comfort or convenience, the doctors noted. Also, people are more distracted while working from home as anxiety impacts their ability to do their jobs, and some have been turning to alcohol as a way to cope.
Those with chronic conditions to monitor, like diabetes, blood pressure or mental illnesses, have in some cases had lapses in medication compliance and medical appointments despite an increase in virtual and telehealth visits.
“We know that poorly controlled hypertension, diabetes and worsening obesity are risk factors for those patients that are doing poorly with COVID-19,” said Lauren Barfield, an Our Lady of the Lake physician. “If they’re not getting regular check-ups and aren’t following up, then they don’t have a handle on it, and when compounding that with depression and anxiety, it makes it even worse.”
As for new patients seeking help for anxiety and depression, Barfield said, some are seeking virtual visits for those issues. But most are still very private about their personal life and how they’re coping.
“Most people don’t even realize how much (stress and anxiety) impacts their health and general well-being, but we pick up a lot from just walking in with a patient like if they’re looking tired, slumped, how they walk in and how they talk,” she said.
Barfield emphasized the importance of finding a consistent primary care doctor who follows your health over time to identify those changes.
Some doctors and counselors are seeing patients reporting everything from erectile dysfunction to relationship issues and even fertility problems.
“People are for the first time in a very long time looking at relationships through a different lens,” said New Orleans-based counselor Brian Knight, who specializes in sex therapy.
“Before, we were burdened by the daily grind, mortgage payment, kids, and sex was a small part of that; but with all this closeness and people participating in isolation, it gives them pause and time to reflect on their relationship.”
He said couples that may have been going through a rough patch pre-pandemic are likely now at a make-or-break period where isolation could bring them closer or be the final straw. He said patients with sexual performance issues as a result of the coronavirus will likely be common especially the longer the pandemic drags on.
“It’s nothing to do with the performance in the bedroom but everything to do with the thousand things going on outside of it,” Knight said.
Tracy Carlson, another New Orleans-based therapist, said she’s been following studies done at the Kinsey Institute at Indiana University as they survey the impact of coronavirus on relationships, sex and mental health.
“We don’t know what’s going on with this virus, people are losing their jobs, they can’t go to school, can’t socialize; it’s really uprooting this way of life,” she said. “We’re used to looking at things through an individual lens, but now in this situation, it’s a collective lens.”
Added to that are a likely decrease in privacy with every family member at home all the time, Carlson said. And then there are stressors like the savings account dwindling while the mortgage is due.
Carlson suggested reaching out to a counselor to find coping mechanisms. She personally is doing all her sessions online, she said, as are many other providers.
The doctors and therapists universally agree that a healthy diet and exercise are among the most important elements to stay consistent with throughout the pandemic to combat the everyday stress and anxiety of life.
Some recommended mind and body activities like yoga and finding someone to talk to regularly, particularly for those people who live alone.
Now that restrictions are lessening and virtual visit capabilities are increasing, it’s important patients not suffer needlessly with issues they think could be minor like chest pain, headaches and shortness of breath, said Munson, the Baton Rouge General doctor. Those symptoms could be linked to anxiety or a more serious underlying medical issue.
“At first, a lot of people were scared to go in and get treated for those non-corona things, but in the long term, they’re doing more damage,” Munson said. “We don’t want to see them go untreated for an unrelated condition, and then it turns into a major condition.”