Sabine Schmid, PhD, is a clinical psychologist with University of Minnesota Physicians (M Physicians), specializing in depression, anxiety, obsessive-compulsive disorder and stress-related disorders. In her clinical work, she has noticed additional challenges for patients with depression and anxiety during the COVID-19 pandemic, specifically feelings of being overwhelmed, burnout and isolation.

“A lot of what we’ve been seeing is an increase in distress often combined with a decrease in healthy coping,” Dr. Schmid said. “For some, the impact has even been traumatic. There is a lot of diversity in how the pandemic has affected individuals — one person avoids social life and feels lonely, another is angry or frustrated and yet another person loses a loved one or job to the pandemic. The impact of the pandemic is also changing over time. Initially, there was much anxiety and uncertainty about what’s next. With COVID-19 lingering on, many have adapted well to the new normal, while others show signs of chronic stress, frustration, avoidance and depression. Some groups — adolescents and young adults, low socioeconomic status, etc. — are hit harder than others.” 

Dr. Schmid believes fostering resilience is key to coping with distress, uncertainty and loss during the pandemic. According to the American Psychological Association, resilience in mental health refers to the ability to adapt to and “bounce back” from hardships, stressors or other adversities. 

“Being a behavior-focused clinician, I see resilience as skills you can learn and improve on, rather than a stable trait.”

This strategy is not only helpful for those patients who already suffer from mental illness or are at high risk, but for everyone struggling with the stressors of the pandemic. 

“What I have seen in my patients is that many of the cognitive and behavioral skills that patients learned in therapy for depression and anxiety disorders also work for coping with pandemic-related stressors,” Dr. Schmid said. “People who have already been in treatment and have an existing relationship with a mental health professional or support system were a lot better off, whether they had a high-risk disposition or not. Importantly, all of us can benefit from resilience strategies that reduce the risk of developing significant problems.” 

Dr. Schmid refers to the Medical School’s “MN Resilience Program” which features a “battle buddy” plan, adapted from the U.S. Army, and an anticipate-plan-deter model for building resiliency. The idea of a “battle buddy” is to pair individuals who will check in with each other regularly and provide an opportunity to process the hardships of the day. The anticipate-plan-deter model allows individuals to prepare for the stressor and ‘inoculate’ us in order to lessen the impact. Phase ‘deter’ refers to executing the plan and seeking additional help as needed to fend off worst-case scenarios, like burnout or suicidal thoughts.

“Obviously there are many things we cannot control during a pandemic. Our focus, however, should be on what we can control,” Dr. Schmid said. “Maslow’s hierarchy of needs highlights that our basic needs require attention before we can meet higher level needs. For building resilience, we want to care for our body and mind with adequate sleep, nutrition, physical and mental strength training. Further, humans need social connectedness and support (even if there are significant obstacles). Finally, the pursuit of purpose and meaning in life is central to resilience. Specifically, the practices of gratitude, spirituality, time in nature and listening to music can all foster positive emotions and put stressors in perspective.”

Dr. Schmid encourages seeking professional mental health services when circumstances become overwhelming or if you are unable to cope with them effectively. She notes that certain groups — for example, adolescents or disabled individuals — who do not have sufficient coping mechanisms in place may need to seek help earlier than others. Despite COVID-19 related restrictions, the rise in telehealth medicine offers easy and convenient access to professional help.

“Resilience is easier to build than recovery,” Dr. Schmid said. “A lot of the stress of COVID-19 comes from us spending a lot of time worrying about what we cannot control. While this is natural, it is not always helpful. We can turn unproductive worry into productive worry and focus on what we can do. And for the things we can’t control or predict, we practice letting go and acceptance.