Minding Your Mental Health: Dr. Jeffrey Borenstein, President and CEO of Brain & Behavior Research Foundation, on Dealing with Pandemic Stress

January 25, 2021
Dr. Jeffrey Borenstein, president and CEO of the Brain & Behavior Research Foundation, describes the troubling trends in mental health in the wake of COVID-19 and provides a roadmap for thinking about productive coping mechanisms and how to support loved ones.

The COVID-19 pandemic has upended every aspect of the way we live, but it has also had a drastic impact on many individuals’ mental health due to months of heightened stress and anxiety and limited social interaction. To get a better look at the current state of mental illness in the country and what we can do to navigate this time, we spoke with Dr. Jeffrey Borenstein, the president and CEO of Brain & Behavior Research Foundation (BBRF), the largest private funder of mental health research grants.

Let’s set the stage for our conversation. What do the mental health numbers look like in the U.S.?

The number that BBRF and others in the field use is that one in five people, 20% of the adult population, has a psychiatric condition in any given year. If you think about it, one in five people means pretty much everyone knows someone, whether it be a close friend or relative, who is affected by one of these conditions – depression, anxiety, bipolar disorder, schizophrenia, chemical dependency or obsessive compulsive disorder. I know that when I give presentations to large groups, and I ask who has a loved one affected by mental illness, everybody raises their hand. It’s very common.

What trends is BBRF seeing as it relates to mental health during COVID-19? What issues are on the rise?

The stress of this pandemic has really taken a toll on people, and everybody feels it. It has been especially challenging for those who already had pre-existing psychiatric conditions, which stress and social isolation both exacerbate. While people have the benefit of telehealth, it’s different than being able to go into the office and see their psychiatrist or other healthcare professional. There’s also an increase in anxiety and depression among people who haven’t had mental illness issues in the past, so we are watching this closely.

On top of that, so many people have lost loved ones as a result of this illness, which is even more difficult than other situations and is an added stress. First, if your loved one is dying in the hospital, you don’t get to be with them. Then, the mourning process is challenging. Many people died without a funeral because they couldn’t have groups of people together. Even now, funerals may be limited attendance, and you may not have the other activities around the funeral, such as sitting shiva or having a wake. Whatever people typically do to get through the mourning process isn’t available.

The stress of this pandemic has really taken a toll on people, and everybody feels it. It has been especially challenging for those who already had pre-existing pychiatric conditions, which stress and social isolation both exacerbate.

How does this impact vary among age groups?

Different age groups are affected in different ways. This is really hard on kids. In many ways, the work of childhood is social interactions with other children and other people. For younger kids especially, while there’s a big negative in terms of the educational issues we’re having with remote and hybrid learning, more important is the social interaction piece. I don’t think we’re going to know exactly what the effects of that over time are for years down the road, but it is something that we all have to be sensitive to.

It’s also challenging for teenagers. One of the key tasks of being a teenager is learning your place in the world and social interactions.

Single young adults are in another difficult situation, where they’re kind of trapped.

Last, this is very difficult for older people. They’re at a greater risk and often have chronic conditions. I know a number of people in this group who have been locked in their home since March in order to maintain their safety.

It’s difficult across the board for everybody, and we’ll have a better understanding of these effects over time.

What advice do you have for navigating this time? How can we cope and focus on our well-being?

First of all, being socially distant doesn’t mean being socially isolated. It’s important for people to reach out to friends and loved ones by telephone and video. Use the technology that is available, and if you know somebody who isn’t so adept at technology, helping them learn it is important so they can stay connected.

Exercise is also extremely important. It’s easy to be locked away, and that’s not healthy. People who are staying in their own home for safety reasons need to find ways to exercise inside. For people who are able to go out, it’s important to get out of the house on a regular basis – even just a short walk can have a huge effect.

Routine is important, too. We are used to having routines, and that has been broken. You want to establish some type of routine that works for you during the pandemic. Choose a particular time of day for exercise, make sure that you get up at a regular time in the morning and get out of your pajamas. In that routine, make sure you include something that breaks up the day so that you’re not just sitting at a computer all day.

Maintaining a healthy diet is also important. It is easy to fall into bad habits when we’re sitting at home, so be aware of this one. Along those lines, be careful about alcohol and other substance use. Don’t get into a habit of drinking more than you normally would, whether it be because you’re stressed or bored. Studies have shown that there has been an increase in alcohol and other substance use during this time, so it’s important to be cognizant.

Something that is always important, but now more than ever, is maintaining proper sleep. Close down the computer and have some sort of routine at the end of the day to get away from it all so that you can have a good night’s sleep.

One very important message: If that stress gets to the point that it’s difficult for somebody to function, it’s time to seek professional help. People should not suffer in silence. If it’s affecting their day in and day out functioning, they should get help, whether it be talk therapy, medication or a combination of the two.

Are there any additional sources of stress you are seeing among women? What advice does BBRF have to help manage this?

I think women have an added burden during this. Even in the most supportive relationships, the mother is still the principal person taking care of the kids. There’s added stress from trying to get kids to sit in front of the computer for virtual learning and use up energy that they aren’t burning during normal playtime. Then, the responsibility of older family members often falls on women. Combine these responsibilities with the fact that many women are also trying to work while taking care of everyone, and the stress adds up. On top of these factors, being together all the time at home, even if you have a magnificent relationship and love your family, is stressful.

I do think that women who are bearing that extra burden should calmly sit down with their partners and ask for help. That’s not unreasonable. Talking about it is very healthy and will relieve some of the burden. The other piece is having a routine and incorporating all of these tasks into that, so it’s a regular part of a schedule that everyone can have a role in.

What role do research partnerships play overall and in the foundation’s work with families?

All of the researchers that receive support from BBRF are selected by our scientific council, which is made up of 181 top brain scientists from around the world. The researchers apply for grants, and the council selects the most promising grants based on the science all around the world.

Once the researchers have been selected, some of our donors participate in the Research Partners Program. These donors choose one of the scientists selected by the council, and their funding goes to that scientist. This is appealing to people who want to fund an area that is important to them – whether it be a particular illness, institution or geographic location. The donor then receives regular reports about the progress of the research and has the opportunity to speak to the scientist and visit the lab. The scientists appreciate this support, and it gives donors the opportunity to support promising scientists with new ideas and to follow the progress over time.

You are the host of “Healthy Minds,” an Emmy-nominated television program. What do you hope people take away from the series?

The purpose is really to educate the public and engage people so people get the help they need. I started the series because I felt the field of psychiatry had not done a good job with outreach around educating the public. Sometimes we would be reactive to certain news events or activities, but we weren’t proactive in education. My goal was to be able to educate the public about these conditions with the facts so that people would reduce the stigma and prejudice that exist toward psychiatric conditions. People use the term stigma – I think stigma is too soft of a term. It’s prejudice that gets in the way of people getting treatment. My vision was that with this information and engagement, people wouldn’t suffer in silence and would seek help.

Awareness and engagement are big drivers of the show. When I’m sitting in the studio speaking to somebody or looking at the camera at the beginning and end of an episode, I’m thinking of a person or family sitting at home who cares about the illness I’m talking about because it affects them, and I’m speaking to them directly. And over the years, the feedback has been that it’s opened up conversations at home where there weren’t any. I’ve had the privilege of interviewing some of the top scientists in the world and also people recovering from conditions, including famous people, but in many ways, the regular interviewees have been the most moving for me.

[I]f you have a friend or loved one who you think is suffering, reach out to them. Let them know you are there to help it. It makes a difference...

What would you say to those who may be on the edge and need support, but who are still reluctant to reach out because of stigma or prejudice? What words would you say to get them over that line?

You’re not alone in what you’re experiencing. These are common conditions, and getting help will make a big difference. We have effective treatments for these conditions, so please don’t suffer in silence.

On top of that, if you have a friend or loved one who you think is suffering, reach out to them. Let them know you are there to help. It makes a difference, especially if you are concerned about a loved one having thoughts of wanting to hurt themselves. It’s a common misconception that asking about suicidal thoughts can increase suicide – there is clear-cut evidence that is not true. Asking a friend or loved one about this can save a life.

Thank you for speaking with us, Dr. Borenstein.


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