"I’m literally breaking inside": As COVID-19 leaves millions jobless and struggling, the mental health toll rises

When Sandra Fowler lost her job as a hotel manager in March, she thought of the many homeless people sleeping on the streets of Tucson, Arizona, and feared she would soon be among them.

“I could mentally see myself on the street,” says Fowler, 58. “That type of anxiety is what kept me up at night … I was planning on being homeless because I didn’t know how I was going to make it.”

It took Fowler eight months to find a job in a shipping-and-packing store that replaced her previous $42,000 salary with a part-time position that pays $12 an hour. Her wages are barely enough to keep a roof over her head and not enough to steadily put food on the table.

“Every day I have to go to work and put on a smile for strangers when I’m literally breaking inside because my finances are just totally out of whack,” Fowler says. “Mentally it’s going to take me a while to get back to a place where I feel safe financially, where I know I’m going to be OK.”

Mental toll of COVID-19

The physical toll of COVID-19 is stark, with more than 484,000 dead, and over 27 million infected in the U.S. But among the millions of Americans who lost jobs during the economic downturn sparked by the pandemic, or who have seen their hours and wages cut, the toll on mental health is also widespread.

According to a new survey from the Pew Research Center, 70% of those who are jobless say being out of work has left them more stressed out. Over five in ten said they were dealing with more mental health challenges like anxiety and depression. And 81% said they’d felt adrift, fought more with loved ones or experienced other emotional issues since losing their jobs.

“Not only is unemployment putting people in a more vulnerable financial situation, but our survey founds it’s also having a negative impact on their emotional well-being,” says Kim Parker, Pew’s director of social trends research and co-author of the report.

In part that’s because what we do affects how we see ourselves.

“Unemployment at any time takes a significant toll because employment is connected to identity and self-worth,” says Robin L. Smith, a psychologist who is counseling patients who are struggling with the pandemic. But during COVID-19, it has been particularly stressful “because we are bearing witness to more than just job loss. We are having an extended and real experience of catastrophic loss.”

First shock, then depression

Whether Americans are employed or not, symptoms of anxiety and depression, as well as substance use and thoughts of suicide, have spiked during the pandemic says the Centers for Disease Control and Prevention.

At first, Fowler says she was numb.

“For the first few months, I think I was just in shock,” Fowler says, “but my anxiety level has probably gone up 50%. And I went through a period of depression. I’m functioning, but I’m always worried about the next month. … I’ve been robbing Peter to pay Paul.”

This isn’t what she thought she would be going through at this time in her life.

“I’ve been on my own since I was 19,” Fowler says, “so for me at this point … to have to ask people to buy groceries, or to just help me pay a bill, that’s not what I’m used to.”

Fowler has set up payment arrangements with her credit card companies who’ve frozen her accounts because of her loss of income. “I’ve had to borrow from family to feed myself,” she says. “I’ve had to utilize food pantries. It’s not a matter of pride. It’s a matter of living.”

No job insurance, no therapy

And Fowler says she walks a tight rope, wanting to work more while also worrying that every extra hour could jeopardize the unemployment benefits she needs to make ends meet.

She’d like to get therapy, but she lost her health insurance when she was laid off from her full-time job. She’s also been isolated during the health crisis. She moved to Tucson with her now ex-husband, and most of her family lives in Michigan.

To calm her nerves, Fowler goes for walks, prays, and tries to hold on to the hope that she will eventually be able to find another job in the hospitality industry, “to get back to what I know and what I’m good at.”

Anger, then joy

Kelly Newman quit her job as a family law attorney in July. She and her wife, Rachel, were juggling the care and remote schooling of their six children with work and buckling under the strain.

“The last year was extremely challenging mentally and emotionally,” Newman, 46, says.

Now, while her wife, a teacher, instructs her students from their dining room, Newman ferries their children to daycare and school, which they attend in person at least part of the week.

The family is getting by with stipends it receives for the four youngest children who the Newmans are in the process of adopting, as well as assistance from a federal food program and meals the school district distributes to local children.

“We are surviving,” Newman says, adding that they’ve gotten rid of cable and currently owe roughly $3,000 on their electric bill. “We’re just paying as much as we can at a time. We cut back on everything.”

Newman’s mental health sharply declined during the first half of the pandemic. After her doctor prescribed anti-depressants and the family moved to a larger home, Newman says she briefly felt better.

Unable to get out of bed on Christmas

Then, with bills continuing to pile up, she found herself unable to get out of bed on Christmas Day.

“I was angry and lost contact with people I cared about,” Newman says of her deteriorating mental health. “(I) said things to people I shouldn’t have said because my filter was gone.”

She is taking yoga at a studio that often lets her participate for free. And in the last couple of weeks, Newman says she’s begun taking a new medication that is helping her mood.

“I finally am feeling stable in the sense that I don’t have this looming fear of the next shoe dropping,” Newman says. She’d been shoving overdue bills into a drawer, but recently “I was able to stare down the pile and make some very difficult phone calls. … I’m just at the crest of feeling able-bodied and able-minded.”

While going through her bills, Kelly came across a gift certificate. She treated herself to a manicure and pedicure.

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