Bereavement during social distancing

It’s never easy to lose someone you love. Imagine not being able to be at their bedside or say goodbye in person. Imagine losing them and not being able to have more than ten people at their funeral … if you are even able to have a funeral. There is no hugging, no tears wiped away, just the same feelings of loss without the human touch of comfort. For thousands upon thousands of friends and family members left behind during COVID-19, they do not have to imagine this. This is reality. The number of deaths related to COVID-19 grows daily, leaving tens of thousands in their isolated grief. However, people are not only dying from coronavirus. Deaths from all causes have continued during this time, leaving family members and friends in a static state of loss. For persons of color, the loss of loved ones could be even more catastrophic during these turbulent times, directly affecting the mental health of those left behind.

Bereavement can last up to a year, and even during bereavement, major depressive episodes can be experienced. Given the current pandemic, will those left behind be more likely to experience a major depressive episode than they would have been prior to the pandemic? Are we about to experience a new era of major depressive disorder diagnoses? How can we better track our patients as they grieve? Given the number of deaths and the isolation many people are facing, an increase in mental health diagnoses is likely. Physicians and other mental health providers must remain vigilant during these times and explore telehealth/telepsych practice options to increase patients’ ability to connect. But, the rapidly growing telehealth space has its own implications.

If you’re a physician or other mental health provider, your patients and your family need you now more than ever. Work-life balance has always been complicated, and now those boundaries have been blurred. Regardless of your occupation, overwhelming work demands, including “Zoom fatigue,” colliding with family life has been a daunting challenge for many. The effects of isolation during COVID-19 may have long-term implications that we will only begin to grasp in the fullness of time. The major problem for physicians and other mental health providers is this is just the tip of the iceberg.

Moreover, how can we, as providers, protect ourselves from feelings of isolation, especially if you are also experiencing the loss of a loved one? I think we must recognize our limitations as physicians and fully acknowledge the increased potential for both transference and counter-transference during this unprecedented time in our lives. Take a stake in your own mental health. Have self-check ins and carve out self-care time during your day to take note of your own feelings. Talk with your loved ones, both with you and far away. With recent reports of health care providers committing suicide, vigilance is needed perhaps now more than ever to protect our patients, friends, family, and even ourselves.

K. Maravet Baig-Ward is a psychiatry resident and can be reached on Twitter @drmaravet.

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