Stress and Addiction During the Era of COVID-19

How has stress affected addiction during the era of COVID-19? Montefiore’s Addiction Psychiatry Program Director, Dr. Merrill Herman, explains how increased levels of anxiety and depression caused by the pandemic impact addiction, why people self-medicate, and how treatment can make a difference.

Dr. Merrill Herman, Montefiore’s Addiction Psychiatry Program Director, talks about stress and addiction during the era of COVID-19
Transcript

STAY STRONG

Stress and Addiction During the Era of COVID-19

How has stress affected addiction during the era of COVID-19?

Many people are struggling with stress during COVID-19. Understandably, there are a myriad of challenges and uncertainties that people are facing. Will I contract the virus? How safe is it to go out? Will my loved ones get sick? Can I even be with my family if they're sick? Or if a loved one dies, what do I do? What happens if I lose my job and I can't make ends meet? How do I manage online schooling for my children? This can be complicated by living in a crowded house or apartment, and there's space for anybody to do their work, or if the children don't want to do the schooling online. We have lost social connections. What if I can't go to proms, or parties, or graduations, or weddings? All of these uncertainties lead to a sense of fear and isolation. The stress can surely result in anxiety and depression. Some of these feelings can emerge in anyone during challenging times, but for people who have underlying psychiatric and addiction problems, they are especially vulnerable.

What are symptoms of depression?

Depressive symptoms that you can look for include decreased energy, not getting out of bed, changes in eating and sleeping patterns, sense of hopelessness, not motivated, not enjoying anything anymore, tearfulness all day, isolating from friends and family, and even suicidal ideation.

What are symptoms of anxiety?

Anxiety symptoms can be overwhelming as well including fearfulness, excessive worrying, compulsive cleaning, inability to stop your mind from racing along. "I can't stop worrying." "I can't relax." "I can't concentrate," are thoughts that people might have.

What are drug and alcohol patterns to look for?

It is understandable if people seek out drugs or alcohol to self-medicate these disturbing and scary feelings. People who already struggle with addiction are vulnerable to increased cravings and relaps. Some drugs and alcohol patterns to look for may include starting to use drugs again after not using for many years; using all day long; trying new drugs to feel better, such as heroin or sedatives or even alcohol just to calm down or go to sleep, or using cocaine to get out of bed; going to dangerous or unsafe places without masks to pick up drugs; feeling out of control with drug use and unable to stop; financial problems start to flow from their drug use. This can surely create tension with your family around the drug use or if you're not even able to go to work, or school, even if you're supposed to be working remotely; increased guilt and shame from the drug or alcohol use may result in further isolation.

How can addiction treatment make a difference?

The most important thing to know is that you are not alone. There's help for people with addiction and co-occurring emotional symptoms. Treatment can make a big difference. We are thankful that, due to technology, we have been able to continue treating patients with virtual health through telephone and video visits. People have access to many modalities of services including counseling, individual group therapy, medication management both for their addiction as well as for their emotional problems. These medications may include suboxone, methanon, anti-depressants, medications for anxiety. We have a wide array of clinicians in our treatment settings, including social workers, psychologists, psychiatrists, vocational counselors, and even have integrated primary care in our programs. We have found that patients who are already engaged in treatment are doing so much better than one would have imagined during the pandemic. The access to virtual health decreases their sense of isolation, and provides hope and perspective about the road to recovery during uncertain times. So if you already have a treatment provider, please reach out for continued care. If you do not have a treatment provider, please know that there are many treatment options available from your home. Whether you seek help from our vast consumer treatment services that we provide at Montefiore Health System, or through another provider, I encourage you to seek help. Treatment makes a difference.

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Mental Health and Coping


Mental Health Myths

Is it normal to think about COVID-19 all the time? Montefiore’s Chief Psychologist, Dr. Simon Rego, discusses why it's normal and whether to seek help.

Why am I always anxious? Do I have COVID-19? Will I lose my job? Montefiore’s Chief Psychologist, Dr. Simon Rego, explains how part of our brain works to keep us safe from something that could go wrong, and where and when to seek help for COVID-19 anxiety.

Why can’t I deal with my COVID-19 feelings on my own? Montefiore’s Chief Psychologist, Dr. Simon Rego, explains why it’s not weak to ask for help and why you might need assistance coping with COVID-19.

I’m supposed to be providing COVID-19 help, not asking for it. Montefiore’s Chief Psychologist, Dr. Simon Rego, discusses why healthcare workers should ask for and receive COVID-19 help.

Will people judge me for seeking help for my fears and anxieties about COVID-19? Montefiore’s Chief Psychologist, Dr. Simon Rego, explains ways to overcome concerns about being judged, and why seeking support to cope during this time is perfectly fine and necessary.

I'm just too busy with family and work. How can I find time for my COVID-19 feelings? Montefiore’s Chief Psychologist, Dr. Simon Rego, explains why finding time is important for our self-care, and recommends small things we can do to talk about our COVID-19 feelings that can fit into a busy schedule.

How can a therapist help me cope with COVID-19? Montefiore’s Chief Psychologist, Dr. Simon Rego, explains the tools a therapist can provide to help you handle COVID-19, what happens in a session and what to talk about.

I’ve had therapy, and I’m not sure how it can help with COVID-19? Montefiore’s Chief Psychologist, Dr. Simon Rego, explains what COVID-19 treatment looks like and which approach might work best. 

COVID-19 and Relationships

How can I best stay home with a partner? Montefiore’s Chief Psychologist, Dr. Simon Rego, discusses ways to work through the challenges of staying home with another person, as well as things to work on together.

How can I best stay home alone? Montefiore’s Chief Psychologist, Dr. Simon Rego, shares tools and techniques to help single people stay home, which can help with social isolation.

How do I juggle work, life and COVID-19? Montefiore’s Chief Psychologist, Dr. Simon Rego, discusses ways to maintain focus and a healthy work-life balance during the COVID-19 pandemic.

COVID-19 and Managing Feelings

How do I manage my feelings of anger toward COVID-19? Montefiore’s Chief Psychologist, Dr. Simon Rego, discusses why it's normal to have strong feelings about COVID-19, how to recognize triggers and things we can do to manage anger.

How do I deal with feeling lonely in isolation? Montefiore’s Chief Psychologist, Dr. Simon Rego, discusses managing feelings of isolation during COVID-19, and how to seek help.

How do I deal with my anxiety about finances affected by COVID-19? Montefiore’s Chief Psychologist, Dr. Simon Rego, explains how to manage financial fears during the crisis.

How can I manage addictive behaviors during COVID-19? Montefiore’s Chief Psychologist, Dr. Simon Rego, explains how to avoid negative coping methods during the crisis.

How do I deal with the human toll from COVID-19 and the impact on life as we know it? Montefiore’s Chief Psychologist, Dr. Simon Rego, explains how to cope with the loss of normalcy and changes in our lives as a result of the crisis.

Anxiety Busters

Taking a deep breath can help reduce anxiety. Montefiore’s Supervising Psychologist and Assistant Director of the Trauma-Informed Care Program, Dr. Paul Bulman, demonstrates ways to breathe better when feeling anxious about COVID-19.

Balancing negative thinking with positivity can help reduce anxiety about COVID-19. Montefiore’s Supervising Psychologist and Assistant Director of the Trauma-Informed Care Program, Dr. Paul Bulman, shows how making a gratitude list can spark positive thinking.

Focusing on the moment can help reduce COVID-19 anxiety. Montefiore’s Supervising Psychologist and Assistant Director of the Trauma-Informed Care Program, Dr. Paul Bulman, shares techniques for staying present during this difficult time.

Negative thoughts can create more anxiety. Montefiore’s Supervising Psychologist and Assistant Director of the Trauma-Informed Care Program, Dr. Paul Bulman, provides techniques to combat negative thinking during the COVID-19 crisis, including knowing the triggers and the 3 questions to ask.

Getting a good night's sleep can help combat anxiety caused by the COVID-19 crisis. Montefiore’s Supervising Psychologist and Assistant Director of the Trauma-Informed Care Program, Dr. Paul Bulman, provides techniques for sleeping better during the pandemic.

Keeping your body active is a great way to relieve anxiety and can boost your immune system. Montefiore’s Supervising Psychologist and Assistant Director of the Trauma-Informed Care Program, Dr. Paul Bulman, provides ways to work in regular exercise during the COVID-19 pandemic for physical and mental health.

Essential Workers and COVID-19

Montefiore’s Supervising Psychologist and Director of the Trauma-Informed Care Program, Dr. Dana Crawford, explains how essential workers and their families can handle concerns arising from COVID-19 work.

Montefiore’s Supervising Psychologist and Director of the Trauma-Informed Care Program, Dr. Dana Crawford, explains how the family and close friends of essential workers can navigate concerns arising from their loved ones’ COVID-19 work.

As an essential worker, how can I best handle conversations about COVID-19 with my loved ones? Montefiore’s Supervising Psychologist and Director of the Trauma-Informed Care Program, Dr. Dana Crawford gives essential workers tips on how to have conversations about COVID-19 with loved ones.

If my loved one is an essential worker, how can I best handle sharing my concerns about COVID-19? Montefiore’s Supervising Psychologist and Director of the Trauma-Informed Care Program, Dr. Dana Crawford offers advice on how to communicate about COVID-19 with loved ones who are essential workers.

Surviving COVID-19

What's it like to survive COVID-19? Montefiore’s Dr. Miguelina Germán, Psychologist and Director of Pediatric Behavioral Health Services, shares her personal experience with COVID-19. She talks about quarantining with her family in a two-bedroom apartment, coping with her fiancé contracting COVID-19, asking friends for help and emotionally working through her diagnosis. She also offers advice based on what she learned during this experience.

What happens after recovering from COVID-19? Montefiore’s Dr. Miguelina Germán, Psychologist and Director of Pediatric Behavioral Health Services, shares her personal experience after recovering from COVID-19, and what she learned about symptoms coming back and the importance of self-care after recovery.

Who to tell about your positive COVID-19 diagnosis and when? Montefiore’s Dr. Miguelina Germán, Psychologist and Director of Pediatric Behavioral Health Services, discusses life living with COVID-19, how she decided which family and friends to contact and when was the right time to tell them about her positive diagnosis.

Parenting During COVID-19

How can parents talk about what's happening as a result of COVID-19 with kids of all ages? Montefiore's Chief of Child and Adolescent Psychology, Dr. Sandra Pimentel, discusses how to help kids understand COVID-19 using techniques to encourage talking about their feelings resulting from the life changes and uncertainty they're experiencing because of the pandemic, and how parents can model coping methods to help kids make more sense of their world.

How can I help a teenager cope with the life changes and risks caused by COVID-19? Montefiore's Chief of Child and Adolescent Psychology, Dr. Sandra Pimentel, discusses ways to help teens cope with uncertainty and loss due to COVID-19, as well as taking the risks of contracting or spreading the virus seriously.

How can parents manage both their stress and the stress inflicted on their families by COVID-19? Montefiore's Chief of Child and Adolescent Psychology, Dr. Sandra Pimentel, shares techniques to help cope and manage stress in these unprecedented times.

What are red flags I should look for to know if my child needs help? Dr. Sandra Pimentel, Montefiore’s Chief Child and Adolescent Psychologist, shares advice for parents of children struggling during COVID-19 and explains what therapy looks like for children, including virtual health options.

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How should parents talk to their kids about the next phase of COVID-19? Dr. Sandra Pimentel, Montefiore’s Chief Child and Adolescent Psychologist, explains what’s important to communicate to children about the ongoing pandemic and how parents can create resiliency in their children by reflecting with them on what has happened, continuing to engage them in safe behaviors and including them in planning ahead. Dr. Pimentel also shares how to handle a child’s worry about the uncertainty of school by validating their feelings and focusing on what we can control.

Addiction During the Era of COVID-19

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How is behavioral addiction being affected and manifested during the era of COVID-19? Montefiore’s Director of Addiction Consultation Service, Dr. Howard Forman, describes the impact the pandemic has on those with behavioral addiction, why many people are developing behavioral addiction, and shares what help is available.

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How can a person get help for behavioral addiction during the era of COVID-19? Montefiore’s Director of Addiction Consultation Service, Dr. Howard Forman, shares ways to seek help for behavioral addictions that have increased or begun during the era of COVID-19.

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How is internet addiction being affected and manifested during the era of COVID-19? Montefiore’s Director of Addiction Consultation Service, Dr. Howard Forman, describes the impact the pandemic has had on those with new or existing internet addictions, and offers guidance on available treatment options.

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What are the treatment options for internet addiction during the era of COVID-19? Montefiore’s Director of Addiction Consultation Service, Dr. Howard Forman, shares available treatment options, including ways to receive treatment today from home.

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How can the era of COVID-19 motivate recovery from addiction? Montefiore’s Director of Addiction Consultation Service, Dr. Howard Forman, describes how the pandemic has impacted those with existing addictions and describes how this time can be used to recover from addiction.

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How can someone struggling with addiction get help during COVID-19? Montefiore’s Director of Addiction Consultation Service, Dr. Howard Forman, discusses how video visits and technology have transformed addiction care for the better during the pandemic, made care accessible to people in a whole new way, and how to get medical help if needed.

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How can someone access medication for addiction recovery during the era of COVID-19? Montefiore’s Director of Addiction Consultation Service, Dr. Howard Forman, explains the ways Montefiore eased how people can have access to medication during the era of COVID-19 with more flexible personalized medication pick-up and delivery scheduled tailored to the individual.

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What is gambling disorder and help during the era of COVID-19? Montefiore’s Director of Addiction Consultation Service, Dr. Howard Forman, explains what gambling disorder is, how lack of pleasure and activity during the era of Covid-19 created a new wave of gambling addiction for many people, and ways to get and seek help.

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How has stress affected addiction during the era of COVID-19? Montefiore’s Addiction Psychiatry Program Director, Dr. Merrill Herman, explains how increased levels of anxiety and depression caused by the pandemic impact addiction, why people self-medicate, and how treatment can make a difference.

 

Pediatrics


MIS-C During the Era of COVID-19

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What is Multisystem Inflammatory Syndrome (MIS-C) in children, what to look for, and how is it treated? Dr. Nadine Choueiter, Montefiore’s Director of Noninvasive Imaging and Pediatric Cardiology, explains the symptoms of MIS-C, what is known so far about what causes it, and why follow-up care is important after children are discharged from the hospital.

 

Neurosurgery


The Brain and COVID-19

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How does COVID-19 impact the brain? Montefiore’s Chief of Division of Cerebrovascular Neurosurgery and Surgical Director of the Montefiore Comprehensive Center for Stroke Care, Dr. David Altschul, explains the neurological symptoms associated with COVID-19 and details when they can occur, who is at risk of experiencing them, and their long-term impact.

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What research is Montefiore-Einstein conducting to explore COVID-19’s impact on the brain? Montefiore’s Chief of Division of Cerebrovascular Neurosurgery and Surgical Director of the Montefiore Comprehensive Center for Stroke Care, Dr. David Altschul, shares the details of the ongoing, wide-ranging, multi-disciplinary biomarker analysis to determine who is at higher risk for serious reaction to COVID-19 as well as neurological complications.

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Are those with pre-existing neurological conditions at greater risk of getting COVID-19? Montefiore’s Chief of Division of Cerebrovascular Neurosurgery and Surgical Director of the Montefiore Comprehensive Center for Stroke Care, Dr. David Altschul, clarifies the risk of contracting COVID-19 or experiencing recurring symptoms for those with pre-existing neurological conditions.

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What symptoms from pre-existing neurological conditions could return with COVID-19? Montefiore’s Chief of Division of Cerebrovascular Neurosurgery and Surgical Director of the Montefiore Comprehensive Center for Stroke Care, Dr. David Altschul, gives examples of symptoms that can be triggered by COVID-19 and when to seek immediate care.

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Montefiore’s Chief of Division of Cerebrovascular Neurosurgery and Surgical Director of the Montefiore Comprehensive Center for Stroke Care, Dr. David Altschul, discusses a range of options from the most advanced medical treatments for strokes and seizures to over-the-counter medications for minor neurological symptoms.

Stroke & COVID-19

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Why are some COVID-19 patients having strokes? Montefiore’s Medical Director at the Comprehensive Center for Stroke Care, Dr. Charles Esenwa, explains why some COVID-19 patients experience strokes, who is most at risk and what causes these COVID-19-associated strokes.

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If I am diagnosed with COVID-19, what can I do to help prevent a stroke? Montefiore’s Medical Director at the Comprehensive Center for Stroke Care, Dr. Charles Esenwa, explains why it’s important to keep taking existing medications while sick with COVID-19.

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Dr. Charles Esenwa, Medical Director at Montefiore's Comprehensive Center for Stroke Care, shares the symptoms of a COVID-19-related stroke and what to do.

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What is the recovery process for patients who have experienced COVID-19 related strokes? Montefiore’s Dr. Charles Esenwa, Medical Director at the Comprehensive Center for Stroke Care, describes how Montefiore treats the unique challenges of COVID-19 related strokes with a multi-disciplinary team to ensure the best possible chance for long-term recovery.

The Nervous System & COVID-19

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How does COVID-19 impact the nervous system? Dr. Richard Zampolin, Neuroradiologist at Montefiore, explains how COVID-19 impacts the nervous system, its potential long-term effects and the research Montefiore is currently conducting in this area.

Trusted Information Resources

Centers for Disease Control and Prevention

The leading national public health institute of the United States
 

NY.gov

For the latest COVID-19 guidelines and information from New York State 

World Health Organization

UN agency responsible for international public health