Neill Epperson

Resilience — what is it and how to boost it — has become a recent focus of numerous medical talk shows, blogs, books and electronic apps. Surveys to calculate one’s resilience quotient have become popular. Of course, facing the morbidity, mortality, social isolation and economic uncertainty that characterizes the COVID-19 pandemic, we crave concrete reassurance that we and our loved ones are going to be okay. We will weather this storm. We will bounce back, as one of my colleagues texted me earlier today, “Bigger, badder, stronger.”

Indeed, the majority of us will demonstrate resilience. We will return to our workplaces, schools, houses of worship, favorite restaurants, and mountain trails with no appreciable adverse health effects from the pandemic.

However, this is not the case for roughly one million Coloradans who will suffer from mental health concerns this year alone. Add the adverse psychological and biological effects of chronic, pervasive and persistent stress to the baseline prevalence of any mental disorder (19%) or serious mental illness (5%) and we should expect — and prepare for — a surge in suicides, depression, post-traumatic stress disorders, anxiety disorders and problems with alcohol and drug use.

Mental Illness: The Second Surge?

While we have had other infectious disease scares and disasters in the U.S., we have not experienced a pandemic of this scope for more than a century. This type of disaster is unprecedented in our current society. We are psychologically inexperienced.

However, it is time that we go beyond focusing on emotional supports and discussing resilience, coping strategies, sleep hygiene or exercise routines. While these are all admittedly important to one’s well-being, we must launch a frank dialogue about psychiatric disorders as the “second surge” of this pandemic.

Over the next several weeks, we will begin an open and honest discussion of what we can expect, from a psychiatric point of view, over the coming months. We will publish conversations with experts in the assessment and treatment of depression, anxiety, PTSD and other stress reactions, as well as problems with substance use and abuse. These are exceptionally common medical problems in our society and, like COVID-19, are not exclusive to any particular socioeconomic class, race, ethnic or age group, sex or gender.

Our goal is to promote recognition that mental illness can strike any of us during and after this pandemic. It is important to recognize the signs and symptoms in ourselves and others. Mental health care is available through multiple avenues such as one’s primary care provider, the Department of Psychiatry and the Johnson Depression Center. There is no shame in reaching out for help. Suffering from depression or PTSD does not mean that one is not resilient. Resilience is complex and multifaceted. Appropriate and timely treatment can aid a person’s innate resilience and return him or her to health.

We hope you will take a few minutes to read and discuss these articles. The more frequently we speak the words “depression, PTSD, panic, suicide” the less stigmatized they become. I am optimistic that one day we will feel as comfortable seeking treatment for psychiatric and substance use concerns as we are for any other common medical condition. The majority of psychiatric disorders are episodic and highly responsive to treatment. Let’s all do what we can to prevent this second surge from becoming the chronic medical condition that will be the legacy of the COVID-19 pandemic.

C. Neill Epperson, MD
Robert Freedman Endowed Professor and Chair
Department of Psychiatry

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