The holiday season is often difficult for many, and now the presence of COVID-19 and its variants coupled with tragic events across the country have increased the strain.

Prior to the pandemic, the expectation to emulate the media images of “merriment,” family obligations, the financial pressure to shop for gifts and the sense of loneliness or depression when one’s experiences or personal circumstances don’t meet expectations was challenging enough. These “feelings,” were often dismissed as having the “holiday blues.”

But far more than the “holiday blues,” the pandemic as well as the fatal shootings that have shaken the country, has many people uneasy — grappling to consider how to have a “normal” Christmas amid so much tragedy that assaults mental health. 

“The social unrest has been playing on a lot of people’s feelings of safety and isolation,” said Dr. Jonathan E. Sherin, director of the Los Angeles County Department of Mental Health (LACDMH).

 “The myriad of problems affecting communities from global warming to stresses from quarantine and the pandemic are compounding upon the already difficult holiday season,” Sherin said. “There are a number of factors right now that are pressing on human beings here locally, and all around the world that are really unprecedented, creating for some a sense of existential crisis.” 

There is no doubt. The physical and mental health risks posed by the continuing COVID-19 pandemic these past two years have taken their toll. The mere topic of vaccinations has created divisions and wedges among friends, family members and co-workers.

It has divided the nation. 

“Whether it’s because of fear, loss of routines, loss of jobs, loss of family members, isolation, the lack of feeling of choice and autonomy can be really problematic and challenging,” Sherin said. 

“Depression is the number one issue facing people. Without support, mental health problems can quickly snowball and have a deep impact on our lives, and mental health stress doesn’t discriminate…it can impact someone of any age or background,” said County Supervisor Kathryn Barger.

COVID-19 Fallout

Dr. Jorge Partida del Toro, Chief of Psychology at the Los Angeles County Department of Mental Health, points out that this unforeseen pandemic arising in communities has caused many to suffer from unresolved grief.  

“We’ve had a lot of relatives that have passed away, and the fact of the matter is, it hasn’t allowed our communities to grieve properly,” Toro said. “The ritual of funerals and the ritual of being able to let go and say goodbye is interrupted, because in the beginning of the pandemic a lot of folks just went into the hospital and were never seen again.”

Toro said many people have experienced significant losses without experiencing the catharsis of the grieving process.

“It also is prolonged. The human mind has the ability to adapt to critical situations if they’re in short bursts. But as it becomes more normative, when the sadness and grief is prolonged, psychologically there is an impact of feeling overwhelmed and feeling as though we’re losing hope.

“What ends up happening in our communities is our parents and grandparents are doing their best to just get by and ignoring certain signs and symptoms of their own stressors,” Toro continued. “That cuts our ability to communicate with others, family, and relatives around what’s happening. And that solidifies that stigma of talking about what we’re experiencing, because we’re afraid to be so open and honest that we might scare the children or others in our family. There’s a tenancy for our communities to hold on to this prolonged grief.”

Toro said there has been a dramatic increase in suicide attempts, domestic violence, and self-harming behaviors, and particularly in men there is an increased tendency of acting out through addiction, sexual compulsion, or gambling.

“We have to recognize that these acting out behaviors are an indirect way of addressing and expressing the unresolved grief we sometimes are experiencing. Sadness and grief doesn’t always look typical, and it’s really critical for us to understand that,” he said.

The Impact On Children

Toro raises concern for the ways the long-term effect of the pandemic has been affecting children. The sudden shift of schooling and education to a digital space has caused academic lags as well as disruption in children’s psycho-social development.

“We have children whose social development has been curtailed for over a year, and in communities of color in particular,” he said. “We already know that children have been having issues with lagging behind in their academic performance. Now that parents are having to play a double role of not only parents, but educators, we recognize that they are sometimes not quite prepared to be able to deal with what that really means for their children.”

In addition, the proliferation of social media during the pandemic, which was documented as a high-risk factor for the mental health of children and teens even before the pandemic, has caused its negative impact to become amplified as a consequence of becoming one of the primary ways for youths to interact safely.

“Now as children have been isolated at home and utilizing social media as a means of connection, we also see that there is a dramatic increase in the tension and anxiety that children feel around this time,” Toro said.

Communication is Key

Shirley Ray, an LACDMH client living in Long Beach, spoke of her personal experience that helped her to receive mental health support and get a hand up.

She had a “normal” life — married with children, she worked at Cedars-Sinai Medical Center for over 13 years. She had also worked previously for the California Science Center, and at California State University Long Beach.

Life was rolling along until two heart attacks brought serious hardship, which led to homelessness. Ray lived in her car for a number of years.

“I probably should have reached out to family members but they, too, weren’t doing that well. And I don’t want to impose on anyone, and at least I can drive my car or move my car whenever I needed to. But around the holidays it was difficult for me,” Ray said.

“I’ll never forget I was in my car [when] two beautiful nurses from Mental Health America in Long Beach saw me, and I was trying to play it off. They said, ‘I noticed you’ve been in your car for quite a while, do you live in your car?’ They were sweet and kind; they always checked on me to make sure I had food, and they told me about the San Pedro Mental Health Clinic.” 

Because of the stigma associated with mental health, Ray was initially apprehensive. But after meeting with a therapist, she was overjoyed with the services provided, and the opportunities it gave her to network and attend art classes through the clinic, leading to her art being featured as a part of the “We Rise” exhibit before the pandemic shut non-essential businesses down.

The nurses submitted her name in a lottery, which provided her with housing. Ray became inspired by the help she received, and took her experiences at the clinic to help others as a volunteer.

“I learned how to push my ‘holiday blues’ aside because I was able to have people to communicate with,” Ray said. “That’s how I’ve been able to overcome being homeless. Now I’m housed, I’m working with beautiful people, and I volunteer with the peer resource center and the clinic. So I’m a happy camper at this time. I believe that self-care and personal medicine are very important.”

Stay Connected

The feelings of loneliness and isolation during this pandemic have increased, and for those like Ray who fall on hard times, they can pull themselves back even more which can enhance problems.

“We learn that we’re not supposed to talk about our personal stuff, and we learn that what makes us strong is to be silent. What we need to teach our children and each other is that the opposite is true. What makes us a community is the ability to stay connected and to share, not just in the good times but the difficult times,” Toro said.

“What helps and what we can do to cope is to create a normative experience where families get the opportunity to sit at a table and recreate the traditional practices like sharing meals together or creating a sense of continuity for the day.” 

Toro suggests that families look for ways to set up times for normal meals, homework, and opportunities to discuss things that we sometimes feel uncomfortable discussing.

“The idea of ‘Emotional Intelligence’ is something we must teach our children,” he said. “Many children in our communities don’t have permission to discuss how they feel. It is very important for parents to get guidance about how to have conversations with their children around emotions.”

Added Sherin, “It’s critical we stay connected to ourselves — our loved ones, our friends, our neighbors, and those who can provide professional help.”

The Department of Mental Health has a 24-hour Help Line at (800) 854-7771, available to those who find themselves without someone to reach out to in a time of crisis. The county also has two app-based programs: Headspace, a mediation-oriented program; and Iprevail, a web-based, avatar-based cognitive behavioral therapy program.