Most people don’t want to relive the period of lockdowns and social distancing. Unfortunately, for many of us, the hidden emotional effects of the pandemic will persist long after the measurable visible effects of the pandemic – job loss, hospitalizations, and physical isolation – will dissipate. 

 

Isolation helped slow the spread of Covid-19, but it is having unintended long-term consequences on mental health, including increased abuse of alcohol and other substances.

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The unintended increase in mental health issues

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The unintended mental health consequences of Covid-19 restrictions are wide and, for some people, devastating.

 

Most of us spent way too many hours on our screens. The result has been elevated anxiety levels, difficulty concentrating, and insomnia. Lack of social interaction contributes to anxiety, especially social anxiety.

 

At the same time that we were increasing screen time, we were losing access to healthy coping mechanisms. Going to the gym, meeting friends for dinner, and traveling help keep many of us feeling balanced.

 

Without access to social support and limited opportunities for healthy coping, many people experienced a downward spiral of emotional difficulties and substance abuse.

 

When we get out of equilibrium we seek ways to regain balance

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All people have a physical and mental internal regulating system that is constantly trying to find equilibrium. In ordinary times, life is always throwing us curveballs, knocking us off equilibrium. The pandemic was not just a curveball. It was a mental and physical tsunami.

 

When we are able to access healthy solutions for rebalancing our bodies or emotions, we are often able to get back to a healthy balance and resume life stronger. Unfortunately, if you were already struggling before the pandemic, if you felt excessive pain, or if you felt overwhelmed by life, you may have used alcohol or drugs to self-regulate. Substance abuse does temporarily ease or numb your pain, but it is destructive. Instead of dealing with the underlying issues, you now have to deal with those issues and your dependence on alcohol, cannabis, prescription medications, or other drugs.

 

Both alcohol and opioids flood the brain with dopamine, which induces feelings of pleasure or calm. Cocaine in particular makes you feel extremely vibrant and alive, but it also follows with a profound period of depression and listlessness. It also directly affects dopamine.

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Covid-19 as a gateway to substance abuse

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During the coronavirus period, alcohol consumption and other forms of substance abuse spiked. Overdoses increased. Use, and abuse, of alcohol, marijuana, cocaine, and other opioids all went up – including among educated, successful, professionals. 

 

In the last year, my caseload of bright, capable, and otherwise resilient people who abuse alcohol, cocaine, and other opioids has jumped. 

 

The story of David (a pseudonym) is increasingly common:

 

David – ❝I used to drink the occasional glass of red wine during the week or grab a drink with friends at a bar after work. During long periods of working at home, I found myself reaching for a bottle daily or more just to get through the day. I needed the bottle to get calm and to fall asleep. I am no longer a moderate drinker. I am a problem drinker.❞

 

Once your substance use has ticked up, each time you need a higher dose — more drinks, more pills, or a bigger hit  — in order to get high. You become so desensitized that you may need to use the substance to just feel normal. What started as a coping mechanism during the pandemic can easily become a full-blown addiction.

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Admitting that we need help is so hard, and so necessary

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Two of the major deterrents to getting help for any substance abuse are acknowledging that it’s a problem and recognizing the shame that often accompanies that acknowledgment. It’s very hard to admit that we are harming ourselves or others around us. This difficulty is especially true for people who have been successful physicians, attorneys, executives, or other professionals in demanding careers. There is a deep shame in admitting that you are struggling when you feel that you are supposed to be a leader, a person who helps other people. 

 

Shouldering the burden of your substance abuse problem alone exacerbates painful emotions. Guilt, shame, and loneliness can make your addiction worse.

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Medication-assisted treatment helps you deal with the physical and emotional aspects of substance abuse

 

Quitting is physically hard. Substance abuse changes our brain chemistry.

 

Medication-Assisted Treatment (MAT) combines medication, psychotherapy/counseling, and behavioral therapies. Medication addresses the psychological cravings and chemical imbalances in the body. Psychotherapy, counseling, and behavioral therapies address you as a whole person, helping you build resilience, coping skills, and addressing underlying emotional difficulties that might be fueling your need to self-medicate.

 

Many people experience the coexistence of both a substance use disorder and emotional illness, such as depression, anxiety, or bipolar disorder. In treatment, addressing any mental health challenges (known as a co-occurring disorder) can help you better recover from substance abuse.

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Will alcohol abuse and other substance abuse just disappear after the pandemic?

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For some people, just getting back to normal routines will be sufficient to break a pattern of substance abuse that spiraled during the pandemic. For many others, however, the chemical and psychological effects of substance abuse have created a destructive trajectory that will outlive social distancing rules.

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If you use alcohol or other substances to manage challenges and negative feelings, you are less likely to take other steps to address those problems effectively. As a result, the longer you wait to address the underlying causes of your discomfort, the longer you will tend to experience increased emotional challenges, work stress, or relationship issues.

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Break the cycle and take steps towards healing

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In treatment, you can expect me to draw from motivational interviewing, cognitive interventions, and talk therapy while addressing any co-occurring disorders. When called for, I may suggest medication-assisted treatment. 

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You can’t just erase the pandemic period, but you can certainly get your life back on track. You can regain control over your internal regulating system, build healthy behaviors, and develop practical coping skills.