Mental Illness on the Front Lines

A dear friend texted me the other day, and after chatting a bit, I asked how she was doing. She’s an ER nurse in Florida, so I was concerned. Florida, if you don’t already know, is a hotspot for coronavirus and the governor is incompetent, in my opinion. This was her reply: 

It’s bizarre and sad. The first wave was mainly elderly folks from nursing homes mixed with regular people; some very sick, some not. In the beginning we had a tent outside where we tested people with minor symptoms, when it declined they took it down. The numbers we saw in the beginning don’t even compare to now. Every room with a door has a COVID patient. Four units have been converted and they’re full. Our governor was actually at the hospital today talking about how everything is fine. It’s not fine. This new wave is younger, mainly Hispanic; people who are low income and work either illegally or in cramped factories, they live in multi generation homes, so they all get sick. I feel relatively safe though, we have enough PPE. It’s just crazy. The saddest part is nursing home patients; they literally haven’t seen their families for months, even if they don’t have it, if they come from somewhere that has people who are positive, no visitors. I try to find beauty and love in tragedy when I can. 

Her response broke my heart. I’ve read that it’s bad but to have my sweet friend recount the chaos and horror just shook me. Can you imagine what first responders, nurses and doctors feel being bombarded with sick patients who can’t see their family and those who die? A local friend who is a doctor said her friends cry in their cars after working a shift because there are so many codes. 

Unfortunately, there is no where you can go to escape the pandemic, the divisiveness that’s occurring or the uncertainty. Corpus Christi is especially bad and has made national news, for all the wrong reasons. We have more cases than the larger cities (Dallas, Houston, Austin) per capita. Since March, 85 babies have tested positive for COVID-19. 

My Florida friend also told me that she had to start taking antidepressants because of stress and trauma of it all. Thankfully, the meds are helping and I’m so glad she reached out for help, but I couldn’t help but think of Dr. Lorna Breen, the ER doctor in New York who killed herself. She had no history of depression, other mental illness or suicidal ideation, according to her father. I can’t say for sure why she killed herself but I imagine the weight of so many people getting sick and dying was too heavy. Not only were people dying, but at that time, medical providers in New York struggled with a shortage of personal protective equipment. Dr. Breen also contracted the coronavirus before her death. 

The trauma of everything she faced every day could’ve changed her brain. Trauma has a way of doing that – just think about our vets who suffer with PTSD and depression. Trauma can also cause feelings of despair, and right now, who isn’t in despair? A 2013 study done by researchers at the University of Liverpool showed that traumatic life events are the single biggest cause of anxiety and depression, followed by a family history of mental illness and income and education levels.

It’s enough that our front lines workers have to worry about contracting coronavirus, but it can be just as bad developing depression (or other mental illness). Both diseases are ravaging and both can kill. I don’t really know what I can do to help these heroes other than bring awareness to mental health and the consequences of untreated mental illness. It’s overwhelming and I hope lawmakers will keep all of this in mind, because make no mistake, this will be a real problem — one that can’t be ignored. America’s supposed to be the greatest country in the world — so what does it say if we don’t take care of those who take care of us? It’s happened before.

After texting me about the chaos and death that surrounded my friend, she left me with this: “It’s so unfair that what should be an exciting time is tainted by all this but find the joy in it, too.” 

My friend is so strong and has such a good heart. She’s doing God’s work and she is more than worth protecting and taking care of.

G, if you’re reading, I love you and cherish our friendship. I’m so proud of you. Just keep swimming, my love.

If you know somebody struggling with mental illness or suicidal ideation, please direct them to the National Suicide Prevention Lifeline at 1-800-273-8255.

To learn more about depression, please visit the National Institute of Mental Health.

Trauma and Depression

Dr. Lorna Breen. Photo from Ny Times

A couple weeks ago a well-liked ER doctor at a Manhattan hospital killed herself. Dr. Lorna Breen, the medical director of the emergency department at New York-Presbyterian Allen Hospital, had been reportedly working long hours and on the front lines fighting the coronavirus. She was 49 years old. Her father, also a doctor, said Dr. Breen had no history of mental illness or depression, but sometimes that doesn’t matter. Dealing with trauma, be it a one-time situation or an ongoing ordeal, can lead to depression and I imagine that was the case for Dr. Breen. She saw hundreds, if not more, of people suffering. People who couldn’t be with their loved ones during their final moments. Just thinking about how scary it must be for those dying alone makes me so overwhelmingly sad – not just for those dying but their loved ones who couldn’t say goodbye. Couldn’t tell their loved ones, “I love you,” or pray with them.

As of April 7, there had been 59 patient deaths at Dr. Breen’s hospital, according to an internal hospital document.

New York continues to be a hot spot for COVID-19, with 333,000 people infected and more than 21,000 dead. The weight of those numbers is so heavy, it hurts my heart. And I feel a combination of compassion and pain for nurses, doctors, first responders and others who are fighting this battle that has no end in sight. These people are heroes. They continue to fight a losing battle with not enough personal protective equipment and other life-saving medical supplies.

Everything I just mentioned can have a huge toll on anyone, and sometimes traumatic events can actually change your brain and can cause depression. A 2013 study done by researchers at the University of Liverpool showed that traumatic life events are the single biggest cause of anxiety and depression, followed by a family history of mental illness and income and education levels.

According to the National Institutes of Health, some depression can be situational and with life changes, medications and therapy, it can be manageable. Other times, depression, anxiety or PTSD can be life-long problems.

What’s scary to me is that Dr. Breen’s depression (I’m assuming it was depression brought on by severe trauma) came on fast. There wasn’t much time to prepare for COVID-19, as fast as New York was hit. I’m sure priorities were treating sick patients, providing PPE to health care workers among numerous other jobs that had to get done. Which means, there was no time for Dr. Breen to get help. She felt she was best needed at the hospital and no doubt she helped hundreds of people and supported everyone in the ER Department, even after contracting COVID-19 herself.

Dr. Breen was no doubt a hero and dying by suicide doesn’t change that. It just emphasizes the need for better mental health care, more support for those struggling and more understanding from the public, who still support the stigma of mental illness and depression.

Look for these symptoms of trauma-induced depression:

  • Extreme sadness
  • Frequent crying
  • Feelings of loss
  • Emotional numbness
  • Disillusionment
  • Loss of appetite
  • Difficulty sleeping
  • Recurring memories/flashbacks
  • Nightmares about the traumatic event
  • Social withdrawal

If you know somebody struggling, please direct them to the National Suicide Prevention Lifeline at 1-800-273-8255.

To learn more about depression, please visit the National Institute of Mental Health.