Leela Magavi, a child and adult psychiatrist, has experienced the pandemic through a range of perspectives. Working in Newport Beach, Calif., she has been helping clients navigate the realities of the pandemic, including an increase in child abuse. One day, a young client of hers confided that a family member was sexually abusing her, Magavi says. “When I finished work that day, my husband asked me if I was okay, and I immediately burst into tears, wishing I could rewind time to save that precious child from the despicable things she had endured.”
All the while, Magavi is also facing the painful effects of being isolated during the pandemic. In the past year, she lost her last living grandparent, as well as a childhood friend. Her father-in-law is battling cancer.
As Magavi puts it: “I am concurrently tackling my own grief and the grief of my patients.”
Magavi is one of the many mental health professionals who are guiding people through this mentally trying time while simultaneously grappling with their own problems. In a survey of therapists by the American Psychological Association published in October, 74 percent of therapists saw an increase in demand for anxiety disorder treatment since the start of the pandemic, and 60 percent saw a rise in demand for depression disorder treatment. In the same survey, 41 percent of therapists reported feeling burned out.
This has disproportionately affected women, who make up about 82 percent of therapists, 72 percent of counselors and 67 percent of psychologists, according to data from the U.S. Department of Labor. Women also report certain mental health disorders at higher rates than men; anxiety, notably, is twice as prevalent in women.
Magavi says her hours are longer, and she has missed meals and lost sleep over her constant worry about her patients. “When our patients suffer, we inevitably suffer,” she says.
In the past, therapists may have more easily separated their personal stress from that of their clients. But now, everyone is dealing with the pandemic’s impact on mental health.
“In some ways, it has added depth to the therapeutic relationship because there is a synonymous understanding of the ways in which the pandemic has affected everyday life,” says Shemiah Derrick, 38, a licensed professional counselor and certified alcohol and drug counselor based in Chicago.
Derrick says that since realizing that the pandemic would have no quick solution, she has struggled to serve her clients without compromising self-care. “The pandemic has taught me to follow my own advice, remember that I am human, too, and focus on what’s most important outside of the office,” she says.
However, she adds, “A lot of this year has meant acknowledging that there aren’t solutions for things, or that real suffering is happening and that I feel that impact, too.”
For people of color in particular, the past year’s protests against racial injustice have added another layer of stress — and unity. Derrick, who is Black, says she feels inspired by the Black Lives Matter movement. “Like many, the disregard for Black lives and blatant hate has taken a toll on my mental health at various points,” she says. “Seeing the unity and strength from BLM has been a motivator and gives me hope that things will get better for me, my family, friends, colleagues and clients.”
Therapists who are parents are also facing added pressures during the pandemic. This has been well-documented across industries, with millions of women leaving the workforce since the pandemic’s start. According to a 2020 survey from UN Women, 36 percent of women have experienced an increase in caring for children, and 34 percent of women have increased time spent entertaining children since the pandemic began.
At the beginning of the pandemic, Emily Guarnotta, 31, a licensed clinical psychologist in Merrimack, N.Y., learned she was pregnant with her second child. She specializes in helping clients navigate the challenges of parenting, and many of Guarnotta’s experiences mirrored theirs. “Like my clients, I am having to juggle working from home, finding alternative forms of child care and dealing with anxiety about covid exposure,” she says.
Guarnotta says she has used self-disclosure — when a therapist shares personal information — more frequently during the pandemic to show clients they are not alone in this. She has also had to cancel more appointments because her children were at home, she says, so she’s made her cancellation policy more flexible.
Erika Evans, 45, a licensed marriage and family therapist, experienced panic attacks at the onset of the pandemic. By May, she began to adjust and had “a routine established that felt like a new normal that was somewhat livable.”
Then came the weight of child care in a pandemic. “It hit another height again as I realized it was going to be an entire academic year at home with my small human and how that was going to be managed in my home,” Evans says.
As a non-monogamous person, the pandemic has presented another challenging constraint for Evans: “Not being able to see or visit current partners because they may live life in a way that is less restrictive or more restrictive, it has been emotionally and, in some cases, physically overwhelming,” she says.
Ultimately, many therapists say, the pandemic has tested their abilities — and required them to step up to an unprecedented situation. But even with the demands of child care, many have doubled down on the importance of taking time for themselves.
“I am also recognizing the importance of rest and refueling myself in a way that I actually had not done before,” Evans says. “Much of my rest regimen is connected to healing my own hurt heart that again is responding to the same thing.”
Therapists are generally well-trained in a variety of coping mechanisms, but some say that the pandemic threw the rule book out the window. Amid the uncertainty, other habits have emerged.
Evans buys a fresh bouquet of flowers for herself each week. “This has given me something beautiful to look at when things don’t always feel so beautiful around me,” she says. She also watches funny animal videos, plays the iPhone game Candy Crush, keeps an oil diffuser going and makes a conscious effort to find something to make her smile or laugh every few hours. Taking naps and crying have certainly helped, too, she says.
For Derrick, caring for herself means skipping dramatic TV shows or the news, and turning instead to cartoons and animated movies. “Something light with ‘easy’ problems that could be solved was a nice departure,” she says.
Derrick has also shifted her idea of what a routine “needs to look like,” she says, and has allowed herself to be more flexible with her time if it helps her “preserve physical or mental energy.” That means saying no to certain activities, even things she might enjoy, if she’s feeling drained of energy. Instead, she uses the time to reset with habits such as meditation to process and reground herself.
Magavi finds reprieve through mindful hikes with her husband, who she says “manages to make me laugh so much that I get a free ab workout alongside the cardio.”
Finding a support group of other medical professionals has also been a great help, according to Magavi. She processes her experiences with her sister, who’s a physician and regularly works in the intensive care unit. “Her perseverance and dedication motivate me every day,” she says.
As they navigate the mental health stressors of this time, these therapists say they are moving forward in ways everyone can: honest discussion, finding joy whenever possible, and knowing no one is in this alone.
Almost one year into the pandemic, Derrick feels “inspired, sometimes tired and very human.”
“Working throughout the pandemic has challenged me to think differently about how I care for myself in order to continue to care for others,” she says. “There are a lot of struggles, but the resilience I’ve witnessed is indescribable.”