Covid-19 Support & Treatment

Considering Behavioral Health Supports and Treatment during COVID-19

It’s estimated that around 25% of the people in the U.S. will experience some type of mental health disorder in their life. Many of us have experiences with depression, anxiety disorders, substance use disorders, sleep disorders, and many other psychological or psychiatric difficulties. Similarly, children can experience a wide array of mental health problems including various forms of anxiety disorders, mood disorders, school-related difficulties, and attention deficit disorders.

While the COVID-19 virus has a clear impact on the physical health of those who contract it, the broader COVID-19 pandemic has very significant implications for our mental health as well. Somewhat unique to COVID-19, the efforts we need to make to reduce the spread of the virus can be stressful and challenging for our mental health. Being in our homes for prolonged periods of time, having children in the house and not in school, trying to take care of our elderly parents, missing important events, rituals, and celebrations all represent important sacrifices we are trying to make at this point in time, but they can also be a challenge to maintaining good mental health.

The goals of this module include:

  • 1. Help you carefully review how you are doing and make adaptive decisions to promote positive mental health.
  • 2. Provide information that can help you to determine whether or not reaching out to a mental health professional could be useful.
  • 3. Provide you with information about the easiest ways to get mental health assistance, by identifying resources in your community and the potential value of the use of telehealth or telemedicine services in mental health treatment.

Video about mental health, how to spot the signs that your mental health may be affected, and when to seek help.

Click here for video
Covid-19 Support & Treatment

Understanding the Impact of COVID-19 on your Mental Health

The impact of stressful events like the COVID-19 pandemic on mental health can vary from person to person and may change over time. Some people might notice very little effect of the pandemic on their mental health. They might be fortunate to be quite resilient. Others may notice short-term periods of depression or anxiety which is concerning, but basically resolves with time as the stress subsides. Other people might notice a more enduring pattern of psychological difficulty that persists beyond the initial stress of the pandemic.

For many people, psychological symptoms may not develop until after the stress has at least partially resolved. Notably, some people already have significant psychiatric or psychological difficulties and may notice that the stress of the COVID-19 pandemic has changed or complicated their disorder.

I already have a diagnosis of a psychiatric disorder, how might the pandemic affect me and what should I do?

If you’ve been diagnosed with a mental health condition, it’s important to know that the stress associated with the COVID-19 pandemic might cause your symptoms to worsen. We encourage you to take the following steps to look after your emotional health.

  • If you are currently receiving treatment, be sure to continue with that treatment. If you are not able to receive in-person care, develop a plan for telehealth sessions with your provider(s).
  • Make sure that you’re taking your medications as prescribed and have a plan for maintaining access to those medications during the pandemic.
  • If you are not currently receiving treatment, make sure to monitor your symptoms closely and reach out to your mental health care provider(s) if those symptoms begin to worsen or impact your daily life.
  • Think back to the strategies and coping skills that were helpful to you in the past and put them back into action now.
  • Find additional mental health supports.
I am worried about my mental health but have never been diagnosed with a mental health disorder. Am I at risk of developing a mental health disorder because of stress from the COVID-19 pandemic?

For many of us, the COVID-19 pandemic has significantly disrupted key areas of our lives, creating a sense of instability or heightened concern across a number of important domains including health, finance, and personal relationships. In addition to those stresses, recommendations from the U.S. government or major health agencies like the Centers for Disease Control actually encourage us to engage in behaviors that might otherwise seem strange or would not generally be recommended, like repeatedly washing our hands or being isolated from other people. Under these conditions, it can be hard to know what’s healthy or normal behavior, and what might represent a more serious mental health concern. In this section, we hope to help you distinguish between normative and more concerning responses to COVID-19.

View a video to learn about how you can determine what is healthy and unhealthy when so many people are experiencing anxiety, depression, and trauma symptoms during the coronavirus outbreak.

Mental illness during coronavirus

During the pandemic, you might find yourself

  • Worrying that you or someone you care about will get sick with the COVID-19 virus.
  • Washing your hands or disinfecting household and personal objects (such as doorknobs, cell phones, keys, etc.) more frequently than normal.
  • Being on high alert when in public spaces, or paying a lot of attention to how close you are to other people in public spaces.
  • Feeling angry and frustrated that your daily activities are dramatically limited due to the COVID-19 pandemic.
  • Worrying about finances and your ability to care for yourself and your family in the future.
  • Feeling isolated, lonely, and bored when staying at home for long periods of time.
  • Eating more than normal, or choosing more “comforting” foods than might be typical for you.
  • Sleeping more or less than normal.

These are all very unpleasant, but very typical reactions to the extreme circumstances that the COVID-19 pandemic has created. If you find yourself experiencing these things, know that you’re not alone, and that there are strategies and coping skills that might help you to manage some of these normal stress responses.

It’s also important to know that these experiences and other stresses that you might encounter during the COVID-19 pandemic can develop into more serious mental health concerns, for which more active interventions might be appropriate. Some of the most common mental health disorders linked to stress are depression, anxiety, substance use disorder, post-traumatic stress disorder.

Learn more about each of these common behavioral health concerns, and review a list of common symptoms.

Covid-19 Support & Treatment

Depression: Signs and Symptoms

  • Not feeling interested in things or activities that you used to enjoy
  • Tearfulness and crying
  • Angry outbursts
  • Sleeping too much or not sleeping enough
  • Eating too much or not eating enough
  • Thinking and moving more slowly (or more quickly) than normal
  • Having trouble concentrating, even on simple tasks
  • Thinking about death and suicide

Feelings of Sadness or Depression?

Many of us feel sad about the ways in which this pandemic is impacting our lives. We grieve for the loss of normalcy and social connection. Our hearts ache when we think about the pain that the virus is causing us and the people we care about. So, it is normal for us to experience some moments of sadness or depressed mood during this pandemic.

When these experiences last for long periods of time and impact your ability to meet your daily responsibilities to work or family, this can be a sign of a more serious mood disorder (e.g. depression).

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Covid-19 Support & Treatment

Anxiety: Signs and Symptoms

  • Feeling nervous or tense
  • Having trouble concentrating
  • Having trouble sleeping
  • Feeling weak or tired
  • Avoiding people, places, or things that make you feel nervous, even when you know you shouldn’t avoid those things
  • Experiencing intense physical symptoms out of the blue (including fast heartbeat and breathing, sweating, and trembling) that can’t be explained by a physical health condition

Feelings of Worry or Anxiety?

The COVID-19 pandemic has created a sense of fear, worry, and anxiety about the future for nearly everyone. We are encouraged by health officials to be on alert for an unseen pathogen that might harm us or others. We hear daily or hourly news reports about economic problems that could threaten our financial future. We worry about ourselves, our friends, our families, and millions of people that we’ve never met, but that we know are suffering. Just like sadness, anxiety or worry about the future is a common experience for many people right now.

It may represent a more serious disorder if you find that your worries are getting in the way of you being able to carry out your responsibilities or daily activities, are lasting for days at a time, or are difficult to stop.

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Covid-19 Support & Treatment

Substance Use Disorder: Signs and Symptoms

Look for the following issues, which might indicate a more serious substance use disorder:

  • Drinking more alcohol or using more drugs than normal, or more than you originally intended
  • Needing to drink more alcohol or take more drugs to get the effect you want
  • Having strong cravings or urges to use alcohol or drugs
  • Feeling like you need alcohol or drugs in order to wake up in the morning or get through daily activities
  • Spending lots of money on alcohol and drugs, even when you can’t afford it
  • Continuing to drink alcohol or use drugs when you know that it is harmful to your physical or mental health, or when other people have told you to stop
  • Spending lots of time getting alcohol or drugs
  • Failing at attempts to stop using alcohol or drugs
  • Driving or doing other risky behaviors after using alcohol or drugs
  • Experiencing severe withdrawal symptoms such as excessive sweating, shakiness, agitation, or mental confusion

Normal Substance Use or a Use Disorder?

People commonly drink alcohol to relax, or to help reduce unpleasant feelings like stress, anxiety, sadness, or boredom. During this pandemic, when we’re stuck inside, surrounded by stress, and have limited access to other tools that we might normally use to help us cope with painful emotions, many of us will turn to alcohol.

Although light or occasional alcohol use may not pose a problem for many people, it is important to keep in mind that alcohol is an addictive substance that can cause serious problems for a lot of people. Similarly, other substances like marijuana, might be used to relax, but could also cause significant problems.

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Covid-19 Support & Treatment

Post-Traumatic Stress Disorder (PTSD): Signs and Symptoms

  • Having frequent memories about the event that make you upset
  • Feeling as if you are reliving the event all over again
  • Feeling intense fear or distress when something reminds you of the event
  • Avoiding people, places, or things that remind you of the event
  • Feeling hopeless about the future
  • Feeling negative about yourself, other people, and the world
  • Having a hard time staying close to family and friends
  • Feeling numb
  • Being easily startled
  • Feeling that you are always on guard and needing to protect yourself from danger
  • Trouble sleeping
  • Trouble concentrating
  • Feeling guilt or shame because of the event

How can COVID-19 cause PTSD?

The COVID-19 virus has already taken or threatened to take the lives of many people in the U.S. and across the world. Because of this, unfortunately, many people will experience traumatic events related to the pandemic. For example, you or someone that you love may experience a life-threatening illness. You may see someone pass away, learn about the painful or unexpected death of someone you’re close to, or be exposed to repeated or extremely aversive details of a traumatic event (e.g., first responders who must collect the remains of deceased individuals). When people directly experience these extreme forms of stress, they are at risk for developing posttraumatic stress disorder (also called “PTSD”).

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Covid-19 Support & Treatment

Suicidal Thoughts

The pandemic has increased stress for a lot of people. There have been disruptions in jobs, childcare, healthcare, and other areas of life. In the face of the added hardships, physical distancing has made it hard for people to turn to their usual healthy ways of coping. You may feel isolated or stuck in the house. Your sleeping, eating, and exercising routine may have been thrown off. All of this can lead to emotional pain for some people. When life hurts, our minds sometimes turn to thinking about suicide and death. If you are having suicidal thoughts, we want you to know that you are not alone. Your life is valuable and there are healthy ways to cope in the pandemic. Below, you will find some tips for soothing your pain, finding reasons to be hopeful, and keeping yourself safe from harm.

Soothe your emotional pain

  • With self-compassion. Remind yourself that this is not your fault, and it does not mean that you are a failure. The pandemic has caused a lot of stress that is out of your control. When life is hard, it is extra-important to be friendly toward yourself.
  • With fun/pleasant activities. For example, step outside, stretch, listen to a funny podcast, watch comedy, play a game, listen to music, create art, take a hot shower, nap, or read. Even if you don’t enjoy these activities as much as you would under other circumstances, they can still help to reduce the intensity of emotional pain by creating more opportunities for joy.
  • Relaxation exercises. If you’re feeling stuck and don’t know how to soothe yourself, try these free relaxation exercises.

Look for hope

  • Reduce focus on the negative. Many people are working on solutions to help financially, medically, and to provide support within communities. Our mind naturally pays more attention to signs of danger and despair, but with effort, we can increase attention toward realistic sources of hope too.
  • Find what makes you feel hope. Find pictures, quotes, music, and other things that give you a sense of hope and spend time looking and listening to them whenever you are feeling down.

Connect with people

  • Prioritize connection. Prioritize making time for video chats/phone calls with friends, family, co-workers, etc.
  • Quality time. Spend time with the people that you live with and focus on talking and interacting rather than just sharing space.
  • Reach out. Ask people how they are doing, listen without judgment, and ask how you can support them. Find more tips for how to help here.

Contribute and find meaning

  • Check-in. Check on people who live alone to see how they are doing
  • Send an encouraging message. This can have a powerful impact during a stressful time.
  • Help others. Help people out in ways that you can, and give yourself credit for that. Do not minimize your contribution because it is less than you could do under other circumstances or because it is not as much as other people can contribute right now.
  • Find spiritual meaning. If there are spiritual scriptures or other inspirational quotes that fill you with a sense of meaning, focus on those during tough times.

Increase safety

  • Means reduction: Store lethal means safely (e.g., store guns separate from ammunition, locked in a safe; store medications safely and do not stockpile them). Read more about “means reduction” strategies from Harvard School of Public Health.
  • Reach out. Connect with loved ones and let them know you are struggling. Ask them for extra support. It is okay to ask for help – we all struggle at times.
  • Save resources and supports. Program emergency numbers into your phone – e.g., Crisis Text Line (text HOME to 741741), 1-800-273-TALK. People are available to talk to you in your time of need.
  • Get immediate help.
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Covid-19 Support & Treatment

How you can Gain Access to Mental Health Supports

While most of us are experiencing some challenges to our emotional well-being, two of the biggest clues that your emotional (e.g., sadness, anxiety) and behavioral (e.g., substance use) responses to the pandemic might have turned into a more serious disorder are:

  • If your problematic emotions or behaviors last for long periods of time, or
  • If those emotions/behaviors prevent you from meeting your daily responsibilities

If you think you might be experiencing a mental health disorder, then we recommend accessing mental health supports. This might mean using self-help tools, or working with a mental healthcare professional who can provide support and guidance.


Self-help mental health resources vary considerably. Some resources have very little basis in science, while others have been shown to be quite effective for managing mental health concerns for a number of people. Good self-help resources may help you to manage mild symptoms of a mental health disorder. In addition, if you’re having difficulty connecting with a mental health professional, following a self-help manual can be a great way to bridge the gap until you are able to secure a provider.

Self-help resources:

Finding a mental health provider

Working with a professional mental healthcare provider can be an excellent way to increase your level of support and get personalized guidance for how to move forward. Identifying a provider can sometimes be time-consuming and may take some persistence. So, while you pursue this important source of support, consider using the self-help resources listed above. Take the following steps to find a provider that will work well for you:

  • Contact your health insurance company. They can explain how your plan works and supply a list of covered providers in your area.
  • Connect with your Primary Care Provider (PCP). Your PCP may provide an initial mental health screening and/or offer a list of mental health providers.
  • Check out your company’s Employee Assistance Program (EAP). Your Human Resource Department can provide information about your company’s EAP and/or provide a referral.
Identifying providers in your region

There are a variety of options for mental health services in our region that include private practices, large multi-specialty clinics, state-run human service centers, and a variety of nonprofit facilities and agencies. If you are not aware of the opportunities available to you, trying the Services Locator managed by the Substance Abuse and Mental Health Services Administration.

Get immediate help

If you are having extreme distress or feel like you want to harm yourself or someone else, please seek help now by calling 911 or contacting FirstLink. FirstLink is a free confidential service available to anyone at any time of day or day of the year for listening and emotional support or referrals to resources for assistance, and crisis intervention.

For simple support, you can dial 211 or text your zip code to 898-211 from anywhere in North Dakota or northwest Minnesota.

If you need immediate, urgent assistance please contact either of these services listed below:

National Suicide Prevention Lifeline
  • Toll-Free Phone (English): 1-800-273-TALK (8255)
  • Toll-Fee Phone (Español): 1-888-628-9454
  • TTY: 1-800-799-4TTY (4889)
  • Website (English)
  • Website (Español)
  • Chat with Lifeline
National Suicide Prevention Lifeline
SAMHSA's Disaster Distress Helpline
  • Toll-Free Phone: 1-800-985-5990 (English and Español)
  • SMS (English): Text “TalkWithUs” to 66746
  • SMS (Español): Text “Hablanos” to 66746
  • TTY: 1-800-846-8517
  • Website (English)
  • Website (Español)
SAMHSA's Disaster Distress Helpline

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Covid-19 Support & Treatment

What you Need to Know About “Teletherapy” for Mental Health

To reduce the chances that you or others will be exposed to the COVID-19 virus, many mental health professionals are providing treatment from a distance using your phone or the internet. This is referred to as telehealth or “teletherapy”.

Using telehealth means that you can receive mental healthcare services without having to leave your home. It also means that individuals living in rural areas can have better access to mental healthcare. In response to the pandemic, insurance companies have increased coverage for telehealth to make this tool more accessible.

What you need to know about teletherapy
If you are interested in receiving mental health treatment using telehealth:

  • Speak to your current provider(s) about telehealth options for continuing your care.
  • Reach out to your insurance company to ask about coverage for telehealth services and a list of covered providers.

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Modules describing signs and symptoms of behavioral health conditions are not diagnostic. If you have questions or concerns about your mental well-being, contact My Sanford Nurse at 701.234.5000, 1.800.821.5167, or click here to find a Sanford Health care professional. If you are having thoughts of self-harm, call the suicide prevention LIFELINE anytime at 1-800-273-TALK (8255). If this is an emergency, please call 911.