At 7 p.m. on a Sunday night in March, Daniel Goldberg began to feel a familiar sense of panic and doom.

The public health ethics professor was standing in his kitchen, scrolling through Twitter on his phone, when suddenly it felt like he was spiraling into a dark hole. His heart started pounding furiously, his chest felt like it was constricting and he became lightheaded, ready to pass out. He couldn’t talk. He was consumed by a sense of terror.

Goldberg had been reading about a man his age who had contracted COVID-19. The man became so sick, he had to be intubated. The story may have triggered Goldberg’s panic attack, but he knows a long list of other things contributed.

And even though logically, he knew it was highly unlikely he would die at that very moment, “it doesn’t matter because you feel like you are,” he said.

Suicide prevention resources Colorado Crisis Line : 1-844-493-8255, coloradocrisisservices.org. Chat online or text TALK to 38255.

: 1-844-493-8255, coloradocrisisservices.org. Chat online or text TALK to 38255. Mental Health First Aid : mhfaco.org. Get trained to recognize the signs and how to respond.

: mhfaco.org. Get trained to recognize the signs and how to respond. American Foundation for Suicide Prevention : afsp.org. Join one of their upcoming walks for awareness in Colorado.

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Goldberg has spent much of his life developing strategies to cope with his generalized anxiety disorder. But the unprecedented coronavirus pandemic is testing him in new ways. He can’t detach from conversations about it, even if he wants to, because it’s literally his job to be informed and lead discussions on these issues at the University of Colorado Anschutz Medical Campus.

He’s far from alone in dealing with mental health issues alongside the physical health risks the coronavirus has brought. Social distancing and staying at home may be the best way to fight a global pandemic, but they also take a mental and emotional toll as the days wear on.

Calls, texts and chats to the Colorado Crisis Services hotline, including Colorado calls to the National Suicide Prevention Lifeline, saw a 47% increase with 19,985 contacts last month vs. March 2019. January and February also had higher volumes, but the jumps weren’t as big, according to data from the Colorado Office of Behavioral Health.

The increase has amounted to about 20 to 30 extra calls per day over the last couple of weeks, and the calls are also lasting about two to four minutes longer than is typical, said Camille Harding, state division director for Community Behavioral Health.

There are a number of factors that could be contributing to the higher volumes and lengthier calls, Harding said, but it’s clear that callers are dealing with anxiety, depression, financial stresses and having to pivot their lives quickly.

Two-thirds feel emotional impact

In a recent McKinsey survey, 64% of those responding reported feeling anxious or depressed for reasons related to the novel coronavirus, and suicide hotlines nationwide are getting more calls daily, according to Psych Hub.

“When you have an event like a pandemic or 9/11 or stock market crash, you will see increased depression and increased anxiety and increased misuse of substances,” said Dr. Carl Clark, president and CEO of the Mental Health Center of Denver.

Although suicides don’t have any one specific cause or trigger, Clark said stressful events exacerbate suicidal ideations, often disproportionately affecting people from lower-income households. The Mental Health Center of Denver, which is providing therapy over video calls, offers services regardless of income. Clients who don’t have the technology can visit kiosks to connect with their therapists electronically.

Denver resident Anastasia Briggs deals with anxiety as well as post-traumatic stress disorder. Her stress escalated when she lost her marketing job. She not only had to figure out how to pay her bills, she had to suffer through it alone.

“It feels like the rug was ripped out from under me,” she said. “And now, it’s the rug and the TV and the couch are being ripped out, too, because Denver is extremely expensive to live in.”

Her friends and family tried to support her from afar, like by dropping off banana bread at her door, but it’s different than getting wrapped in a hug. Same with FaceTime and Zoom meetings.

The stresses of the pandemic don’t just affect people who have a history of mental health issues.

“People do not need an official mental health diagnosis in order to suffer during unprecedented times like these,” said Alexis Verbin, a therapist at WELLCORE in Lakewood. “It is very normal and natural for us as humans to experience anxiety during heightened periods of stress and uncertainty.”

It's normal for people of all ages to feel worried, frustrated, or even angry, in the face of circumstances that change or feel uncontrollable. We encourage you to reach out & support others who might be struggling. https://t.co/w6mUZpkHGR pic.twitter.com/gVFtUHjWal — Colorado Department of Public Health & Environment (@CDPHE) April 1, 2020

Rae Moore, a 31-year-old Denver resident who runs her own sewing business from home, often thinks about how hard it will be to not have physical contact with friends or family for six weeks or more. And, she wonders, what will it be like to meet people after social restrictions are loosened? What will dating look like?

“When I think how long it’s going to be before it’s safe to do things like that again, I feel a little afraid that it’s going to be really hard where you feel comfortable and safe touching somebody again,” she said. Plus, people will be financially strained, she said.

Loneliness carries dangers for elderly

Although much of the distancing is about protecting vulnerable people such as older adults, they are also among the people who most need interaction. Studies have shown that isolation and loneliness may contribute to the health and mortality rates of older adults. There’s a 45% increased risk of death in seniors who report feeling lonely, according to the Health Resources and Services Administration.

“While coronavirus is impacting everyone in some fashion, certain individuals and populations are facing more change, loss of control, trauma and uncertainty than others,” Verbin said.

Richard Erickson, 78, moved to an assisted-living facility in Denver after his wife died so he could take part in social activities and feel less isolated. His daughter works five minutes from his apartment and lives only 20 minutes away, so she used to visit often. But since at least one resident was hospitalized with the coronavirus, the rest have been in quarantine.

Erickson still goes walking outside twice a day, wearing a mask, and he can get the mail. But aside from the nurse who comes in to help him and his son-in-law bringing his medicine, he doesn’t see many people. He can’t gather with fellow residents in the dining room, and he doesn’t see people in the hallways anymore. His meals, ordered by phone, come to his door. Erickson said he tries to stay busy with reading, but he misses seeing his family and friends.

“I try not to let it bother me because if I did, I’d be in a depression that I don’t want to be in,” he said.

Aurora resident Angela Pierce worries about her parents. Her dad lives at a skilled nursing facility after taking a fall last year, and the facility has been locked down except to essential personnel. He has dementia, so the isolation has been confusing for him.

“My dad is so scared because he doesn’t understand why he can’t see my mom, even though she’s calling every day,” Pierce said. “It’s been pretty difficult for all of us.”

Pierce also worries about him contracting the virus from another resident.

Her mom, who is immunocompromised, temporarily lives in a hotel because her condominium flooded, but Pierce can’t go see her because Pierce’s husband worked with someone who tested positive for COVID-19. Her mom is similarly struggling with anxiety being surrounded by people she doesn’t know.

And to add to the stress, Pierce was laid off from her job.

“We’re all just kind of worried and wishing everyone would just stay home,” she said.

Coping mechanisms

Therapists encourage people to find coping mechanisms to help them through difficult times, including establishing routines and taking advantage of resources available.

Briggs said it has felt like a “storm cloud you can see in the distance and all you can do is try to not let it come closer.” So she focuses on what she can do, including exercising and using teletherapy.

Among Moore’s coping mechanisms is making masks for health providers, because doing something for others helps her put away some of her own worries.

Goldberg realized he had to make changes. He started by deleting the Twitter application on his phone. And he tries to focus on compassion for himself and others, particularly his students.

But the professor worries that while the country is dealing with the acute crisis — as it should be, he said — it isn’t dealing enough with how to solve the problem long term, making it more likely that everyone will have to stay home again for an extended period of time.

The harm from isolation increases as time passes and affects many of the same people the country is trying to protect with distancing measures, creating an ethical dilemma, Goldberg said.

“Extreme physical distancing has to be understood as a harm,” he said.

Where to find help:

Healthier Colorado: healthiercolorado.org/about/covid-19-resources

Colorado Crisis Services: Call 1-844- 493-8255, text “TALK” to 38255 or go to coloradocrisisservices.org

American Foundation for Suicide Prevention’s Mental Health and COVID-19 page: afsp.org/campaigns/covid-19

COVID-19 Mental Health Resource Hub: psychhub.com/covid-19

Mental Health Center of Denver: mhcd.org/covid19

Mental Health of Colorado: www.mentalhealthcolorado.org/resources

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