Why did this big challenge get worse in the pandemic — and will we recuperate?

Experts say depression, sadness — and unwanted weight gain — were common complaints when folks considered their mental health

When the pandemic first sent Americans home in March 2020, licensed psychotherapist Lisa Bahar thinks a lot of them were happy to have a break — from school, from work, from commutes and driving the kids around. Plus, most people had access to financial supports they hadn’t had before, like federal stimulus money.

But as COVID-19 dragged on, the story changed and both sadness and depression increased. Folks gained unwanted weight. And they started to question whether life would return to what used to be normal or if they’d have to adapt to a new version.

Bahar’s seen the increased stress, sadness and depression in her family therapy practice in Newport Beach, California. Research studies confirm the trend, too, including the 2021 American Family Survey, a nationally representative annual study conducted by YouGov for the Deseret News and Brigham Young University’s Center for the Study of Elections and Democracy.

Mental and physical health both took a hit in the pandemic, survey respondents said. It also became trickier to access care, especially mental health services.

“One of the biggest ways that this pandemic has impacted our mental health is in the loss of social supports,” says David Routt, a licensed clinical professional counselor in Caldwell, Idaho. “Many of us relied heavily on others to keep the wheels of our lives turning, and when those supports are lost, we don’t move as well as we did before. This causes a significant increase in stress, which can easily lead to depressive or anxious symptoms.”

Who’s hurting most?

Although many pandemic-related restrictions have been lifted in recent months, life remains different than it was.

“People of all ages are coming to me because they are experiencing feelings which are resulting in lack of motivation, not being able to engage in social activities or withdrawing from family members,” said Laurie Singer, a licensed marriage and family therapist in Camarillo, California. “These individuals are exhibiting maladaptive behaviors due to these feelings.”

Singer believes the pandemic is to blame for the increase and part of her therapy includes finding ways to help people see what’s positive in their lives.

“It is more difficult to get people to focus on the positive during these times of uncertainty. People have different opinions and belief systems,” said Singer.

She noted that family and friends may pick on or avoid an individual because of their beliefs about the pandemic. And school-age kids pick up on the discord and struggle to process it, sometimes resulting in maladaptive behavior like aggression or noncompliance.

Meanwhile, older individuals are more apt to isolate themselves and become lonely, which brings other problems, including lack of self-care, she said.

People were used to interacting with friends, family and even locations until the pandemic shut much of that behavior down, David Simonsen, a family therapist from Olympia, Washington, told the Deseret News. “This inability to get out and express oneself, be social and generally be free to do what you wanted has had a negative impact on mental health.”

About one-third of respondents to the American Family Survey said their feelings of sadness or depression increased. Just 9% said they felt less sad or depressed between March 2020 and when the survey was fielded in late June and early July 2021. The survey questioned roughly 3,000 adults.

Nearly 1 in 4 said members of their family hadn’t gotten needed mental health care, while 20% said they didn’t get the physical care they needed. 

Additionally, more than a third said they gained weight, compared to 17% who lost weight and 49% whose weight stayed the same, the survey found.

Exercise habits overall didn’t change, but for individuals they often did: 1 in 5 people said they exercised more and the same share said they exercised less.

Single adults with no kids were the most likely to claim increased depression or sadness (40%) in the survey.

Which Americans support spanking kids?
Young people’s attitude toward marriage is changing. Here’s why it matters

Marital status and family structure

Bahar has seen a lot of single adults who were very lonely and sad, especially college students who had to either leave their campuses and friends and classes or, conversely, those who were stuck where they were. High school kids missed a ton of the fun activities and social occasions — and many had their college plans put on hold for a bit, too.

Young people, she said, “had a lot of depression and disappointment and feeling isolated and losing their community.”

Asked if they felt more depressed or sad, the response of single adults with kids was very similar to those married without kids, at 34% and 33%, respectively. Just over 1 in 4 married adults with kids claimed more depression or sadness.

Bahar said married couples without kids that she knew seemed to draw closer, at least initially. For some, that changed later with too much togetherness.

Those with kids had other adjustments to make, some quite stressful, including figuring out how to run class remotely. For parents who struggled with that, “it turned into a big issue of not knowing how to teach kids and feeling bad about that, as well as frustrated they had to do it,” she said.

For anyone who was ill in the pandemic, “quarantining at home can be extremely isolating and human beings were created to be relational, so it stands to reason we would suffer from this lack of human contact,” Routt said.

He thinks extroverts might have had the hardest time with that. “There’s a great deal of truth to the fact that about half our population is ‘more OK’ with being home alone on  a Saturday night.”

Just having others around — whether children or a partner — provides a natural support system at home. “Having those relations can keep us going,” said Routt. 

Also true, though, is families sometimes increase stress, including in difficult intimate relationships (perhaps with abuse), when we rely on medical supports or child care or treatment, or when someone loses a job or is sick, among others.

“When we look at the many variables that impact our lives, there are lots of reasons why people may already be stressed or depressed,” said Routt. “With the addition of a global pandemic, it doesn’t make anything better, but instead makes it much worse.”

Money resources mattered, too. The survey found high-income people in households making at least $80,000 a year were slightly less likely to cite increases in sadness or depression (29%) compared to 34% of folks with incomes below $40,000 and 31% for those with income in between. The survey margin of error is plus or minus 2%.

The good news in this survey – and a bit at odds with some news reports and counselors’ experience with clients — is that while 12% said they drank alcohol more often, 20% said they drank less often as the pandemic went on.

Weighty challenges

Issues with weight gain and eating can be a symptom of depression, according to Simonsen. And that’s not unexpected in a global pandemic.

“When there are no places to go and nothing to do, sitting at home and bingeing the latest show on Netflix is bound to be problematic,” he said.

Bahar said weight gain has been a common patient complaint and for many, the stress it causes is striking.

“Food serves as a way to push feelings down,” said Bahar. “It’s self-calming and often a mindless thing.”

But for many people, as weight increased, so did negative self-talk, body issue images and not liking oneself. For those already struggling with body image issues or an eating disorder, the pandemic was especially bad.

She said more of her young male clients were eating more, drinking more and using more substances during COVID-19. Couples home for six months at the beginning of the year followed a similar pattern. And even if they didn’t drink, they were preparing more meals at home: breakfast, lunch, dinner and more snacks.

Among those polled, the share of those who added pounds ranged from 30% of married parents to 36% of single parents. Those without kids were somewhere in between.

Eating is a tried-and-true coping mechanism, Routt said, noting that “Eating releases dopamine into the brain which makes us feel better. It’s one of nature’s most natural drugs.

The 2021 Stress in America report by the American Psychological Association found even more dramatic unwanted weight gain by adults. Its March 2021 snapshot said 61% of U.S. adults said they experienced unwanted weight gain in the pandemic, averaging 29 pounds.

Somewhat fewer men (39%) than women (45%) said they gained unwanted weight, but the men who did gained more pounds, 37 compared to 22 for women.

In that survey, millennials were the most impacted by so-called COVID-pounds: 48% said they gained and the average was 41 pounds.

But 47% said they delayed or canceled health care services.

Pandemic drags on

When the pandemic began, Americans geared up to ride out what they expected — and officials predicted — would be a calamitous but limited-time crisis. Instead, COVID-19 has found its own rhythm, ebbing and changing and roaring again in an unpredictable, discouraging cycle.

Policymakers and public health officials find it hard to predict what will happen next.

Uncertainty never reduces stress. Americans are in a “slow process of accepting a new reality that the end is not clear here,” said Bahar. “It could be a way of life we have to accept.”

Still, a lot of folks — including Simonsen — feel hopeful.

“With life getting back to a new normal, I imagine we will see depression rates reducing and weight gain lessening, which is a great thing,” he said.