Mental health

MANKATO — Psychotherapists say the COVID-19 pandemic has magnified two mental health issues: fear and stress.

Most mental health practices in Mankato remain open, although many are now offering remote counseling as the number of infected Minnesotans continues to grow.

George Komaridis has been a Mankato psychotherapist since 1970. Because he falls into the at-risk age group of people over 70, he is working remotely; but his practice, ASC Psychological Clinic, remains open for in-person appointments.

“We decided to maintain contact because we work with people that are either suffering from traumas or some other critical thing,” Komaridis said. “To just make them sit and wait is almost unethical.”

Uncertainty, Komaridis said, is fueling people’s anxieties. He said external threats from the current pandemic can create a snowball effect — once one person begins to panic, it can be contagious.

While he sees parallels between the pandemic and other crises, like periods of social unrest during the Vietnam War or the fear of further attacks following 9/11, the sense of unease and uncertainty today is unprecedented because there are so many unknowns.

“The natural tendency under uncertain but potentially threatening circumstances is to become afraid, feel a threat and potentially have that tendency to panic,” he said. “If people start panicking, then others pick it up and that can rapidly spread.”

While fear is a natural reaction to uncertainty, Komaridis said the best thing people can do if they are by themselves is to engage in an activity that occupies the mind. He said physical exercise, such as a walk, can do wonders for a mind full of worry. And people can practice physical distancing while still maintaining social contact with others, even if that’s reduced to Skype, social media or a phone call.

Maintaining social interaction is especially important for kids now that schools are closed, said Jese Rugroden, lead therapist for the child and adolescent program at Prairie Care in Mankato.

“Usually as parents and professionals, we’re concerned about the use of technology with our children,” Rugroden said. “Now is a good time to teach them some of the potential positive ways to utilize technology to stay connected with family and peers. That’s where a lot of these kids are struggling; they’re feeling that lack of connection.”

Just as panic can be contagious, so can the spread of bringing down the fear levels a notch through social interaction and communication.

“One of the best things that stops people from going into panic states is contact with others,” Komaridis said. “We tend to be able to help each other stay in a balanced state. Someone starts panicking and someone else can say, ‘Wait a minute, why don’t you look at it this way?’ That’s important.”

Rugroden encourages parents to limit media exposure for younger children, who aren’t equipped to digest that information without increased anxiety. That, he said, leads to short fuses and irritability, some of the recent behaviors he’s witnessed as kids attempt to cope with so much uncertainty.

“Some of our younger kids are really catastrophizing in their head,” Rugroden said. “It’s important to give them the right healthy, fact-based education so their anxieties can be managed.”

Andrew Archer, owner and therapist at Minnesota Mental Health Services in Mankato, said he’s been looking at the pandemic from more of a sociological perspective. While he is currently seeing clients in his office, he and his staff have been expanding their options to include remote communication.

“We’re utilizing telemedicine for consultations with new people,” Archer said. “I might be rolling that out across the board depending on conversations with specific clients. But I don’t equate telemedicine with in-person psychotherapy. There’s certain practical limitations.”

He said the COVID-19 outbreak poses an immediate and existential threat for his clients, many who are college students looking ahead to an uncertain future as the economy slows from business closures and stretched resources.

“The path that’s been laid out for them since they were kids in terms of what they’re going to do post-graduate, the career they’re looking at long term is essentially gone because of the contraction in the market,” Archer said.

For others, the crisis is immediate, especially for people in the service industry who are asking themselves how they are going to pay their bills and rent without a steady income. Archer said it’s crucial to help clients distinguish their own subjective feelings of the unknown with the reality of here and now.

“I’m helping them to sequester what they’ve internalized from the culture from what’s actually happening in reality, which is you’re breathing, you’re having emotional experiences, you’re responding to stimuli,” he said.

Lou Ann Mayhew, a licensed psychologist with Associated Psychological Services in Mankato, said her clients have increased anxiety related to the virus itself. She said the Minnesota Psychological Association has loosened regulations to allow telephone appointments during the pandemic to alleviate client fears of in-person appointments.

“We don’t necessarily have to see them face to face, which was a requirement in the past,” Mayhew said. “A lot of clients are taking advantage of that.”

But for Rugroden’s teenage and adolescent clients, group therapy is a vital component to healing. It allows clients to learn from their peers and see that they’re not alone in their struggles.

Working out of a building with plenty of space and multiple floors allows his clients to spread out, keep a distance and practice good hygiene. Clients are assigned seats and writing utensils to avoid hand-to-hand contact.

“The group part is so crucial,” Rugroden said. “These kids are trying to avoid hospitalization or out-of-home placements — having that peer support gives them that validation they need to really dive deep into their work.”

Dan Greenwood is a Free Press staff writer. Contact him at dgreenwood@mankatofreepress.com