Abstract

Background

Clinical Features of Lockdown Anxiety

CBT to Decrease Symptoms and Build Resilience

Practical Application of CBT

Role of the NP

Conclusion

References

Abstract

     Mental health morbidity has increased amid the COVID-19 pandemic due to social isolation, impairment of basic needs, financial instability, and fears of the virus. New cases of anxiety and depression have been on the rise, while preexisting mental and chronic illnesses have been exacerbated. Cognitive behavioral therapy (CBT) is a highly flexible technique used to manage an array of mental illnesses. CBT may be of particular benefit under conditions of social isolation and virtual health care delivery. This report addresses the critical role of nurse practitioners in navigating effective CBT for mental wellness.

Background

     The prevalence of mental illness and substance use is steadily rising in Canada and the United States. These illnesses are associated with an estimated economic burden of $51 billion annually in Canada and $225.1 billion in the US.1,2 A significant portion of the Canadian (56%) and American (41.5%) population has experienced increased stress and anxiety as a result of the COVID-19 pandemic.3,4 In addition, mental illness and substance use are risk factors for early mortality, accounting for an average of 10 to 20 years of life lost.1 During times of extreme stress, such as a global pandemic, rates of mental illness would be expected to rise rapidly.

     The current COVID-19 global pandemic and subsequent forced quarantines and physical lockdowns have dominated every aspect of people’s lives worldwide. The pandemic measures have dramatically increased anxiety and fear related to contracting the virus, acquiring required medical supplies, receiving timely medical assistance, and accessing basic necessities and food items. Social, economic, educational, and recreational opportunities were abruptly ceased by governments during the pandemic, which further exacerbated perceived threats to safety and security.5,  ۶,  ۷,  ۸,  ۹,  ۱۰,  ۱۱ Compulsory mandates to conduct work from home disrupted work routines and schedules and placed additional strain on individuals’ mental health. Work from home orders also led to dissociation between home and work responsibilities. The consequences of the pandemic are catastrophic for society and have been associated with increased mortality and morbidity, social isolation, and loss of financial security and employment.5,  ۶,  ۷,  ۸,  ۹,  ۱۰,  ۱۱ Due to the negative global impacts of the pandemic on mental health, the purpose of this report is to address cognitive behavioral therapy (CBT) for mental wellness and the role of the nurse practitioner (NP) in providing this therapy.

Conclusion

     The COVID-19 pandemic has profoundly impacted and increased overall burdens on mental health, perpetuating a mental health pandemic. As a result, mental wellness needs to be integrated rather than ignored as a routine component of all health care encounters. The pandemic measures and subsequent lockdowns have presented an opportunity to close existing gaps in the delivery of mental health services through the integration of effective alternative therapies and methods. In particular, COVID-19–induced stress and anxiety can be successfully treated using CBT techniques. Growing research confirms that CBT can be delivered remotely or as self-guided support, both of which are particularly beneficial under pandemic restrictions. Remote use of CBT could revive a sense of joie de vivre in patients who have suffered from isolation, stress, and anxiety as a result of the COVID-19 pandemic.