Mental Health Wins of 2021

Assessing our collective mental health in 2021 can feel like an arduous task, especially when most of us are still processing 2020. After a year that cracked us wide open, many continue to struggle in putting the pieces back together.

But despite the stress of our current circumstances, we manage to go on, because, in these struggles, there is resilience. And never before has mental health been such a topic of discussion and concern. While it’s unclear whether we’re “returning to normalcy” or headed toward another period of restrictions, it’s more important than ever to look at how far we’ve come.

If we allow ourselves the space to focus on the progress being made in the field of mental health, it’s not too difficult to find a silver lining on this dark cloud of a year.

Athletes Are More Than Their Medals

If we’re discussing wins this year, we need to talk about sports. These may not be victories that yield trophies, but there are two all-star athletes in particular that deserve recognition for their role in advancing the conversation around mental health.

It’s no small feat that superstar gymnast Simone Biles and tennis champion Naomi Osaka, two young women subject to near-insufferable amounts of scrutiny, chose to put their mental health ahead of their careers this year.

After being fined $15,000 for skipping a post-game press conference in the interest of preserving her mental health, Naomi Osaka withdrew from the 2021 French Open altogether. And at the 2021 Olympics in Tokyo, Simone Biles withdrew from the final all-around competition as an act of prioritizing her mental health. These decisions created waves, both in athletics and public conversation.

As the news broke that Biles had withdrawn, countless fans voiced their support on social media, but still there were others that expressed only disappointment. Unfortunately, these athletes' decisions were not met with the same sweeping fanfare as their killer serves or double layouts.

This uglier side of the public’s response revealed the degree to which elite athletes are dehumanized by their fans. But, as Naomi Torres-Mackie, PhD, head of research at The Mental Health Coalition, sometimes we need to face our demons in order to address them.

“That backlash being unearthed provided an opportunity to have a conversation around mental health and how we treat it so differently from physical health, as if it’s less important when it’s absolutely not,” Torres-Mackie says.

For Biles and Osaka, these decisions were undoubtedly difficult to make. But the fact that they were made at all reveals a shift in our approach to mental health—both publicly and privately—and have set the wheels in motion for much-needed change. By putting mental health front and center on such a grand stage, these athletes remind everyone that it’s OK to not be OK.

The Power of Shared Experience

It’s safe to say that most of us, at some point, have been affected by the stress of this pandemic, whether it’s impacted our moods, energy levels, behaviors, or sleeping and eating habits. While this might not be positive overall, we can take something constructive away from it: shared experience. We have certainly not been alone in our struggles.

“There’s this sense of universality, which is really important for psychological health,” Torres-Mackie says. “This idea that there are some things that are universal in the human experience. The pandemic gives folks a sense of that, so there’s more acceptance.”

And haven’t acceptance, compassion, and understanding become default themes this year? We’ve tried our best to accept the things we cannot change—lockdowns and canceled plans—and be understanding as inconveniences arise—crying kids interrupting a business call or pets wandering into a zoom meeting.

“I think this feels more authentic,” says neuropsychologist and associate professor of psychology at Pepperdine University Judy Ho, PhD. “Before, there was that facade of ‘I’ve got it all together.’ Now it’s ‘I’ve got it all together, but there will be interruptions.’”

Along that same vein, it’s possible that we’ve developed greater empathy toward people who live with less visible conditions. For example, even if they’ve never experienced substance use disorder themselves, countless people struggled during the pandemic with overconsumption of alcohol and slipping into patterns with unhealthy coping mechanisms.

Within the first month of the pandemic, alcohol sales in-store and online surged by more than 300% compared to the previous year. This set the tone for an extremely taxing period, as one survey of 800 people published at the end of 2020 found that 60% of respondents were drinking more than they had before the pandemic.

While an uptick in alcohol consumption might not be a positive overall, it is revelatory that the root of addictive patterns often lie in experiences of trauma, anxiety, and depression. And of course, addiction can come in many forms—not just via alcohol or hard drugs.

“Folks are getting a much better understanding of what trauma actually is and how it impacts us,” Torres-Mackie says. “What might’ve been brushed aside as ‘This person is difficult, or has a terrible personality,’ [now] there’s a better understanding of how experience impacts how you operate in the world.”

This understanding can shift the mindset of a person who might have previously looked down on addiction. Ho points out that now, as more people are willing to admit they’ve indulged in unhealthier coping habits to get through this tough time, such as spending more time online, there’s a better ability to relate.

“It has shown that the power of wanting to escape when we are stressed, and how easy it is to have a slippery slope,” she says.

Understanding COVID-19’s Effects on Cognitive Health

We know the collective experience of lockdown and life during a global pandemic have exacerbated mental health concerns, but as a psychiatrist, Thomas Oden, MD, is seeing an increase in mental health symptoms in long-haul COVID-19 sufferers, as well. Patients have reported an inability to focus or tolerate stress, as well as the reemergence of previously controlled mental health symptoms or new symptoms entirely, mostly relating to depression, anxiety, or insomnia.

While COVID-19 has obviously had a major impact on the state of mental health in a broader sense, studies have shown that the virus can spread through the central nervous system, and researchers are working toward a better understanding of the effects on the brain itself.

After having COVID-19, people have most commonly reported such neurological symptoms as headache, migraine, numbness and tingling, fatigue and other muscular issues, according to neurologist Pooja Patel, MD. Meanwhile, research shows that instances of other severe effects of COVID-19, like psychosis, are extremely rare.

Patel specializes in the treatment of headaches at Baptist Health’s Marcus Neuroscience Institute. During the pandemic, the most common cognitive symptom she’s seeing in patients who have or have had COVID-19 is brain fog, which is a term patients use when they’re having trouble focusing or are experiencing lapses in memory.

“We don’t know whether it’s going to last a few weeks, a few months, or if it’s a chronic condition,” Patel says. “That’s something we’re still learning.”

This might not sound like a win, but when mental health professionals and the public are armed with a better understanding of the cognitive effects of COVID-19, people who are struggling can make more sense of their experiences and get the support they need.

Embracing Online Therapy

Thanks to more open conversations of mental health and a reduction in stigma, more people struggling with anxiety, depression, or any number of mental health conditions have been able to embark on a path to healing. For many this past year, that opportunity to heal came virtually.

Through online therapy, countless individuals were able to find the support and relief so desperately sought after this year—and in the comfort of their own homes. Talk therapy became, effectively, less exclusive.

“Mental health, as a field in general, historically has not been accessible enough, especially to communities of color or folks who are financially strapped,” Torres-Mackie says.

Electronically delivered therapy decreases some of the barriers to mental health care, such as overall costs, lengthy wait times for appointments, or long distances of travel, which so often keep people from getting the help they need.

And when looking specifically at studies on cognitive-behavioral therapy (CBT), one recent meta-analysis found that CBT delivered virtually was at least as effective as face-to-face therapy at reducing the severity of depression symptoms.

While not everyone wants to add more video calls to their schedule (hello, Zoom fatigue), virtual therapy can provide a new, helpful perspective for practitioners, as well.

“It’s really nice to see somebody in their habitat,” Ho says. “Because someone can come to the office like ‘Everything’s great, everything’s fine,’ kind of holding it together. But when you see them in their home, you get this intimate look and it helps with rapport-building. You can notice when things go awry.”

Virtual therapy isn’t perfect, and we’re still learning about how well it works in the context of the pandemic. But it’s an improvement on accessibility to mental health care, which is a major win for those seeking support.

An Injection of Hope

Certainly, one of the biggest indirect mental health wins this year was the introduction of a COVID-19 vaccine. We began 2021 with a plan for vaccine rollouts across the country, and the promise of a life-saving vaccine induced a collective sigh of relief.

For a brief period, before the Delta variant became the concern it is today, fully vaccinated individuals were able to comfortably enjoy some semblance of what life looked like pre-lockdown. We’ve hugged our loved ones again, shared meals indoors, and even attended live events without the same level of fear for our safety that became second nature during the pandemic.

While we’re still not out of the Covid-19 weeds, the wins we’ve witnessed in the field of mental health this year have given us hope for something different—perhaps less of a return to normal, and more of a new one entirely.

While no one comes out of this unscathed, on the other side could exist a world with less stigma and more support, individuals with greater empathy and awareness of the universal nature of our experiences and struggles. After all, we are surviving this together.