Managing mental illness during COVID-19

Photo credit: Sharp Health News/Sharp HealthCare

COVID-19 has undoubtedly turned people’s worlds upside down. While the stay-at-home orders, loss of routine and feelings of uncertainty can cause stress and anxiety for many, it can be particularly difficult for those living with mental illness.

“In this pandemic, we are facing many unknowns — economically, socially, medically and otherwise,” says Lori Alford, LCSW, a therapist with Sharp Grossmont Hospital. “This uncertainty can be a breeding ground for anxiety, worry and paranoia. Thoughts can spiral downward to unrealistic and catastrophic realms, and those with a mental health diagnosis are more susceptible to this.”

Without our usual freedom to socialize, travel and, in some cases, go to work, many of us feel extremely isolated. This can feed into a negative emotional state, particularly for those with mental illness. Focusing on thoughts of feeling alone — cut off from family, friends and peers — can amplify depression. With more downtime, a person’s mind may wander and sometimes those wandering thoughts may be unhealthy and turn into a ruminative process — excessive and repetitive thoughts of hopelessness and helplessness, for example.

Mindfulness can divert the mind from unhealthy thoughts

Practicing mindfulness can be very helpful for these issues. By fully and non-judgmentally focusing on the present moment and sensory observations, we can be transported away from unhealthy thought processes.

The importance of routine

Routine plays an important role in managing mental illness, and Alford recommends having a written daily plan. With bipolar disorder and other illnesses, regular sleep and wake times, mealtimes and outdoor activity times serve as anchor points throughout one’s day.

“The sense of being out of control can be very frightening for any of us, particularly for those living with mental illness,” says Alford. “As people try to adjust to lifestyle changes, economic impacts and losses great and small, they must also cope with ongoing uncertainty about what lies ahead. It’s useful to focus on what is within one’s control, not on what lies outside of it.”


To help keep the focus on what is within one’s control, Alford recommends a tool called GRAPES, an acronym for key concepts to implement daily. It stands for:

Gentle with self






Each day, engage in behaviors that reflect each one of these areas. To be gentle with self means to speak kindly to and seek to understand, not judge, oneself. Socializing may look quite different from what we’re used to. Try reaching out to others with phone calls, texting, social media and video chats. You can also write cards or letters and send them in the mail. If your neighborhood is built for walking, consider it an opportunity to greet others from a distance.

Don’t hesitate to get help

Anyone struggling with their mental health is strongly encouraged to reach out for support. “Keeping dark, unhealthy thoughts and depressed feelings to yourself is not a good place to be in,” says Alford. “When one is depressed, it’s hard to see things clearly and sometimes rationally. Getting help is extremely important; don’t let the pandemic stop you from doing so.”

For people living with mental illness, it is important to ask for help and receive the help that is offered to you. Reconnect with your psychiatrist and therapist by phone or video visits.

People experiencing mental health concerns who are not in treatment should not hesitate to seek help now. Mental health providers are available, and a limited number of programs and practitioners may also offer in-person sessions. From a primary care consult to a more intensive program, a range of services are available. People seeking services can contact their primary care doctor, health insurance provider or 211. Those in crisis should call the Access and Crisis Line at 1-888-724-7240, or call 911.

Sharp Grossmont Hospital Behavioral Health Services offers intensive outpatient group therapy programs for people with mood disorders, addiction issues and schizophrenia. To learn more about available programs, visit our outpatient services page or call 619-740-5811.

This article features experts from Sharp Grossmont Hospital. For more health stories visit