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Illustration: Eniola Odetunde/Axios

This season could bring exceptionally bad winter blues — and even worse mental health conditions.

The big picture: The pandemic already is causing stress, anxiety and growing mental health disorders — and it could get worse with COVID fatigue, seasonal affective disorder and holiday-related depression, experts warn. But there are steps you can take to alleviate the dangers.

Driving the news: The CDC is urging Americans to stay home this Thanksgiving as deadly infections are spiking across the United States.

  • Hospitals are overwhelmed and understaffed, making social distancing and other measures even more important, public health officials say.

What's happening: The pandemic is exacerbating mental health trends — when mental health conditions already tend to worsen with holiday stress — and introducing new issues.

1. Loneliness is growing in senior adults and is leading to a rise in substance use disorder, according to a survey of 1,000 adults who have parents over 70 living alone.

  • 88% are more isolated from loved ones, 85% are more lonely, and 53% feel forgotten.
  • 77% are abusing prescription drugs, and 65% are abusing alcohol.
  • 54% have a diminished will to live, and 49% are believed to be at a higher risk for self-harm or suicide.

2. Young people also face greater mental health issues.

  • The CDC found the proportion of mental health–related visits to emergency departments rose 24% for children aged 5–11 and 31% for those aged 12–17 between April and October, when compared with the same period last year.
  • The pandemic is stressing a health care system already overburdened, as there's only about one child psychiatrist for every 15,000 youths under 18, Parker Huston, pediatric psychologist at Nationwide Children’s Hospital, tells Axios.
  • "What we've seen is that kids who are already at risk and already needed some basic mental health support are now finding themselves even more in need. And then kids who might have been managing relatively well are being put into the at-risk or even in-need category," Huston says.

3. Substance abuse is rising.

  • While it is too early for data to establish a direct correlation with the pandemic, suspected overdoses rose 18% in March, 29% in April and 42% in May from the prior year, the Washington Post reports.
  • "The COVID-19 pandemic has increased the challenges for people with a substance use disorder. Certainly, let's just look at the individual increased risk factors: more anxiety, more stress, more worry, isolation, economic anxiety, losing jobs," Patrice Harris, the immediate past president of the American Medical Association, told the National Association of Attorneys General on Monday.

Yes, but: There are steps individuals and communities can take to combat the pandemic's punch to mental health.

  • Create new holiday traditions, such as have families make cookies, potato latkes or tamales together while on Zoom, Huston suggests.
  • Get outside every day for exercise and to see green spaces or national parks, all of which will help produce serotonin and help with seasonal affective disorder and wellbeing, says Ken Yeager, professor of psychiatry at Ohio State.
  • Keep in constant contact with older family members.
  • Check on your older neighbors who live alone and help with their yard or errands. Plus that "gift of sharing gives you a rush of dopamine, which is your mood boost in your brain," Yeager adds.
  • Look for outreach programs in communities. Yeager says some match older adults with students or others for assistance and connection, or they offer daily phone check-ins.
  • Remote-learning kids need to develop routines at home — "one of the big benefits for most kids about school is the consistency," Huston adds.
  • Utilize tools like light treatment and Vitamin D for SAD, Yeager says.

The bottom line: "Social distancing does not mean social isolation" says Yeager, adding that society can encourage resilience to protect mental health.

If someone is having suicidal thoughts, go to your local ER immediately, call the Nationwide Suicide Prevention Lifeline at 1-800-273-TALK (8255), or reach the Crisis Text Line by texting "START" to 741-741.

Go deeper

The biggest pandemic labor market drags

Data: U.S. Bureau of Labor Statistics; Chart: Naema Ahmed/Axios

State economies most exposed to industries that have been slow to bounce back from the pandemic shutdown — like tourism — are seeing the worst labor market pain.

Why it matters: Even states that have the coronavirus more under control than others are taking harder economic hits, thanks to their dependence on sectors slammed by the pandemic.

12 hours ago - Health

U.S. coronavirus hospitalizations keep breaking records

Data: The COVID Tracking Project; Chart: Axios Visuals

The number of people hospitalized with COVID-19 in the U.S. has reached new record highs every day since Nov. 10.

Why it matters: Governors in states like North Dakota and Illinois have been warning about overburdened hospitals and limited beds for weeks.

Caitlin Owens, author of Vitals
18 hours ago - Health

U.S. coronavirus hotspots far outpacing Europe's

Data: CSSE Johns Hopkins University, Census Bureau, United Nations; Chart: Andrew Witherspoon/Axios

America's coronavirus outbreak has surpassed Europe's.

Why it matters: It wasn't long ago that public health experts were pointing to Europe as a warning sign for the U.S. But the U.S. now has a higher per capita caseload than the EU ever has during its recent surge.