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'A collective trauma': New report details the effects of stress in America in 2020

Stress has led to potentially harmful behavior changes that could thrust the U.S. into a whole new health crisis.
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A new report from the American Psychological Association shows just how stressful life in America was in 2020.

The APA's "Stress in America" report, published Thursday, provides a stunning example of how mental health directly impacts physical health. It comes exactly one year after the World Health Organization declared the coronavirus a global pandemic.

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"We've gone through a collective trauma," said Arthur C. Evans, chief executive officer and executive vice president of the APA.

The resulting stress, the report found, is showing up in drastic weight changes and increased alcohol use.

The online poll, conducted in February, included responses from 3,013 adults about life over the past year. A majority — 61 percent — said their weight fluctuated in 2020. Of those, 41 percent said they'd gained more weight than they wanted to: nearly 30 pounds on average. Ten percent reported gains of more than 50 pounds.

"I'm not surprised," said Kara Caruthers, an associate professor in the physician assistant program at The University of Tennessee Health Science Center College of Medicine in Memphis.

Caruthers explained that when the body feels stress, a cascade of physiological changes takes place. The body releases a hormone called cortisol, which increases insulin levels in order to maintain normal blood sugar. Higher insulin levels increase fat deposits along the waistline.

Adding to the problem, more than half of respondents said their exercise levels dropped during pandemic.

Hispanic adults were most likely to report changes in weight and physical activity, the report found.

Eighteen percent of respondents actually lost more weight than they'd intended to lose: 26 pounds on average.

"We know we all do maladaptive things to cope" with stress, Evans said. "The issue is the magnitude of the problems we're seeing as a result of those behaviors."

The report also found that a growing number of adults have turned to alcohol as a coping mechanism. Nearly 25 percent of survey respondents cited pandemic stress for drinking more than usual.

But that percentage more than doubled to 52 percent among parents with children in early elementary school — a "stunning" finding, said Scott Bea, a clinical psychologist at the Cleveland Clinic.

"When stressors go up, there are changes in behavior that affect our bodies," he said. "I think those effects are going to last for some time."

Parents with young children at home for remote learning have been particularly impacted, with 60 percent reporting their stress has increased. Three-quarters of parents said they craved more emotional support.

Mothers often carry much of the added responsibilities.

Nearly 47 percent of women with children doing remote learning at home said their mental health had worsened during the pandemic, compared to 30 percent of men in the same position.

"Unfortunately, the way our society is structured, the burden of family life and house life still falls to women," Caruthers said. "They're managing their own careers, many also teaching school and they're not educators. I think it's been hard."

Still, fathers are also feeling the stress. Eighty-two percent of dads said they needed more emotional support, compared to 68 percent of moms. Fathers were also more likely than mothers to report weight changes and increased alcohol use.

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The added stress has also led to restless nights for many, the report found. Sixty-seven percent of respondents said they slept more or less than necessary over the past year.

Also heavily burdened are essential workers, whose jobs are required to maintain the basics of society: health care personnel, firefighters, sanitation workers, police officers, public transit workers and those in the food supply chain, for example.

The APA report found that a quarter of essential workers were diagnosed with a mental health disorder during the pandemic, compared to 9 percent of other working adults.

What's next?

Just because Covid-19 cases are falling and Covid-19 vaccines are rolling out does not mean the stress will disappear anytime soon, experts predict.

"We have a mental health pandemic coming, and we have to act now," Evans warned. "It's only going to get worse."

In the survey, Black Americans were most likely to say they are concerned about the future. And more than half of the respondents reported feeling worried about resuming close interactions with others.

Even the vaccine couldn't change that uneasiness. Forty-eight percent of those who have been vaccinated expressed angst about being around others when the pandemic ends, compared to 49 percent of unvaccinated people.

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