From Linda M. Rio, MA, Marriage & Family Therapist – No one knows for sure, but it seems the world has, hopefully, passed the worst of the COVID-19 pandemic. Even with eventual variants, many experts are saying that with all we learned from scientists, public health experts, municipalities, medical professionals, and the public, we ought to be able to avoid the most restrictive measures endured over the past two years. However, one thing we have all learned is just how powerful and formidable nature is. Humankind, still cannot control or even predict many of the forces and mysteries of nature.
For those who have or had a pituitary disorder or those undergoing the diagnostic process to determine if this accounts for their symptoms, the news of the end to pandemic lockdowns and restrictions may be very welcomed. But for some people with pituitary disorders the end of mask-wearing and isolation may not be a welcomed event.
People diagnosed with pituitary disorders have unique responses to their illnesses and anxious events such as a pandemic. But it is worth mentioning that this article does not classify those with pituitary disorders solely due to their responses to a global event. It does, however, attempt to examine the collective experiences and potential psychological and emotional effects that may occur following any impactful event. Also, it is essential to note that some things have changed permanently due to the pandemic.
There are specific behavioral, cognitive, and emotional symptoms and traits associated with certain pituitary gland disorders, which may exacerbate or exaggerate what any person might demonstrate in the face of a major stressor such as a worldwide pandemic. The potential effects of recent events may be somewhat unique for those with pituitary disorders and therefore worthy of consideration.
Firstly, it is important to briefly look back on the last couple of years to understand the impact COVID-19 has had on how some things have changed.
Impact on the Delivery of Healthcare Services
Almost immediately after healthcare providers and organizations became impacted by quarantine restrictions, the delivery of medical and psychological services changed. Although Telehealth existed years before the pandemic, it was not widely used nor trusted. A report from the U.S. Department of Health and Human Services (HHS) found that massive increases in the use of Telehealth helped maintain some health care access during the COVID-19 pandemic, with specialists like behavioral health providers seeing the highest telehealth utilization relative to other providers. This report found that the share of Medicare visits conducted through Telehealth in 2020 increased 63-fold. Surges in how people learned how to access medical and mental health services were not across the board. A Press Ganey’s survey found that 60% of Gen Z and millennials, along with 44% of baby boomers, research their healthcare practitioners based on positive reviews. That is an increase from just a few years ago, in 2019, when only 17% of baby boomers and 47% of Gen Z or millennials conducted digital research before booking with a telehealth provider. They searched for reviews from devices such as tablets or smartphones. A four to five-star rating played an important factor, as the findings revealed that “83% of patients go online to read reviews about a provider after they receive a referral”. A vast majority of “84% would not see their preferred provider if they had less than a four-star rating”. Therefore, a positive digital presence is crucial for online providers despite a patient’s age.
In general, younger individuals increased their use of telemedicine during COVID-19 compared to older individuals, although individuals in their 70s also increased their use of telemedicine. Disparities in telemedicine have occurred with those living in rural environments and lower-income brackets having less access and use. Of course, not everyone found it comfortable nor easy to meet with their physician or other healthcare providers online. Not everyone has the financial means or the comfort in using technology. The term “digital divide” has been used to describe the existing inequities. A study published in JAMA looked at those who used Telehealth during the early part of the COVID-19 crisis and found that women were more likely than other subgroups to complete their Telehealth visits but that older persons, Black, Latinx, and those with lower incomes were less likely to use Telehealth services. They concluded that Telehealth is indeed here to stay, but are changes needed to address access inequities.
Studies during COVID-19 have tried to assess whether changes in the use of Telehealth during the pandemic were a short-term solution or a more permanent change. For example, one report states that women are more likely than men to see their physicians and other healthcare services in general and are seen as particularly attractive to women. A Rock Health study even showed that 25.9% of women considered Telehealth visits better than in-person care, and almost 70% of those surveyed rated their mental health experiences as “very good.”
Impact on those with Pituitary Disorders
There is no one description of a pituitary patient because there is no one pituitary illness. And, each time there is a disorder on this tiny gland it affects each person in its unique way. The diagnostic and treatment process of such diseases, often determined “rare,” is complex, requiring highly specialized care. And the road from initial symptoms to diagnosis can be long and elusive for many patients. As written about many times on Pituitary World News, some of the symptoms of pituitary disorders begin not with obvious physical signs but mental and emotional symptoms such as depression and anxiety, cognitive and memory changes, and more often cited. This mix of psychological and physical concerns makes a diagnosis quite challenging. Adding to this interesting mix of a pandemic that has affected access to proper healthcare providers, global fear of illness/death, isolation on top of whatever might have already existed due to the disease equals a lot to deal with!
Anyone with a severe medical illness was undoubtedly on high alert in the early months of the pandemic. Even most physicians were unsure of the impact on specific patient populations in the early phases. Some pituitary patients who were either scheduled for surgery or who had recently had pituitary neurosurgery experienced a lot of anxiety about how the COVID-19 virus might affect them. For some, their surgeries were delayed, or they went to their procedures without the usual availability of loved ones to be nearby following. Hospitals and medical facilities had to have highly restrictive policies leaving many to go it alone. Many of those who were reassured by their endocrinologists that having a pituitary illness did not put them into the high-risk category for COVID could not feel reassured.
For some patients whose illness has caused physiological changes to their appearance, living a life of isolation has become routine. So, when worldwide lockdowns were put into place, the effect might have felt minimal, possibly even that they were more prepared than the majority of the population. Those for whom retreating from the world has been emotionally protective from the gaze of others who don’t understand may have felt an additional layer of distance from an all too often mean world. Feeling, looking ‘different’ comes at a high price, especially when there are too few who truly understand. This is why, of course, much more online help has become available. However, pituitary support groups, patient advocacy groups, and pituitary patient conferences abruptly stopped early in 2020. It was only after larger groups of people overcame the technological challenges of connecting that patients and families could get information and support from one another and the experts. One of the real positives of the pandemic is all the new online platforms that allow so many more patients and others to interact, connect, and get the help they need and deserve.
Mental Health and the Pandemic
According to the Washington Post, the pandemic has significantly worsened conditions, according to mental health practitioners, officials at mental health professional associations, people seeking care, and a wide variety of additional data. The American Psychological Association surveyed its members in the fall of 2021 and found a surge in demand and new referrals, particularly for anxiety, depressive, and trauma-related disorders. The APA report shows that 65% of the more than 1,100 psychologists who responded to the survey said they had no capacity for new patients, and 68 % said their waitlists were longer than they were in 2020.
It is, of course, always nice to hear good news too, especially when it always seems like only the negative reports make the news. One study of over 150,000 Americans was published in May 2021 and suggested that although there were initial negative impacts on emotions and mental health symptoms in the first few weeks of the pandemic, many Americans demonstrated resilience over the following months. As a result, the study researchers project that the impact of the pandemic on mental health may not be as severe as predicted. Another Dutch study published in The Lancet showed that those with depressive, obsessive-compulsive disorder (OCD), and anxiety disorders do not seem to have further increased symptom severity than their pre-pandemic levels.
It is important to note that research into the effects of an event on a person’s mental and emotional state is difficult to ascertain immediately. Studies are often longitudinal since the actual impact on mental health may unfold only during the course of time. This is especially true in the case of children whose growth and developmental stages at the time of an impactful event are significant factors. It is also important to note that the term “pandemic” has been uniquely experienced by every person on the planet. This means that there are many folks to discuss, argue, debate, and understand. Some people viewed events daily, hourly on TV and social media and, personally, had loved ones succumb to the virus. Others remained aloof and were only mildly concerned. Those who either had a severe and chronic illness or were close to a health-compromised person felt the mental/emotional effects far greater and more deeply.
Going through any significant medical, emotional, spiritual, social, economic, financial, or physical event can have negative psychological results. Research shows that enduring tribulations alone silently most definitely causes the effects to increase and worsen. There is no doubt that humans living in this period have a lot of differences, but one thing in common is having survived a global event together. Actually, this makes for the largest support group ever.
What Does “Post-pandemic” Mean?
The Kaiser Family Foundation conducted a poll in February of 2022 to determine what “return to normal” means? Most respondents said the worst of the pandemic is over. They report that 62% of adults say that when COVID-19 in the U.S., “the worst is behind us.” Another 17% say the worst is still yet to come, while 17% said they don’t think COVID-19 is a significant problem in the U.S. This shows a change from what people thought about the pandemic in December 2020 when 25% thought the worst was behind us while 51% said the worst was yet to come.
Looking Past and Looking to the Future
The COVID-19 pandemic will undoubtedly go down in history just as the Black Death of the Middle Ages, the Smallpox Infection that destroyed the Aztecs in the 1500s, the 1918 Spanish Flu pandemic, the Aids crisis of the 1980s, and many, many other massive infectious events that impacted the course of civilization. We have lived and are living history, which means experiencing the pain, peril, and triumph others have witnessed as defining moments that change the trajectory of the world. There is a blessing and a curse to these poignant times in life. Each country, population, family, and individual have endured the most recent events somewhat uniquely and collectively. It is always up to each person to put meaning to their life experiences. Some will one day tell their grandchildren or great-grandchildren about the ‘terrible pandemic of the 21st century. Others will barely mention this. Each of us will tell our stories about this time clouded by other life experiences that just happened to accompany lockdowns, mask-wearing, social unrest, confusion about medical information, vaccinations or no vaccinations, and a new war in the world renewed threat of nuclear obliteration. In the last two years, people and families have had babies, deaths, marriages, divorces, new jobs, and losses of jobs, all under a cloud of uncertainty over the level of threat of a microscopic virus.
Has COVID-19 affected you or not? What narrative will you construct as time moves forward resulting from the events of recent years? Pausing to examine what you choose to derive is up to each person, but it is essential to know that the more a person decides to choose rather than allow the choice to be made for them, the more they can move forward and beyond. Having lived through a worldwide pandemic means we have all not only survived, but we’ve endured. Humans have once again been shown to be truly resilient. Putting the pandemic, for however long it lasts, into proper context will make a difference in physical and psychological healing for those with a pituitary disorder, their family and friends, and for us all.
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