Like many other people around the world, at the beginning of the COVID-19 pandemic, I felt overwhelmed with anxiety. As the founder of a large mental health practice, I was rightfully concerned about the transition of over 500 individuals and families to telehealth. Along with the logistical challenges came some very real concerns about how our already anxious patients would fare given the incredible stress, uncertainty, and isolation.
To my very pleasant surprise, my anxieties did not come true. Clinicians in our offices noted that our patients have done surprisingly well both with the transition to telehealth and overall, despite the rapidly evolving, globally uncertain landscape. Our patients did not experience decompensations, increased risk behaviors or other worrying phenomena. In fact, many reported feeling better than ever.
Recently, my colleague Dr. Steven Pirutinsky and I analyzed our clinical data to see if there were any observable trends. We focused on 764 adult patients who attended my clinic from October 2019 to March 2021, and divided them into four groups1 based on when their treatment started: (1) Pre-pandemic patients who started treatment before 2020, (2) Pandemic- patients starting treatment between January and March 2020, (3) patients during the pandemic who started treatment between April and December 2020, and (4) post-pandemic patients who started treatment after January 1, 2021. All Patients completed anxiety measures at each session they attended. We then used advanced statistics to examine changes in anxiety symptoms over the course of treatment.
We discovered something truly incredible: As a group, patients who were receiving cognitive and dialectical behavioral therapy (CBT and DBT) before the pandemic did not experience an increase in anxiety at any point during 20202. Furthermore, regardless of when patients began treatment , experienced the same trajectory characterized by rapid improvement over the first 3 to 4 weeks, followed by further graduate improvement over the next 2 to 3 months.
What are these findings due to? I think the explanation is quite simple. Those who experienced anxiety before the pandemic and came for help had tools and skills to be able to thrive and demonstrate resilience and strength, under pressure. CBT and DBT can prepare people for even the most unusual stressors—even those that come around once a century!
- Patella K. Our pandemic year: a timeline of COVID-19. Yale Medicine [Internet]. 2021 March 9. [cited June 16, 2023]. Available from: https://www.yalemedicine.org/news/covid-timeline
- Rosmarin DH, Pirutinsky S. Anxiety treatment response before, during and after the COVID-19 pandemic. Plus one. 2024;19(3):e0296949.
