We Need to Talk About Loneliness Amid This Pandemic

“The number one emotion that people are dealing with right now is loneliness.”
Loneliness and the Pandemic We Need to Talk About How These Collide
Irina Kruglova/Adobe Stock

In our What It’s Like series, we speak with people from a wide range of backgrounds about how their lives have changed as a result of the COVID-19 pandemic. For this installment, we spoke with Sarah Kuriakose, Ph.D., BCBA-D, who is the statewide director of psychology services for the New York State Office of Mental Health.

Governor Andrew Cuomo declared a state of emergency in New York on March 7, a day marked by the state’s 89th confirmed case of COVID-19. Two weeks later, Kuriakose says, Cuomo asked the Office of Mental Health to create a help-line for New Yorkers struggling with anxiety and other mental health issues caused by the pandemic. In just four days, Kuriakose and her team established the free, confidential COVID-19 Emotional Support Helpline, which she now oversees. Since March 25, it has operated daily from 8 a.m. to 10 p.m. and has received more than 17,000 calls.

Here, Kuriakose talks about why the mental health effects of a pandemic differ from what people typically experience after a natural disaster, how callers’ reasons for seeking help have changed over the past few months, and how the pandemic could affect the way we perceive mental health. (Her responses have been edited and condensed for clarity.)

SELF: What do your workdays look like right now?

S.K.: Like all the state agencies, I would say, we have been on a seven-day-a-week workweek for months now, coordinating the public health and public mental health response. Relatively recently we’re starting to see glimmers as New York moves into New York Forward, Phases 1 and 2, and we’re pivoting a little bit to think about what’s next versus just being in a reactive state all the time. [Editor’s note: In the time between this interview and the publication of this article, New York City moved into Phase 3 of reopening.] But certainly, especially in the early days of the help-line, when we were just building it, it was just about around the clock.

What has been the demand for the help-line? Has it decreased as the state’s COVID-19 stats have been improving?

The highest numbers that we had were in that first week, when I think there was really a ton of panic. We haven’t seen a big decrease, but steady numbers since then—not approaching what it was that first day or two.

One of the things that our work group has been talking about, especially in the shift of the kinds of anxiety that people are experiencing, and what we know about mental health after a disaster, is that we actually anticipate a possible increase in calls in the next several weeks and months. Much of the time when you are dealing with a disaster, you’re in that put-one-foot-in-front-of-another, survival mode; a lot of the mental health consequences after a disaster are actually only seen in the several weeks or a few months afterward.

How do the mental health effects of the pandemic differ from what people experience after a natural disaster?

There are a couple of things that are different about this situation. One is the length of the crisis—it doesn’t have that clean, kind of “the hurricane hit, and now it’s passed, and now we’re all going to go in and rebuild.” So much of the anxiety around the coronavirus( is about uncertainty, and there’s still ongoing uncertainty about so many things that we don’t know about—what’s the future going to be like, or is there going to be a surge, or anything like that.


Another thing that is a little different about this versus another kind of disaster is that because the virus is invisible, it brings up different kinds of fears for people—to have a reaction to something that you can see, that is tangible, versus a kind of elemental fear about something you’re so scared about but you can’t see and you can’t make it concrete in your mind.

When the disaster is biological, you’re more likely to see somatic anxiety—people having headaches or feeling short of breath or feeling chills—and that creates a cycle of anxiety. When you have physical symptoms, you start worrying if you have the illness, and that makes you more anxious, so you’re more likely to have physical symptoms. There are a lot of different aspects to stress and anxiety around a pandemic that you wouldn’t necessarily see for the kinds of traditional disasters.

How many volunteers did you start with, and how many do you have now?

So we have many, many, many more volunteers than we could ever possibly use. I think it says something really wonderful about New Yorkers and about mental health professionals. Our governor put out a call for medical and mental health professionals, and more than 10,000 volunteered.

We then offered folks an orientation for the help-line and a training about how to use the technology, and we actually had to cut off the number of volunteers, because in the first evening 1,300 people signed up just to take that orientation. So we put folks on a wait list, and right now we have about 400 volunteers working on the help-line.

What are the most common emotions that are leading people to call?

It really has shifted a lot. At the beginning we were hearing people in extreme panic. People were crying, sobbing on the phone, really scared, really anxious, and what we were doing was talking them through, helping them remember: How have you coped with things in the past? Who can you reach out to for support? How do you put one foot in front of the other?

The number one emotion that people are dealing with right now is loneliness. The majority are calling to say, “It’s just so nice to hear a voice on the other end of the line. It is so nice to talk to someone.” We have a lot of folks who just have been isolated for a long time, and the typical kinds of things that they might engage in, whether it’s the senior center or the community center, have closed, and they just haven’t talked to someone in a long time. They’re so grateful to have that connection with somebody.

We also have a lot of folks who are experiencing anxiety, especially around risk assessment. Making decisions where there aren’t clear answers—how do they weigh how to keep themselves safe, how to keep their communities safe, should they go out, should they meet their family?

A lot of folks are being very hard on themselves. People will call and say, “I’ve never needed to ask for help like this before—I’m not normally the kind of person who would ask for support or who would call this kind of line.” A lot of what our volunteers do is just remind people to have some compassion for themselves, remind people how hard the moment really is and how much they’ve gotten through already.

Can you share some of the advice that help-line volunteers give that could benefit anyone right now?

One of the big things that the help-line focuses on is really normalizing stress reactions. Especially at the beginning, but even now, we got a lot of folks who are really struggling and maybe haven’t really struggled with mental health or emotional symptoms before—people who have not had racing anxiety, or a depressed mood, or trouble sleeping. They’re worried: Is something wrong? Is this normal? What’s happening to me?


What I want to share is that it’s normal to have a stress reaction in the time of a disaster. It’s absolutely expected that you might have a whole range of emotions, whether it’s feeling anxious, or feeling depressed, or having trouble sleeping, or maybe you’re picking fights with your partner, or it’s hard to focus on anything. That’s how humans are built, to have those stress reactions in times of stress.

Do you think the attention that mental health has gotten during the pandemic could decrease the stigma around mental health conditions in general?

I do think that the more that it becomes mainstream to talk about mental health, and especially talk about seeking support for difficulties with mental health, that’s going to be very, very positive. I think it is really wonderful that it’s been front and center from the beginning, in terms of not just thinking about the medical and the social and the economic repercussions, but also emotional and behavioral health. I think that anything we can do to destigmatize talking about mental health and seeking support is really important.

With the timing, and the way that this pandemic panned out, we’re also in this phase where, because of social distancing, teletherapy has exploded in a way that was completely inconceivable prior to the pandemic. Teletherapy makes mental health services so much more accessible to so many people, and not just teletherapy in terms of traditional phone or video, but also app-based therapies and virtual, self-guided courses on mental health.

Those things, I think, will intersect really positively—both the increased awareness of mental health and the increased access to mental health. As we go forward, this is a really big priority for us, to make sure that those two pieces come together for New Yorkers and for folks around the country who will be struggling with mental health issues.