he hardest part was the isolation.

Caroline Cozzens was thriving at school. Then came the pandemic: Learning at home. No work. No activities.

“I found myself sitting at home alone, all day, every day. That’s not how I’m supposed to be going through my school year,” said Cozzens, 17, a senior at Mt. Lebanon High School and student body secretary. “It got really, really hard.”

Some days, she would only go downstairs for meals. School, homework and life took place in her bedroom. It got so bad that her parents even went to speak at a school board meeting to plead with leaders to open the schools back up to in-person learning because of her struggle. Through it all, Cozzens knew she wasn’t alone in feeling this way. “It’s a national problem,” she said.

Senior class president Sydney Saba, 17, loves being in school. So for her, learning at home was also very challenging. “It was really hard being alone,” she said.

School’s back in session this year, but things still have been challenging.

Both Cozzens and Saba are mental health advocates. As ambassadors and teen representatives for Outreach Teen & Family Services, the two have made their voices heard. Outreach, a Mt. Lebanon-based nonprofit, provides services to clients age 5 to 21, including individual and family counseling, parent consultations and psycho-educational programming.

Through their platform with Outreach, Cozzens and Saba spoke at a school board meeting to advocate for added mental health resources, have attended events for Outreach to share their perspective and, most recently, started a podcast.

While struggling throughout the pandemic, both Cozzens and Saba know they have been more fortunate than many others. They had resources at hand, along with supportive parents, that helped them through the difficult times. They continue to advocate for more resources to be readily available for their peers, both in school and the community.

It was hard, but one thing that helped Cozzens get through the most difficult days was focusing on the good.

“My favorite Mister Rogers quote is: ‘Always look for the helpers,’” she said. “Looking for the good is what kept me going. Seeing the videos of people in New York City coming out onto their balconies at hospital shift changes to clap for the frontline workers, all of those wonderful stories like that. There was good through it all.”

IT’S ALL BEEN TOO MUCH

The pandemic was hard on all of us. Whether you began working from home with little to no interaction with the outside world while simultaneously learning to teach your children virtually along with what seemed like a million other new responsibilities—just thinking about it now can be overwhelming—or you were an essential worker who had to show up, all while finding child care for your kids, who were now learning at home. COVID-19 brought with it a heap of new stressors for most. We ended up tired, spacey and just feeling funky in what some are now referring to as the “pandemic daze” or “COVID fog.”

The pandemic took its toll on all of us emotionally. The Centers for Disease Control, in partnership with the U.S. Census Bureau, reported that the number of adults experiencing symptoms of anxiety or depressive disorder  increased significantly, from 36.4 percent in August 2020 to 41.5 percent in February 2021. In December, 2021, the U.S. Surgeon General issued an advisory on youth mental health exacerbated by the pandemic. Across the country, a surge of people are seeking support to help them through the toughest days.

“There’s been an influx of requests for services,” said Dr. Tracy Scanlon, clinical director at Outreach. “That’s across the board for mental health.” Initially, when the world was forced into lockdown in March 2020, there was a sense of shock, and for many it seemed almost exciting to have a break for a bit, she said. But that quickly faded.

“We went beyond our limits,” Scanlon said. “The prolonged isolation became too much.” Many of the calls to Outreach seeking help start the same way: “My child asked me to call you.”

Even kids are noticing that something doesn’t feel right. They’re struggling to adjust, and they realize that it’s time to get help.

“Parents sometimes don’t know how to articulate what they think is happening, because they don’t see crying and all of the other stereotypes,” Scanlon said. “With depression since COVID, it feels like this general malaise, like a lesser, more muted version of their normal, happy kid. With the anxiety, it’s more of this, ‘Why does my child seem more distressed more easily than ever before?’”

For many years, the number one reason for referrals to Outreach was depression. About a year prior to COVID’s start, anxiety overtook depression as the most common reason teens sought help at the center. That has remained the case over the last two years.

The uncertainty of it all was one of the hardest things for some to handle, experts say. For others, it was the isolation, while still others had trouble balancing all that was being thrown at them.

“Psychological research says that, even in your darkest hour, if you can look ahead and forecast something that you’re looking forward to or hoping for or that vacation that’s coming, it drives some energy,” Scanlon said. “But every time that we’ve done that in the past year and a half, they’ve gone: ‘Oh nope, we’re back!’”

WE ALL STRUGGLED

At St. Clair Health, an increased number of adults also sought mental health treatment since the start of the pandemic. Some of the folks seeking help have already been dealing with a diagnosis, which was exacerbated by the pandemic. Others have never sought help before but pandemic life pushed them in a desperate direction.

“We’re seeing a lot of people looking for help in a variety of ways to deal with stress and anxiety and depression,” said Matthew Conlon, staff psychiatrist at St. Clair Health. “We also see stress related to work, to caring for small children, to taking care of loved ones who are older. We’ve seen a lot of people coming in because they feel isolated or they feel that they have new stressors that are overwhelming for them.

“It’s affecting everyone,” Conlon continued.

Scanlon believes the current political climate in the country has had a large impact on mental health for adults.

“The field as a whole has struggled to keep up with the demand,” Conlon said. “We’re doing the best that we can. At the same time, there are different ways that we can provide services because we are doing things virtually from home.”

Prior to the pandemic, teletherapy was not an approved billable service through insurance, Scanlon said. Teletherapy now is a vital way many seek help.

“There’s no going back,” she added.

If you reached out for help during the pandemic, you likely found that it was harder to get, because everyone else was in the same boat.

At Outreach, counselors had to start a waitlist for the first time in its history, Scanlon said. Even with the waitlist, no one had to wait longer than 10 days to get help.

PLANS IN PLACE

For youth, the drastic change from in-person to online learning, and sometimes both at once, was a lot to handle, said Heather Doyle, director of special education in the Mt. Lebanon School District. Now that students are back in school, another adjustment comes: Everyone has to get used to being in person again.

“There were a lot of shifts that happened,” she said. “That’s a lot for adults even to handle, but especially for children to navigate.”

In the Mt. Lebanon School District, leaders implemented a COVID-19 recovery plan in June 2020. Part of the plan focused on mental health. Some teachers were trained in mental health literacy, Doyle said.

The district provided psychological first aid training for some of the faculty and staff, providing a framework for recognizing signs of mental distress and ways to connect students with resources they needed.

The district has a three-tiered system for support in place. Tier 1 focuses on access to school counselors and awareness of available resources. Tier 2 focuses on students who need a little more help and can include short-term group counseling. Tier 3 provides more intensive, individualized support.

‘IT’S OK NOT TO BE OK’

So, how do you know when it’s time to get help?

“Overall, if you’re seeing significant changes in (your children’s) interactions with you and how they communicate with you, or if you see changes in their socialization–excessive worry or anxiety, extreme mood changes, stronger feelings of anger or irritability” are all things to look out for, Doyle said.

While each person is different, if you notice a dysfunctionality or distress in someone around you, and it’s there each day, it also might be time to get help, Scanlon said.

Same goes for you. Remember, your ability to function matters, as well, and will impact the rest of your family.

“If you’re not enjoying things you’ve typically enjoyed before, feeling restless or feeling like you can’t get out of bed, thoughts that you don’t want to be around or even in severe cases, suicidal thoughts, those can all be considered signs of depression,” Conlon said. “If a person is feeling like they’re down most of the time for a sustained period, that would be a strong indication that you should get help.”

While this has all certainly been tough. If we take Cozzens’ advice and look for the good that came from the pandemic, it is there.

“I really hope the pandemic can shine a light on mental health,” said Maggie Zangara, program manager and counselor at Outreach. “I know that these times have been so trying for so many. But, trying times can also be great teachers.”

Take the time to look at the simple things that brought you joy over the last two years. But more importantly, remember: It’s OK to ask for help.

“It’s OK not to be OK,” Zangara said.

Reach out as soon as you feel that you need help.

“It’s never too early and what you’re feeling is never illegitimate,” Saba said. “Everything that you’re going through is always real and shouldn’t be compared to what others are going through.”

Teens Tap In:
Outreach launches a podcast

From the very first episode, empathy abounded.

Podcast hosts Caroline Cozzens and Sydney Saba chatted with two of their teachers from Mt. Lebanon High School. Both left with a greater understanding of what life was like for the other during the pandemic.

“It was a great conversation with a student perspective and a teacher perspective on dealing with the pandemic and how it affected both the mental health of students and teachers and what we didn’t see on their side and what they weren’t seeing on our side,” said Saba, a senior at Mt. Lebanon High School and student body president.

Saba and Cozzens, also a Mt. Lebanon senior and student body secretary, serve as teen representatives for Outreach Teen & Family Services. Last year, they met with executive director Mary Birks to share some of their ideas.

The girls tossed out the idea of a podcast and Birks ran with it.

Teens Tap In, sponsored in partnership with St. Clair Health, promotes conversation around mental health and gives teens a platform to share their struggles.

“It’s a really neat platform that we have to destigmatize talking about mental health, and it’s neat that it’s two teenagers talking about it,” Saba said.

The podcast is meant to give teens a voice in the mental health arena. It’s also a great place for parents to learn what their child might be experiencing, Cozzens said.

Maggie Zangara, program coordinator at Outreach, works with the girls to produce the podcast, which airs on the third Thursday of every month and can be found on Podbean, Spotify and both Google and Apple podcasts.

“It’s a great podcast for the community to tap into and to have really cool discussions on mental health and well-being,” Zangara said.  “If there’s a need in the community for people to find more resources, I hope that this podcast can help lead them to Outreach’s other services that we provide.”

Both Saba and Cozzens have lots of ideas for future topics.

“For me, the biggest thing is creating a conversation,” Cozzens said.

“Have an open mind to learn about everything we’re talking about and to come away thinking how it would feel to be in someone else’s shoes and be empathetic to everyone,” Saba said.