After COVID-19 peaks, we may need a smart task force to plot new rules for getting to know each other again, believes Michelle G. Craske, UCLA professor of psychology and psychiatry and biobehavioral sciences.

There will be questions about daily rituals that have eased social pressures for millennia. Handshakes, for example, date back to ancient Babylonians. Will elbow bumps replace them? What other social norms could change?

After months of living through the stress of the pandemic, people might be grappling with widespread trauma, warns Craske, director of the Anxiety and Depression Research Center at UCLA and co-director of UCLA’s Depression Grand Challenge (DGC).

The DGC seeks to cut the global burden of depression by understanding, preventing and treating the world’s greatest health problem. Aiming to revolutionize treatment, it created STAND (Screening & Treatment for Anxiety and Depression), a scalable system that uses digital technology to screen and create personalized, evidence-based treatment.

It’s a critical time to self-check your mental health, Craske says. Or, to paraphrase the lyrics sung by Kenny Rogers, “drop in to see what condition [your] condition is in.”

Five crucial tools

Using STAND principles, Craske and the DGC have published a self-care toolkit to help people struggling with the irritability, anxiety, sadness and fear associated with the COVID-19 crisis, available on the STAND Together During COVID-19 website. This new initiative is in partnership with Beyoncé’s BeyGOOD, the philanthropic arm of Parkwood Entertainment.

Craske has been refining the DGC online therapy tools, making them more specific. Those developments have helped shape the pandemic-specific STAND Together website, where new materials and topics offering hope and advice are posted weekly. On the website, Craske calmly shares the “five C’s” that can help ease COVID-19 anxiety:

• Stay connected with family, friends and colleagues.

• Focus on what you can control, like your health and wellness.

• Stay calm. Meditate or try deep breathing exercises.

• Cut down on the news.

• Care for yourself and others. Show kindness.

Long-term impact

According to BeyGOOD, the pandemic has disproportionately affected the economically disadvantaged and communities of color.

And its threat to mental health is significant. “This thing we are in is unpredictable and has left us feeling [like we are] without control,” Craske says. “We don’t know when it’s going to end, which drives anxiety. We don’t know what is going to happen — to our lives, families or jobs.”

She adds, “There are a lot of health care workers with post-traumatic stress disorder. [For] some, it may not manifest for months.

“It’s a perfect storm of general anxiety and shame, and levels of depression are going to increase down the road. Depression is that state of resignation, failure, that so often follows anxiety. That sense of ‘I’ve lost opportunities I’ll never get back.’”

Anecdotally, Craske has seen several disturbing trends, such as a rise in drinking at home, which can be less self-regulated than in public with friends. For some, drinking could lead to other problems. For instance, alcohol plays a part in the increase in domestic abuse, which has risen while other crimes in America have fallen dramatically.

Relationships are also being tested. One outcome of safer-at-home orders could be a baby boom. Conversely, it could also lead to the end of relationships. In March, when restrictions were eased in Xian, China, there was a record surge in divorces.

In addition, as temporary furloughs turn into permanent job loss, economists fear that the true toll on employment may not be known for months.

Plus, there might be feelings of guilt among those who fail to become a master baker or learn a new language during the pandemic.

On the other hand, says Craske, there could be new habits to hold on to, such as talking to friends on Zoom and appreciating common spaces.

The Tasmanian-born psychologist points out that global mental health doesn’t follow obvious patterns. During World War II, suicide rates decreased, but they rose again when peace eroded the “We are all in it together” spirit.

Lifting restrictions will create its own anxieties — when will it be safe to mingle, date, travel or eat out? How will we deal with this new world?

As Craske says, self-monitoring mental health is crucial. The UCLA Mental Health Tracker, part of the original STAND program, asks users a few questions each week and generates useful feedback.

“Everybody should be checking in on their mental health in the same way they keep an eye on their physical well-being, like checking your blood pressure,” Craske says. “And it will be critical over the next few months.”

The COVID-19 Care Package is available on ucla.edu/stand-together.