Former First Lady Michelle Obama revealed last week that she is one of those people battling “low-grade depression,” and she has lots of company. One in three Americans is dealing with symptoms of stress or anxiety, according to data from the U.S. Census Bureau and the National Center for Health Statistics.

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This web series features diverse perspectives on health equity from advocates working to address the root causes of inequity in the COVID-19 pandemic.

Speaking on “The Michelle Obama Podcast,” Mrs. Obama spoke about how COVID-19 and ongoing racial tensions across the country have affected her mental well-being.

The following day, AMA Immediate Past President Patrice Harris, MD, MA, commended the former First Lady for her candor.

“I thought it was important that Mrs. Obama talked about the fact that she’s had difficult days and had some days where she feels like she had a low-grade depression,” Dr. Harris said. “We’re talking about it [mental health], and that’s important.”

Stigma has surrounded mental health for years, Dr. Harris said, particularly among African Americans and Latinx. Now, with increased stressors such as job loss and financial insecurity, as well as the physical distancing required to limit the spread of the coronavirus, the risk of depression and anxiety is even more prevalent. Having a recognizable figure such as Michelle Obama openly acknowledge her struggles is helpful to dispel stigma.

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Dr. Harris spoke about this and other topics related to COVID-19 and mental health as part of the AMA’s ongoing “Prioritizing Equity” video series with AMA Chief Health Equity Officer Aletha Maybank, MD, MPH, and Luz M. Garcini, PhD, MPH, assistant professor at the Center for Research to Advance Community Health at the University of Texas Health Science Center in San Antonio Long School of Medicine.


The mental health of health care providers

As the number of COVID-19 cases continues to rise across the country, physicians and other health professionals are becoming strained. Their mental health is of particular concern to Dr. Harris, who heard from countless physicians about their COVID-19 experiences during her term as AMA president.

“We've been trained to take care of a [health] crisis, but the way we've been trained and the way we've thought about crises and disasters is that they would be time-limited; this public health crisis has been unrelenting and nonstop for many physicians,” she said. “There's been no opportunity for any downtime.”

Dr. Garcini said the ongoing stress facing physicians is particularly felt by doctors of color, and she said more diversity is needed across medicine. A 2018 report from the Association of American Medical Colleges found that only 5% of all active physicians were Black, and only 5.8% were Latinx.

Beyond the lack of diversity, physicians of all colors are put under added stress as they consider whether they have the appropriate tools or resources needed to best treat each patient they see, Dr. Garcini said.

Medicine is still working to figure out how to disseminate “contextually sensitive treatments for our providers to best meet the needs of our communities,” she said. “That creates added tension and stress for health care workers.”

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Visit the AMA’s COVID-19 health equity resource page and discover the latest health equity resources that examine the structural issues that contribute to, and could exacerbate, already existing inequities. 

What you can do to improve your mental health

As the novel coronavirus pandemic moves into its fifth month, it is more important than ever for people to examine their mental well-being and recognize when they may feel anxious, sad or depressed. 

Dr. Harris implored the audience to get information from reputable sources. Misleading or inaccurate data can be a source of further anxiety, she noted. Additionally, she urged everyone not to fear reaching out for help when in need.

She and Dr. Garcini both spoke about the importance of trust—particularly in the field of mental health, where patients tell their doctors things they won’t even share with their spouses or loved ones. Dr. Garcini said we all need to work on building trust between one another.

“There is a need to change the rhetoric that is taking place in our country,” she said. “We need to build more tolerant environments, more empathetic communities and less divisiveness among our people. We need to equip our communities and empower them to disseminate valid and reliable sources of information that are ... contributing to so much fear among them.”

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