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Cases of COVID-19 and pandemic related restrictions may be dropping, but don’t be surprised if you’re not ready to celebrate.

For many, the emotional and mental health impacts of the pandemic will linger, according to Dr. Kira Mauseth, co-lead of the at the state Department of Health.

State warns COVID mental health struggles could get worse before better

Consider the timing of the pandemic:

“We had the weather that started to change and hours of darkness really influenced people’s mental health and their emotional experiences. And then we had a really big spike in illness rates in November, which resulted in some additional restrictions and people not being able to experience the holidays in the way that they wanted to,” Mauseth explained.

Personal crises factored in, too, as many families endured not only stay-at-home orders, but unemployment, homelessness, the death of family members, and more, all because of the pandemic.

It contributed to what Mauseth calls a disaster cascade.

“That’s when an individual, or a family, or a community is impacted by more than one disaster, within a 12 month period of time,” she said.

It can all add up.

University of Washington says show that in the midst of the pandemic, “there were up to 40% of people surveyed saying ‘I’m now struggling with depression, anxiety, and thoughts of suicide.'”

Other research indicates during the pandemic, which is another sign that Americans are struggling.

Unutzer says COVID itself may even have a direct impact on mental health.

“About 36% of people hospitalized report ongoing mental and emotional symptoms. About 13% of people who were hospitalized for COVID who had no such symptoms before then said they developed new symptoms of depression or anxiety, or even things like psychosis, which is a much more severe form of mental illness,” he said.

And although just being hospitalized is stressful, Unutzer says there are growing indications that the actual virus, or your body’s reaction to it, can affect brain function.

He says feeling sad for days is normal, but you may need professional help if you struggle for longer periods of time “and you just can’t find your way out of feeling like you’re always anxious, you’re really stuck in a rut — nothing you try is going to help and you start having these negative thoughts that you just can’t get out of your mind. That’s when you may have developed a more serious depression.”

Unutzer says your primary care giver, local health department, or are sources for help.

Washington Listens is here to help you through quarantine

Dr. Mauseth cautions that for many individuals and families, the long-term struggles of the COVID-19 pandemic will linger.

“But I do know — and have seen in my disaster response experience — that the most common outcome from any disaster is resilience,” she said.

Even if it takes a while to get there.