For years, Amy Miller of Kings Mills said, she did her best to manage relentless anxiety. But one day about a year ago, already stressed over the pandemic, she suspected a break-in at home. Fear took over, and Miller decided to throw a tarp over her van in her driveway and live outside, for five months.
Yes, Miller says now, it sounds odd. In March, when family members realized her situation, they got Miller to accept mental health care treatment at the Lindner Center for Hope in Mason. Nine months into intensive therapy for anxiety and post-traumatic stress, the Air Force veteran and mother said she is speaking about the experience to help others who are suffering.
“If you are too ashamed, you need to get through your shame. If you are afraid, you need to step through that fear. If you don’t trust, you need to trust and rely,” said Miller, 56. “If I had realized what was going on, I could have called 911. But I didn’t even realize to call 911. Anxiety made me think I was doing something right, and I wasn’t.”
Miller’s acute anxiety attack is extreme, but it reflects a gathering storm of mental health disorders across the nation. In the second year of the new coronavirus pandemic, providers say they are concerned about the challenge to come.
“We have been at or near capacity on most of our service lines ever since October 2020,” said Dr. Paul Crosby, the Lindner Center’s chief executive officer. “Things kind of died down as soon as the pandemic hit, but then a few months later, all mental health providers have seen an increase in demand for services.” Most commonly appearing, Crosby said, are depression, substance use disorders, eating disorders and anxiety.
In October, the U.S. Centers for Disease Control and Prevention found Americans on an emotional roller-coaster that tracked with the rise and fall of COVID-19 case counts. Using U.S. Census data, the CDC said that from August to December 2020, the severity of anxiety rose 13%, and the severity of depression rose 14.8%. With the advent of the national vaccination campaign, December to June 2021, anxiety severity dropped 26.8%, and depression severity 24.8%.
Pandemic stress has compromised our decision-making, according to a Harris Poll done for the American Psychological Association in August and released in October. One out of three Americans, and nearly half of those born after 1980, said they feel so much stress now that they struggle over basic choices, such as what to eat or wear.
Nearly 60% of Americans said they changed their behavior because of stress, mainly avoiding social situations, changing their eating or exercise habits, or putting off responsibilities, the survey reported.
Yet another study in October found 86% of people who lived with anxiety before the pandemic reported the condition worsening in the past 18 months. That result came through the GeneSight Mental Health Monitor of Myriad Genetics in Salt Lake City. The company’s Mason office produces the GeneSight genetic test, developed in Cincinnati, to guide doctors in prescribing pharmaceuticals for mental health conditions. Doctors at the Lindner Center use the GeneSight test, although Amy Miller did not take it for her care.
The GeneSight Mental Health Monitor uncovered reasons that people with anxiety do not seek treatment. They are afraid to leave their homes. They sleep too little or too much. They cannot shake a feeling of dread. They minimize their struggle, resist spending money on care or back away from trial-and-error medication treatment.
Amy Miller said she did not seek care earlier this year because her anxiety blinded her to the health risks of living outside through the coldest months of the year. “I thought I was protecting my home. I thought I was protecting my environment. But I was moving deeper and deeper and deeper away from reality.”
Miller and her spouse, Paula Southerland, have lived since 2005 in the historic house on Kings Avenue in Kings Mills where Southerland grew up. They have three adult daughters. While in the military, Miller said she experienced post-traumatic stress and anxiety, but for decades, “I have been to manage that with therapy and ongoing treatment, and I had a great, fulfilling, wonderful, happy life. Until the pandemic.”
Southerland is in veterinary medical school at Auburn University, and through last fall and early winter, she was at the Kings Mills home taking a heavy course load online that absorbed her time, she said.
Miller’s isolation grew. She couldn’t socialize at the local post office because of the pandemic. Then she found signs that the house had been broken into. “My mind went into multiple areas of speculation, none of which were good. It was so extreme that I could not stay inside my house.”
While Southerland concentrated on her studies, Miller attached a tarp over a minivan and a portion of her driveway, and spent hours working on her art, even sleeping outside. She kept watch over the house from an armchair in the tent. She walked three-quarters of a mile around the perimeter of the property morning and evening. She ate from the basement storage of food canned out of the huge garden they tended. She used a bucket for her urine and feces.
“I felt absolutely normal, as a soldier in a tent, protecting my home. It was absolutely normal,” Miller said.
Southerland said she did not realize that months had passed with Miller outside so much. “I hadn’t been paying attention. You try not to tell your spouse what to do. But at the right time, I recognized that she was not quite right.”
By March, Southerland found bruises on Miller's legs from ankles to hips, her fingers bleeding.
“I stayed in the tent for five months, and it was absolutely debilitating,” Miller said. “I did not know I was in a PTSD crisis, an anxiety crisis, until COVID brought my family home to me … and when they came to the house and saw me for the first time, all of them said, honey, and mom, this is not right, you need help.”
Miller said she is recovering well. She spent a few weeks recently at Auburn with her spouse for a change of scenery. To people in crisis but not knowing where to turn, Miller said, “Take what you need to take in and move through it. There is help available. We all need help.”