In hospitals like Cedars-Sinai, intensive care units (ICUs) overflowed from the onslaught of a respiratory illness no one had previously heard of—COVID-19. Loved ones of those stricken couldn't be with them in their final hours.

But the dangers have been more than physical. Amid the pandemic, the demand for psychological and psychiatric services has grown exponentially. Fear of the novel coronavirus has harmed the mental health of 45% of Americans, according to a Kaiser Family Foundation poll released in April.

Even for those without previous psychological symptoms, the effects of COVID-19 on mental wellness are significant and could reverberate long after the country reopens completely. 

"There's individual trauma—how people receive and experience these events that render them helpless—but then there's also a collective trauma, where the entire society is rendered helpless in some way," says Megan Auster-Rosen, PsyD, a clinical psychologist at Cedars-Sinai. "What happens with collective trauma is the fabric that ties us together unravels."

More than 115,000 people had died of COVID-19 in the U.S. as of June 15, according to the Centers for Disease Control and Prevention. And with hospitals, care homes, funeral homes and religious institutions on lockdown, many never got the chance to say goodbye.

"You can't even properly grieve because some of the rituals we, as humans, do to mark someone's passing have been delayed," Campbell says.

Even letting go of pre-COVID-19 routines can trigger similar cycles of grief—from denial, anger and bargaining to sadness and acceptance. Social distancing, especially, can be a burden on vulnerable populations and many are feeling the sting of job loss as unemployment has soared, Campbell notes.

Allowing yourself to recognize, name and grieve losses as they happen can be helpful, Auster-Rosen says. Mourning shouldn't be diminished just because others have it worse. "There is room for everybody to experience grief, and this minimization of grief hurts us. It's helpful to experience these emotions so we can let them pass," she adds. 

During times of adversity, humans have a harmful tendency to judge themselves or feel guilt for their feelings, Auster-Rosen says. "People are resisting feeling any emotion at all, because it feels scary." 

Campbell adds: "It's funny but true that, even with positive emotions, the human mind has a way to punish itself if one feels like it's not appropriate. But at what point are you allowed to smile and hold onto something that's positive or silly or irreverent?" 

A silver lining of the psychological effects of COVID-19 may be that the pandemic has brought emotional health to the forefront. "The goal with a [collective] trauma like this is to look for opportunities to reestablish connection, because that's what humans need in order to find contentment in any meaningful way," Auster-Rosen says.

We won't truly know the mental health repercussions of the pandemic until things start to return to some semblance of normal, and we don't know when that will be, according to Auster-Rosen and Campbell.

When the pandemic does end, the experience could be akin to soldiers coming home from war, Auster-Rosen says. People may then believe they should feel more calm but not understand why they don't. "When we're in less of a fight-or-flight scenario, that's when these thoughts and feelings can arise, because it feels safer to process them," she says.

Still, as people digest the experience, the resilience they have built up over months in isolation could shine through. People have adapted to waves of changes, and many have used the time to take stock of what they really want from life. "Some things are really painful and sad, but I think there are also things that are really beautiful," Campbell says.