Pandemic-related 'deaths of despair' were forecast at about 75,000 back in May — now they could be up to 150,000

• A whopping 13 million people have remained jobless since mid-March, per the Bureau of Labor Statistics.
• The risk of depression, substance abuse, and suicide increases the longer one is unemployed, research has found.
• Back in May, researchers at the Well Being Trust estimated there could be 75,000 "deaths of despair" directly related to the pandemic. One researcher from the study now tells Business Insider that number could double, up to 150,000, due to the slow economic recovery and lack of investment in mental healthcare.
• Psychiatrists and psychologists offer tips for how to cope, including the importance of reaching out for help, and changing your internal narrative.
• If you're struggling, call the SAMHSA National Helpline, 1-800-662-HELP (4357), or reach out to the Crisis Text Line by texting HOME to 741741.

For one woman living in Beloit, Wisconsin, life is full of bills, stress, depression, and sleepless nights.

The woman, who asked to remain anonymous for privacy, lost her job as a bartender in mid-March and, like many Americans, is struggling to get back on her feet.

When asked how she's getting by on a day-to-day basis, she responded simply, "I'm not."

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The bar she worked for permanently closed and new job opportunities are slim to none. She relies on a food share to eat.

Her biggest fears are the possibility of eviction, becoming homeless, and "losing everything I worked hard for," she told Business Insider via email.

Her struggle is all too familiar to the 13 million Americans who have remained jobless since mid-March, per the Bureau of Labor Statistics. With each passing week, more will become long-term unemployed, or those who've been unemployed for six months or more.

But this isn't just an economic issue. It's a public health crisis waiting to happen.

Back in May, researchers from the nonprofit the Well Being Trust projected that the pandemic's economic fallout would lead to a median of 75,000 additional "deaths of despair" over a 10-year period.

"Deaths of despair" are deaths related to isolation, unemployment, and financial struggle, usually by overdose, suicide, or alcohol or drug-abuse-related illnesses. The term was coined by Princeton economist Anne Case and Nobel Prize winner Angus Deaton.

But now, due to the economy's slow recovery — and a lack of adequate investment in mental health funding — researchers who made that projection say the number of deaths could be even higher, up to 150,000.

"Our country is not recovering as quickly as expected. We're isolated. People are suffering," Benjamin Miller, chief strategy officer at the Well Being Trust foundation, told Business Insider. "I think if you look at the multiple data points, the number of deaths could be higher than what we originally expected."

"Deaths of despair" have steadily increased over the past decade. They're now the major reason why the average life expectancy in the US has decreased in recent years.

"These deaths could have been prevented, and they could be prevented still by taking initiative in investing in mental health. But our government isn't there yet, our country isn't there yet," said Miller, who holds a doctorate in psychology.

A work-centric culture

A 2014 Gallup poll of 356,000 Americans that included 18,000 unemployed people, captures the troubling trend between long-term unemployment and declining mental health. As the number of weeks a person is unemployed increases, so does the likelihood of that person reporting depression, according to the data.

Indeed, studies have linked long-term unemployment to higher rates of depression and even suicide. A literature review of research on unemployment and substance abuse found unemployment is a "significant risk factor for substance use and the subsequent development of substance use disorders."

Sherif R. Soliman, a psychiatrist who works in the psychiatric emergency department at Atrium Health in North Carolina said over the past few weeks, he's seen an increase of people in mental distress because of unemployment and the risk of homelessness.

"Being unemployed can have a tremendous impact on someone's mental health. It can precipitate a wide-ranging crisis beginning with the most immediate and practical questions of how someone will provide for their basic needs and those of their family," Soliman told Business Insider.

It also leads to a crisis of personal identity.

"When you meet a new person, you usually learn what they do in the first minute or two, if not sooner. Job loss also leads to isolation," he said.

In a work-centric culture, not having a job can feel like not having meaning.

"Unemployment has long been recognized as a risk factor for suicide," he added.

Besides economic hardship and a loss of personal meaning, long-term unemployment can lead to isolation and a loss of one's daily routine, said Dr. Lily Brown, an assistant professor of Psychology in Psychiatry at the Perelman School of Medicine at the University of Pennsylvania and director at the university's Center for the Treatment and Study of Anxiety.

"Unemployment raises the risk for depression because it reduces structure in a person's life. Lack of structure is a big risk factor for depression even under the best of circumstances, let alone during a pandemic," she said.

While increased financial support to those unemployed and additional public resources could help solve this problem on a national level, it's important to recognize what individuals can do on a personal level.

How to cope if you're struggling

Take the first step and get help

The very first thing to do if you're in crisis, are feeling overwhelmed, or feel that you might be at risk of harming yourself or relapsing is to get immediate help. Call the SAMHSA National Helpline, 1-800-662-HELP (4357), or reach out to the Crisis Text Line by texting HOME to 741741 or message them on Facebook here. Both the SAMHSA and Crisis Text Line operate 24 hours a day, 7 days a week and can point you to local resources. If you are in immediate danger to yourself or others, call 911.

Talking with you doctor, therapist, or sponsor, is also a good idea, Brown said.

Don't be ashamed

"People struggling with unemployment can sometimes feel a sense of shame that makes them want to avoid their social network. Hiding from shame amplifies the shame. Instead, practice vulnerability with trustworthy members of your network," Brown said.

Create a routine for yourself

Brown also suggested people stay as busy as possible.

"The more shutdown and inactive we are, the harder it is to accomplish goals," she said.

Incorporate exercise, reading, and connecting with others into your daily routine.

Change your narrative

Remember that you are more than your job or career. Start paying attention to the things you're telling yourself, psychologist and relationship therapist Dr. O. Christina Nelsen previously told Business Insider. Instead of thinking to yourself "I'm a failure. Nobody wants to hire me," counter that with thoughts like "I'm educated. I have a substantial work history. I have skills to offer."