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Cough, fever, tiredness, difficulty breathing — most Harvard College students have spent the past month reading symptoms of the coronavirus in University emails, news articles, and Facebook groups.

But beyond the physical health crisis, some students say the pandemic has had quiet but pernicious effects on their mental health. Separated from their on-campus support systems, students said protracted social isolation, sick family members, lost jobs, and abusive households have overwhelmed them with anxieties beyond fears of the virus.

After spending a week of her freshman year in a psychiatric hospital for suicide ideation, Nicole M.“Nikki” Daurio ’20 founded the Green Ribbon Club, a student-run non-profit aimed at destigmatizing mental health.

Daurio said discussions about the physical threat of the coronavirus often elide the mental stressors it has presented.

“Our lives are all put on hold right now — that doesn't mean our mental illnesses are put on hold too,” Daurio said. “We're all saying health is the number one priority — that's why we got kicked off campus, that's why we're social distancing.”

“But we need to also emphasize that mental health is also our number one priority,” she added.

‘IT’S PARALYZING SOMETIMES’

Marcus M. Trenfield ’21, who sits on the board of the College’s Student Mental Health Liaisons, said the pandemic has stirred a toxic mix of mental health concerns for many students.

Like Daurio, he said he worries the College gave insufficient thought to mental health in a bid to protect students’ physical well-being.

“I think the idea was just like, ‘Let’s get students off this campus immediately so that students won't get [the coronavirus],’” he said. “But I think a lot of people are experiencing stress being at home.”

Some students transitioned to environments where they could not study, and others began to worry about money as they lost steady jobs on campus, Trenfield said. He added that he is personally facing significant stress from having lost his on-campus job working for Dorm Crew.

And for some, going home meant confronting the very real threat of the virus.

Aarushi H. Shah ’21 said she faced similar problems to many of her peers in recent weeks: leaving hastily, studying from afar.

“But what I wasn't prepared for was that my dad was diagnosed with COVID-19 over spring break,” Shah said.

Shah now lives at her aunt’s house in the Chicago area, along with her sister, who is five months pregnant. With her father in the hospital and her mother at home 40 minutes away, she said she and her sister have called their parents multiple times a day.

“I guess I never imagined that I would be in a situation where I'd be video calling my parents in the same city as them but not being able to see either of them,” she said.

For the past few weeks, Shah said she has felt extreme anxiety about her father’s health, which has taken a toll on her own mental health and ability to “function as a human being.”

“It has just been immensely stressful to try to balance school and every other aspect of life while knowing that one's own father is in the hospital struggling to breathe, struggling to live,” she said.

“It's been crippling where I'm by my phone 24/7 wondering if I'm going to get a call saying that something happened to my dad, trying to stay awake at night, but then also knowing in the back of my mind that I have to go to a Zoom class or I have my paper due,” she added.

Shah said she misses the support systems available on campus. She said the series of unspooling high-level decisions prompted by the crisis — the campus evacuation, the transition to online classes, nationwide lockdowns — made her feel like she had little control over her life.

“I couldn't control that I was moving, couldn't control that classes were moving online, and couldn't control my dad's health,” she said. “And the fear of the unknown, of what could happen, it's paralyzing sometimes.”

AWAY FROM THE SYSTEM

For students already living with existing mental health conditions, continuing school away from campus has forced them to find new ways to cope.

Jennifer X. “Jenny” Hong ’23, who works as a peer counselor at Harvard Eating Concerns Hotline and Outreach, said the transition home can be especially difficult for students with eating disorders.

Some students’ eating habits and schedules at home may differ from those at school; others may lack the healthy or fresh foods served in campus dining halls.

Hong said many students may face additional scrutiny from their family members about their weight and eating habits.

“We're forced to now live with parents or other relatives who understandably are very concerned for a lot of students’ health,” she said. “A lot of family members will be talking about things like weight and body image.”

One student, who spoke on the condition of anonymity because he lives in an abusive home environment, said lack of access to exercise facilities has aggravated his own binge eating disorder.

The anonymous student said he has also previously been treated for depression and post-traumatic stress disorder — conditions which living in tight quarters with his family has exacerbated.

“Usually, if I'm at therapy, it's something to do with that fact that I'm gay. I'm not out to my parents,” he said. “My parents are also emotionally abusive, and there's a lot of trauma there that I usually go to a therapist at Harvard for.”

While he was able to access mental health resources at Harvard, the student said his parents prohibit him from seeing a therapist at home and are unaware he had previously visited Counseling and Mental Health Services on campus. He said he is unable to independently seek mental health services at home because he is on his parents’ health insurance plan.

Though the student said others in comparable situations successfully petitioned to stay on campus for the remainder of the semester, his parents insisted that he return home.

“It has also led to a lot more memories of related trauma just because I'm in my childhood home,” the student said. “The week that was supposed to be spring break, aside from sort of unpacking and setting up a workspace, I genuinely think I spent most of that time dissociating.”

The College has recently publicized its reconfigured remote mental health resources offered through CAMHS. On April 2, HUHS emailed Harvard affiliates with information about its new online offerings, such as teletherapy, video-based group therapy, and online resilience workshops.

However, Daurio said she personally does not benefit from therapy delivered through phone calls.

“I need to see therapists in person,” she said. “Even if we say, ‘Okay, great, we have all these mental health resources,’ it's not going to help everyone.”

The anonymous student also said he cannot seek help via teletherapy because he cannot always find the space to speak privately.

“The phone is already a much less effective medium, I think, than face-to-face therapy or counseling,” he said. “But then additionally, it’s phone therapy or counseling under the cover of night, far away, in paranoia.”

Other students cannot access care they sought in the Boston area, a short trip away from campus.

Trenfield said that he specifically worries for this group. He added that some students with bipolar disorder, for example, receive specialized care at Massachusetts General Hospital.

“But now with everyone going back home, they don't really have access to those resources anymore,” Trenfield said. “I'm most concerned for students like that who weren’t in the system because they were looking for more specialized help, and then lost all that support.”

GROUND-LEVEL SUPPORT

In a bid to provide mental health support from afar, some Harvard students have made resource lists and launched social media campaigns in recent weeks.

Laura A. Jenny ’21 leads the undergraduate contingent of the new student task force “Students vs Pandemics.” She said the group is currently working to identify how the pandemic has impacted people’s mental health, as well as publicize solutions and resources.

The group hopes to circulate mental health and wellness resources released by the Center for Disease Control and World Health Organization via social media campaigns, Jenny said.

“A lot of students wouldn't normally seek out those sources because we all have other things on our mind,” Jenny said. “But if we can bring those types of resources to the forefront of what people are thinking about by just posting on social media and talking about it, I think it's a great way to make sure that everybody resets, refreshes and keeps their mental health and wellness in check.”

The group also plans to solicit and publish anonymous writing submissions from students about their experiences during the pandemic.

“I think another big thing is providing people with an outlet to talk about what they're going through,” Jenny said. “What I'm really interested in is making sure social distancing doesn't become social isolation.”

The task force's other initiatives include hosting virtual meditation and yoga sessions and collaborating with peer counseling services to publicize mental health resources to students on- and off-campus.

Hong, who is also involved in “Students vs Pandemics,” said ECHO will also launch various social media campaigns to disseminate motivational messages and information about mental health resources during the coming months.

“We’re just getting the word out there that it's okay if you aren't super productive during this quarantine, it's okay if you gain weight, and your worth shouldn't be determined by either of those things,” Hong said. “Take care of yourself and spend some time for personal care and reflection during this time.”

Jenna D. Lang ’21, who is collaborating with a professor to develop public recommendations for mental well-being during the crisis, also said she believes personal care resources are essential.

“Limiting your news consumption like to keep you from feeling these negative feelings for prolonged periods of time is definitely helpful. Or balancing the time you're spending with news and social media with other activities, such as reading or talking to people on the phone,” she said.

Aside from student-run initiatives, some said they believe house and department networks can support individual students.

Joel P. Balkaran ’20 said he thinks the residential system provides a valuable framework for administrators to connect with and support undergraduates.

“I'm in Cabot, and it definitely has been helpful for the tutors to be checking in with us or just seeing how we're doing,” he said. “It's been good to see the ground-level support.”

Lang said academic departments have a similar capacity to attend to individual students. She pointed to emails that the Psychology department sent to concentrators featuring affirmations, coping tips, positive videos, and webinars about how to find social connection and joy.

Beyond resources, Daurio said students struggling with mental health need consistent empathetic and supportive messaging from the College.

“Give them the resources, but then also just remind them, ‘We're here for you. And you're always in our thoughts,’” she said.

Correction: April 8, 2020

A previous version of this article misstated Nicole M.“Nikki” Daurio's class year. She is a member of the class of 2020, not the class of 2021.

—Staff writer Juliet E. Isselbacher can be reached at juliet.isselbacher@thecrimson.com. Follow her on Twitter @julietissel.

—Staff writer Amanda Y. Su can be reached at amanda.su@thecrimson.com. Follow her on Twitter @amandaysu.