Former first lady Michelle Obama said on her podcast Tuesday she's suffering from a "low-grade depression," which she attributes to coronavirus quarantine, the mental health toll of racism and the "hypocrisy" of the Trump administration.
"These are not, they are not fulfilling times, spiritually," she told journalist Michele Norris during The Michelle Obama Podcast. "I know that I am dealing with some form of low-grade depression. Not just because of the quarantine, but because of the racial strife, and just seeing this administration, watching the hypocrisy of it, day in and day out, is dispiriting."
One in three Americans are reporting symptoms of depression or anxiety, more than three times the rate from a survey conducted in the first half of 2019, a Census Bureau survey found.
USA TODAY spoke with Vaile Wright, senior director of Health Care Innovation at the American Psychological Association, and Victor Fornari a psychiatrist at Zucker Hillside Hospital in New York City, about what low-grade depression is, who is susceptible and how it can be managed, and Obama's statement.
What is low-grade depression?
"Low-grade depression is not an official diagnosis. It is probably closest to what we refer to as subclinical depression, which refers to a person who is experiencing depressive symptoms but does not meet the criteria for a depressive disorder," Wright said.
What are the symptoms?
"The symptoms are similar to depression – sadness, loss of interest in activities, difficulty concentrating, sleep and appetite disturbances, irritability – and research has shown that subclinical depression has serious consequences for quality of life," she said.
Obama said she's "waking up in the middle of the night because I'm worrying about something or there's a heaviness."
Who is susceptible?
"We know that stress can lead to subclinical depression, especially when it is chronic and unmanaged, and it goes without saying that we are all living in a very stressful situation right now – the pandemic, systemic racism, economic downfall, upcoming election," Wright said. "There’s also a great sense of loss right now – whether it’s the loss of a loved one or the loss of what was our 'normal' lives. Unfortunately, no one is immune to the stressors right now and the studies I have seen do suggest that people are experiencing increased depression and anxiety."
Obama said a number of factors are impacting her mental health.
She expressed frustration with Americans who refuse to wear masks. "There's almost like there's a limit to our sacrifice and it was about a month and then we just got tired of the virus," she said. "That's been disheartening to see so many people who have grown tired of staying at home because the virus didn't impact them."
She and Norris also addressed racism. As a Black woman, Obama admits it's "exhausting" hearing stories of racial injustice in the news.
"We talk about white women clutching their purses at the sight of us, or feeling uncomfortable when we walk in the store," she said, "but I wonder, do you know how afraid we are?"
Should we be worried for her?
More like we should be worried for all of us, Fornari said.
"These are particularly challenging times for everyone. Anyone who isn’t anxious or upset about what’s going on on the planet isn’t paying attention,” Fornari said.
"When Michelle Obama shares she is mildly depressed by it, it’s completely understandable. I don’t know if she genuinely meets the criteria for depression ... but I have heard from so many people they are worried and being upset about the circumstances the pandemic has created."
How can it be treated?
"We know that psychological treatment such as psychotherapy is effective but there are also many lifestyle or behavioral things that people can do including exercise, meditation and mindfulness, seeking out social connection, and engaging in coping skills to improve their mood," Wright said.
Fornari also recommends that people get plenty of sleep and avoid too much news programming on television or radio if they find it distressing. Also, they shouldn't have conversations about these trouble times in front of children if they think it will disturb the kids. Try to be optimistic, he said: "We can get through this together. The world has faced many challenges and this too will pass."
What to avoid?
Alcohol and drugs, Fornari said.
"What we must do is be very careful to minimize our consumption of alcohol or other substances because we don’t want it to lead to a problem," Fornari said. "Very often people resort to using alcohol or other substances when they are stressed, but It’s not an adaptive way to cope.”
How is Michelle Obama coping?
Obama said staying connected with loved ones and taking a social media break helps her get out of "a bad place."
She says quarantining with her husband, Barack Obama, and her two daughters, Sasha, 19, and Malia, 22, has helped lift her spirit during tough times.
"You kinda have to sit in it for a minute, to know, 'oh oh, I'm feeling off,'" she advised. "I gotta feed myself with something better. And sometimes for me that means turning it off. It means turning off the phone, not taking in the news, because it is negative energy. I learned that in the days of the White House."
Wright said Obama's approach is worth replicating.
"We can follow the advice of Obama and engage in the good self-care skills she mentioned she’s doing," Wright said. "And it’s important to remember, humans are resilient. We have overcome adversity in the past – even if there were times we doubted ourselves – and have often grown stronger for it."