Before the pandemic, millennials faced a mental health crisis, with nearly one-third reporting a mental health or substance use problem. Rates of some illnesses, like depression, had risen 43 percent in just five years.

But then the pandemic arrived, and the crisis for these younger U.S. adults has arguably become worse.

Fifty-seven percent of adults aged 18-29 years reported symptoms of anxiety or depression this February (up 8 points since last August), as did 46 percent of adults aged 30-39. Millennials are generally considered people currently aged 24-39, with Gen Z adults aged 18-23.

To cope, nearly one in four Gen Z adults and about one in five millennials had begun or increased substance use to cope with stress or emotions during the pandemic. A nearly equal number reported thinking about committing suicide.

Several factors – including social isolation and loneliness, stresses at work and school, and tough economic circumstances – have all contributed to this decline in mental health. Just as troubling, most adults report they are not getting the support they need.

Even as vaccinations offer hope to improve our physical health, we must not overlook these mental health and substance use challenges. They will hardly disappear overnight, with something as straightforward as a shot.

To help young adults emerge from this pandemic with healthier, more resilient lives, here are some ways to offer support.

Recognize the symptoms

The first step in getting help for you or a loved one starts with recognizing the symptoms.

Anxiety is a normal emotion, it but looks different in different people. However, according to the National Institute of Mental Health, there are some common symptoms:

• Feeling restless, wound-up, or on-edge
• Being easily fatigued
• Having difficulty concentrating
• Being irritable
• Having muscle tension
• Difficulty controlling feelings of worry
• Having sleep problems, such as difficulty falling or staying asleep, restlessness, or unsatisfying sleep

Depression is much more than feeling down or having a bad mood. It is a serious mental health condition that affects how you feel, think and act – and even your physical health. According to the American Psychiatric Association, symptoms of depression beyond feeling sad may include:

• Loss of interest or pleasure in activities you once enjoyed
• Changes in appetite — weight loss or gain not connected to dieting
• Trouble sleeping or sleeping too much
• Loss of energy or increased fatigue
• Feeling worthless or guilty
• Difficulty thinking, concentrating or making decisions
• Thoughts of death or suicide

To help prevent suicide, it’s also important to recognize the warning signs. People in distress may give voice to their suicidal thoughts, using such phrases as “I won’t be bothering you much longer” or “You’ll be better off without me around.” The National Alliance on Mental Illness (NAMI) recommends also looking for these behaviors:

• Increased alcohol and drug use
• Aggressive behavior
• Withdrawal from friends, family and community
• Sudden changes in mood
• Impulsive or reckless behavior

How to provide support

Once you recognize the symptoms, there are several ways to help people cope with their emotional and psychological concerns.

The first step in managing anxiety is identifying the triggers that cause stress, such as financial difficulties or relationship problems. Then it’s helpful to understand the factors that you can control and redirect your attention to tasks that can be accomplished. This gives us a sense of empowerment and achievement.

Other coping techniques include practicing deep breathing exercises, meditation or yoga, establishing healthy sleeping and eating routines, avoiding alcohol and recreational drugs, or talking with friends, family, or a counselor about your worries.

Indeed, to help support a loved one showing signs of depression, the first step is having a conversation, listen and validate the person’s concerns. Fortunately, many younger people feel comfortable discussing their mental health with friends.

Similarly, for people voicing thoughts about suicide, they can also benefit from having a conversation about their feelings. These conversations can be hard for all parties since society places such a large stigma around suicide.

Here are some ways that NAMI suggests having these conversations:

• Talk openly and honestly, even asking questions like, “Do you have a plan for how you would kill yourself?”
• Calmly ask simple and direct questions such as, “Can I help you call your psychiatrist or find a mental health professional?”
• Don’t argue, threaten, raise your voice or debate whether suicide is right or wrong

Professional help is often needed to treat mental health conditions, either with medication or psychotherapy. For an illness like depression, 80 to 90 percent of people respond well to treatment.

Making it easier to find help

During the pandemic, the use of telemedicine has soared to help people get care safely and conveniently. For Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) members, it’s never been easier or more affordable to access telemedicine, including for mental health and substance use challenges.

More than 90 percent of Horizon BCBSNJ’s behavioral health network of psychiatrists, psychologists, social workers and counselors are seeing members through telemedicine visits. And, right now, there is no co-pay or deductible for telemedicine visits.

For example, Horizon BCBSNJ offers its members free access to AbleTo, a leading telemedicine provider. Members can visit a licensed therapist, via phone or video chat, where they can learn tools and strategies to help them manage stress and anxiety.

Also, for members struggling with substance use, they can now get medication-assisted treatment – the gold standard to treat opioid misuse – from virtual providers WorkIt Health and Eleanor Health.

As long as this pandemic lasts, millennials and Gen Z adults are going to need additional and ongoing mental health support. We’re here for them. Download this guide to find the right resources for you.