Your patients' texts reveal that relationships are suffering thanks to the pandemic
Key Takeaways
A new report by Crisis Text Line found that many people are reaching out about relationship-induced anxieties, which may have been increased in the absence of pandemic shutdowns.
Listening to people trouble with relationships and thinking about constructing empathetic conversations via text messaging may help them work through these challenges.
Sometimes, relationships can reduce our anxieties. And other times, they can vamp them up.
A new report by Crisis Text Line, a national not-for-profit organization that provides free 24/7 text-based mental health support to people in the United States, found in 2022 that for the first time, relationship anxieties were a top issue among those seeking help.[]
The results can be seen in Crisis Text Line’s United Empathy Report, which is published on their website. The report is an analysis of over the 1.3 million conversations conducted between Text Line workers and people of all ages—with the majority of texters under the age of 24—in 2022.[]
Shairi Turner-Davis, MD, MPH, chief health officer at Crisis Text Line, says that while the 2022 results may seem surprising to some viewers, they may also mirror the social—and social media—structure of the peri-pandemic atmosphere and its influence on relationships.
Connection between social media and reconnecting since pandemic
One explanation for the increase in relationship anxiety could be the increased time and pressure to maintain relationships in the absence of pandemic restrictions like social distancing.
“During the pandemic, the issues that people—our texters—were reaching out for really focused around isolation, loneliness, grief as you would expect,” says Turner-Davis. “I think now that we're coming out of the pandemic, people are trying to find connections.”
These connections aren’t always in-person. The pandemic inspired more virtual spaces for fostering relationships, too. Facetime, Zoom, Slack, social media apps, and more all serve as platforms for connection.
“When you look at relationships, people are reconnecting, trying to reconnect, dealing with interactions both in the home and the workplace,” says Turner-Davis.
How virtual relationships can increase stress
Our new ability to have relationships somewhat, mostly, or completely over virtual platforms can come with stressors. Especially when it comes to texting, written words and phrases leave room for interpretation—or misinterpretation—of the other person's feelings and emotions. In romantic relationships, in particular, texting may also feel less personal.
According to a 2018 survey, 69% of millennials said they had broken up with someone over text.[]
A 2015 survey by the Pew Research Center also found that a sizable number of then-teens reported breaking up with someone or having been broken up by someone over text, despite considering texting one of the least “socially acceptable” ways to conduct a breakup.[]
“We've become such a text-dependent and text-reliant society that, oftentimes, people are conducting the better part of their relationship by text,” says Turner-Davis. “When you think about having difficult conversations or breaking up with someone, it's far less personal to do that by text than it is to call and hear someone's voice.”
She adds that because texting can strain relationships, it is important to intervene and find ways to improve that platform, rather than abandon it and its users.
At Crisis Text Line, volunteers undergo a training in text literacy before chatting with patients. Many say that the training helps them in their personal relationships outside of the job as well, Turner-Davis says.
The training involves things like guidance for “establishing a rapport,” and how to empathetically repeat back to the “texter” what the volunteer is hearing, she adds. “We train them because it's so important to try to create that connection without a voice, without a phone, but purely by text.”
Advice for health professionals
There are limits to how much a doctor can help their patient through relationship anxieties, particularly in the field of primary care. Some doctors may face time constraints in a busy practice, while others may not have the mental health literacy to aid in all situations. Some may deal with both.
As a result, some doctors may need help helping patients through relationship anxieties, and that’s OK, Turner-Davis says.
Sometimes, the best thing for a physician to do is to listen to a patient’s concerns and refer them to a mental health professional—or call or text service—who can give them the time and care they need. While doctors should intervene if the patient expresses experiencing harm or attempting to harm themselves, it is not their role or responsibility to tell the patient what to do in most other situations, she adds.
“We really have to start arming our physicians with the resources and the training to screen their patients because a lot of mental health concerns will be manifested in physical conditions,” says Turner-Davis. “If the physician isn't inquiring about mental health or stressors or the psychology behind physical symptoms, then they're missing an opportunity to help someone who may be struggling.”
If conducting a mental health screening geared toward relationship anxiety, she suggests incorporating questions such as the following:
Do you feel safe in your relationship?
Do you feel supported in your relationship?
Do you experience or have you experienced any physical abuse?
At any point are you or have you been feeling physically threatened by your partner?
People who are interested in seeking help from Crisis Text Line can text “hello” or “hi” to 741741 to chat with a volunteer crisis counselor who is supervised by a mental health professional. They can text in English or Spanish, via text, web chat, and WhatsApp.
What this means for you
More people may be experiencing relationship anxieties now than before the pandemic. Listening to patients and learning how to communicate with people via text messaging empathetically could be ways to help.