For the first time in my life, Ive started seeing a therapist. My mental health had never seriously affected my day-to-day functioning before this year, even when it took a hit in 2019 after an immediate family member was diagnosed with late-stage cancer. But in 2020, the addition of COVID-19 means anxiety and hopelessness now take a starring role.

I, of course, am not alone. The pandemic s psychological effects on the general public , essential workers and coronavirus survivors are similar to those of large-scale disasters , when depression, post-traumatic stress disorder and anxiety spike. This also happened a year after the 2003 SARS outbreak. Being quarantined contributes to adverse mental health outcomes .

Further, in the United States, the pandemic isnt the sole contributor to the poor mental well-being of Americans. The countrys political turmoil has elicited distress in many marginalized groups. For the Black community, police brutality and the microscope on racism can negatively impact mental health.

Americans symptoms of deteriorating mental health havent improved from May to August 2020, according to a recent COVID Response Tracking Study poll from the National Opinion Research Center.

So, what will peoples mental health look like by the end of the year? What challenges will we face? Are there any positives? In honor of World Mental Health Day, we asked therapists to share their thoughts:

People will experience grief and loss in ways we havent had to contend with before.

Ever since our sense of normalcy has been upended by COVID-19, people have experienced astounding loss and grief even if they may not recognize it.

People are not only grieving loved ones who have died, but also the loss of jobs, special events, travel plans and routines. Sima Kulshreshtha , a mental health therapist in Seattle supporting Therapy Aid Coalition , said she anticipates grief will rise each time individuals encounter an aspect of their lives that cannot look as it did pre-pandemic.

Stress will rise as some follow restrictions and others dont.

By this point, people know what to do to be safe and are making decisions for themselves around risks that theyre willing to take, Kulshreshtha said.

But seeing those who arent following proper health and safety guidelines can cause psychological harm. For example, observing family and friends acting in an unsafe manner can evoke particular stress if you are an essential worker doing all you can to protect your loved ones from the virus, Kulshreshtha said. There may be conflict about what is safe when it comes to social or family gatherings.