(CNN) For Shelby Rowe, a bead artist and mother of three adult children, the most difficult day of the coronavirus pandemic came in August.
It was the day her son, Trevor, was rushed to the hospital.
He was already battling Covid-19, and on that day, he was having difficulty breathing.
"That fear that I could lose my child and not be able to visit him, that definitely affected my mental health," Rowe said. "The pandemic has brought a lot more uncertainty and fear and given me more anxiety than I think I've ever experienced."
Rowe, who also works in suicide prevention in Oklahoma City, is not alone.
Almost 41% of US adults in a survey by the US Centers for Disease Control and Prevention reported struggling with their mental health or substance use -- both related to the coronavirus pandemic and some of the measures put in place to contain it, such as physical distancing. Those survey results were published in August.
"At any given time in the United States, about one-fifth of Americans have a diagnosable mental illness," said Dr. Joshua Gordon, the director of the National Institute of Mental Health.
"It does appear that the rates of reporting of symptoms have increased from that baseline -- so that we're seeing as much as 30% or 40% of Americans reporting symptoms," he said, adding that it represents about a two-fold increase over what would have been expected of pre-pandemic symptoms of mental health conditions.
Gordon added that an increase in mental health symptoms -- including anxiety or depression and trauma-related disorder -- has been seen during other national crises, such as extreme weather events or 9/11.
Yet the Covid-19 pandemic has been somewhat unique in that the crisis has continued for an extended period. Such moments of uncertainty can take a significant toll on those already facing mental health challenges.
"Any loss of social support can have a meaningful impact on people with mental illness," said Katherine Ponte, who founded the online peer support community ForLikeMinds and lives with bipolar 1 disorder.
During the last week of March, Ponte and researchers at Yale University School of Medicine conducted an online survey that included 193 people who self-identified as living with a mental illness.
The survey, published in the journal Psychiatric Services, found that most of those living with a mental illness -- 98% -- said they had at least one major concern related to the Covid-19 pandemic.
Among the survey's findings: 74% were afraid that they or someone in their family would catch Covid-19, 64% were concerned their mental illness would worsen, 39% were concerned that they would not be able to receive mental health care and 38% were concerned they would run out of medication.
The analysis did have limitations, including that it was conducted online and that the responses about living with a mental illness were self-reported.
But overall, the findings were no surprise to Ponte.
"It wasn't too surprising because I was experiencing some of the same concerns," Ponte said, adding that she worried she might run out of her medications due to drug shortages.
"I definitely feared that my mental illness would get worse," she said. "In the past, my manic episodes have been triggered by world tragedies."
Ponte wrote in a blog post last year for the National Alliance on Mental Illness, or NAMI, that during a psychotic episode in 2006, she was so overcome with frustration about news of death and destruction around the world that she swung a hammer "like a bat" at the television.
Now throughout the Covid-19 pandemic, Ponte said that she has found ways to alleviate her fears -- and encourages others to find beneficial mental health coping strategies.
"One of the most important coping strategies for me was helping others," Ponte said, adding that not only did she help conduct the Psychiatric Services survey but she also wrote blog posts for NAMI.
"It's essential to make your health a priority during this time. The critical self-care activities are sleep, physical exercise and a healthy diet," Ponte wrote in a blog post about coping strategies in March.
"Find ways to address forms of stress, such as journaling, going for walks or calling a loved one. Maintaining a sense of normality and routine can also reduce stress," Ponte wrote. "It can be especially helpful to practice mindfulness and try not think of the future or worst-case scenarios."
Those facing mental health challenges can seek out two kinds of assistance: formal help from licensed professionals and additional informal support from social connections or self-care.
Anyone in need of formal help can find providers through the Substance Abuse and Mental Health Services Administration or through NAMI.
"Folks should also look to see what their local, state and county mental health authorities are doing because I know many of those authorities have developed crisis lines. We want people to know that they can access the help that they need when they need it," said Dr. Patrice Harris, a practicing psychiatrist and immediate past president of the American Medical Association.
"None of us are helpless against this. We can act. What can we do? We can call on our usual coping skills. If you use yoga, if you use meditation, if you went to church," she said referring to informal help. "Getting physical activity is important."
As for Rowe in Oklahoma -- a mental health advocate, attempted suicide survivor and woman living with post-traumatic stress disorder -- she found ways to cope with her fears and concerns during the pandemic.
Rowe focused on her bead work. As a citizen of the Chickasaw Nation, she also turned to her Native American community and stayed connected with friends.
Rowe said her son, who was sick for about three weeks, has residual symptoms from Covid-19 but is now doing better. In these uncertain times related to the coronavirus pandemic, Rowe said she is still holding out hope for the future.
"We're suffering some real stuff, but I see people in communities coming together like they haven't before," Rowe said.
"Groups like the National Suicide Prevention Lifeline, crisis text line, being there to talk with people about their issues, 24 hours a day, those services are being utilized like never before," she said. "It gives me hope, because people are reaching out."
Ponte also emphasized that there is a light at the end of the tunnel. In response to trauma, some people can experience what is called "tragic optimism," which occurs when someone remains hopeful and builds resilience.
These responses can culminate in what is referred to as post-traumatic growth.
Ponte said that her hope for the nation is growth after trauma.