Maybe if she hadn’t heard the man cough, Paula Parker would still be able to sleep.

She’d been at the convenience store next to the Valero one morning in late May, reaching for a Coke when she heard the cough and saw a woman who had been in line run out the door. Parker dropped the Coke and sprinted after her. She thought there was a robbery.

“She says, ‘He was in there coughing and he don’t have no mask on,’” she said. “I have not been the same since that day.”

At her fiancée’s rental home three blocks away from the Valero, she paced from the kitchen island to the living room door and back again. She shook. Her body wouldn’t let her be still, sit down, relax. Her blood pressure skyrocketed. She called 9-1-1.

The paramedics suggested she take a walk or read a book. Besides, they said, the hospital was where the sick people were. She didn’t want to go there.

Four hours later, she called again. She had tried walking (inside, because of the heat) and reading (she couldn’t get past the first page of How Stella Got Her Groove Back). Nothing helped.

These paramedics took her to the hospital. She was diagnosed with hypertension and anxiety and prescribed hydrochlorothiazide and Lorazepam. Parker is 54 and has never felt his way before. She can’t function right. She’s scared — she’s more than scared, she’s petrified.

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With the novel coronavirus pandemic and all its effects dragging on — social isolation, job losses and crushing uncertainty about the future — the mental health consequences will likely only escalate. Some people feel pre-pandemic mental health issues intensify; others are experiencing their first-ever panic attacks. Numerous studies show a correlation between the unemployment and suicide rates. The National Alliance on Mental Illness of Greater Houston is seeing the escalation in real time: Before the pandemic, the organization’s “warm line” handled about 50 calls a week, including call ins and check-ups on people by staff. Now, on average, staff handles 800 calls a week.

“This whole COVID time has been a time of not knowing,” said Neal Sarahan, the executive director of NAMI Greater Houston. “And not knowing leads to anxiety. It leads to depression. And it leads to panic, emotional regulation difficulties.”

Parker had worked as a home health aide (until the virus) and had picked up a job at FedEx in October 2019. When she went back to FedEx for the first time after her hospital visit, she started hearing about her coworkers catching the virus. She couldn’t quite keep track of how to catch it. Should she wear gloves? The mask? Was it just in the air?

She had to leave. She kept thinking about her own health. She tested negative (twice) and has the papers to prove it. What scares her is that nobody else does.

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Some days, she sits and mulls what’s giving her this much anxiety. Maybe it’s because she doesn’t have money coming in anymore. Her son had to pay the light bill at her mother’s old Third Ward house, where a cousin who got evicted is now staying.

Or maybe it’s being stuck in her fiancée’s rental home. He keeps asking her to fetch things for him, his knees are bad, but Parker is no errand girl and even in her first marriage, her husband did things for her. Everything in his home seems dull and brown and too crowded and she hates it, but she can’t leave it. They had been about to sign on a new home in Pearland before the virus hit and the seller backed out, deciding not to move after all.

Sometimes she thinks she’d have been fine if she just hadn’t asked that woman why she ran outside that day at the Valero.

Parker and her fiancée, 59-year-old Richard Coleman, sat in the living room of his rental house playing dominoes a few days after the Valero incident. She said, “You’re cheating. I don’t like to play nobody who cheats.”

He sighed. “You’re losing it.”

“Yeah,” she said. “I’m losing it.”

“You need to see somebody.”

Se thought about it. “Nobody has taken me serious,” she said.

She felt like the first paramedics, the ones who told her to take a walk or read a book, acted like she was making things up. Her job calls and asks, Are you coming back to work?

“I’m sick,” she said. “You may not think I’m sick, but I’m sick. It’s taken its toll on me, being locked up in the house to do nothing. My mind and my body is telling me: The things I used to do before this pandemic, I just can’t do anymore. It’s just not letting me get there.”

Maybe she should see a psychologist or a psychiatrist. Her sister thinks it’s a good idea. But if she’s not sure what’s wrong with her, then how can somebody else? Besides, she hates medications.

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The long-term impacts of natural disasters like Hurricane Harvey have been well-documented: Increased and new mental health symptoms like depression, anxiety and post-traumatic stress disorder. But the pandemic is different because there’s no real end in sight, at least in the United States, said Octavio Martinez, executive director of the Hogg Foundation for Mental Health.

“We’re not even to the backside of that first wave,” Martinez said. “More and more of our population are gonna have these ongoing issues and increasing risk factors to develop mental health symptoms — and in some cases, become actual disorders.”

Sometimes, Parker is terrified to go to sleep because she fears she won’t wake up. But she does wake up, every morning, and she’s out the door at 6:30 a.m. for a walk down her street and to the tennis court at the nearby school. She paces the court 15 times. She gets back by 7, as the sun comes up and other people start coming outside.

In August, she went to Memorial Hermann Hospital. She doodled in one of her grandson’s coloring books with crayons when she felt her chest constrict and her arm tingle. Her blood pressure was 195/103.

The doctors kept her overnight for observation and discharged her with a prescription for more blood pressure medication. She almost left it at the pharmacy before the pharmacist found her a discount on the initial $300 cost. For the first time, she called herself “depressed.” On her discharge packet, a nurse named Teresa wrote in bubbly print: “Hope you feel better soon.” She doesn’t.