*This blog has been edited since it was first published, and has now been condensed into shorter blogs.
When “pandemic panic” hit Springfield, MO a few weeks ago, I was reflecting on how COVID-19 is changing the world. Not only is it changing the way that we carry on with our daily lives, but it is impacting our mental health as well. Initially the news wasn’t discussing the link between COVID-19 and mental health. In fact, when I first started writing this article a few weeks ago, I saw a few articles here and there about the possible effects of social distancing. While people have geared into “lockdown” mode, I have seen more and more information about depression and anxiety. Other mental health issues, such as addiction, OCD, and somatic disorders haven’t been as popular, but I am certain that there will be a burst of literature about these topics in the upcoming weeks and months (*hint, hint* Stay tuned!).
I have gathered information from various sources about the common topics, such as depression and anxiety, and have offered speculation about how the pandemic may affect other disorders. Over the last few days I have read dozens of articles that have echoed my concerns. The purpose of this post is to bring awareness to what we already know about the pandemic and mental health, and to shed light onto topics that have not yet been addressed. I hope that this will be a catalyst for self-reflection and compassion for others. As you read the following, I invite you to remain curious, open-minded, and willing to check in with yourself or anyone you know and ask about their mental and emotional well-being during this pandemic.
In one way or another, our lives have been touched by the COVID-19 virus. Every single person in the United States has been asked to practice social distancing and self-quarantine in order to decrease the spread of the virus. If you have left your home in the past week, you have likely seen bare shelves at the store and shortages of household items such as toilet paper or cleaning supplies. Social media posts have been filled with a mix of quarantine-related memes and links to stories about healthcare workers struggling to meet patient needs and to cope with their own moral injuries. And, you are likely to be (or to know) one of the many Americans who have been temporarily let go or unemployed. Or, maybe you have watched the stocks (and your retirement fund) plummet to uncomfortable levels. On all accounts, this is a vulnerable time for everyone, which has led me to the topic of this article: how is this pandemic affecting our mental health, and how is it affecting those who already have mental health disorders such as depression, anxiety, or OCD?
Through my own experience as a clinical health psychologist and college professor, I am affected in multiple ways. First, I need to assure my clients and help them process this event as it unfolds. Second, I must continue to provide my students with the information they need for the class that was promised to them, but in an online format. And, to make things more complicated, all of my classes have international students who have returned to their countries, which makes it is near impossible to find a time for everyone to be online and watch a lecture at the same time.And, on top of that I am coping with my own anxiety about the uncertainty of this situation. To be honest, I’ve always been a “worrier.” And, like most other people with anxiety the thing that triggers me the most is uncertainty and ambiguity.
I teach Abnormal Psychology at Drury University. It has been my favorite class to teach because I love being able to share my clinical experiences with my students. I also enjoy the process of teaching and applying this knowledge in real life. I was trying to think of ways to make sense of what was going on, but I also wanted to use the current events as a way to tie everything together.
So, how can I help my students make connections between the real world and class material? Well, it's actually pretty simple. Everything that we have been asked to do to "flatten the curve" (i.e., self-quarantine, social distancing, frequently washing our hands with soap and water, avoiding people who are sick, avoid touching your eyes, nose, and mouth, wearing a mask in public if you are sick, and disinfecting regularly used items) will affect our mental health and will definitely affect people who already suffer from mental health disorders. I hope to unpack all of this in my upcoming blog series.
Major depressive disorder is the most common psychiatric disorder in the United States (Beidel, Bulik, & Stanley, 2017) Moreover, approximately 264 million people of all ages across the globe suffer from depression (WHO, 2020). It is a debilitating and isolating disorder that has been worsening year after year.
Depression isn’t as simple as “sadness”, and it doesn’t have just one cause. Research suggests that depression results from a combination of several factors including trauma or stressful life events, health conditions (i.e., cardiovascular disease), and a chemical imbalance in the brain. In 2019, Johann Hari explored potential causes of depression in his book “Lost Connections: Why You’re Depressed and How to Find Hope.” Hari traveled tens of thousands of miles across the globe and met with several medical and mental health experts. He concluded that there are 9 main causes of depression – and only two of those are biological in nature (i.e., genetics, chemical imbalance in the brain). The other 7 all stem from disconnection. Disconnection from other people, from nature, from work, from meaningful values, from status/power, from respect, and disconnection caused by trauma. Hari points out that although we have the internet and social media, our society is the loneliest it has ever been. We have “disbanded” our tribes and have forgotten the importance of connection with others. If you don’t have time to read the book, I highly recommend watching his TED Talk.
Disconnection from Others
First and foremost, social distancing, which is the process of deliberately increasing the physical space between people (Pearce, 2020) is one of the main sources of disconnection. To make things more difficult, it is being mandated. Large gatherings, including sporting events and conferences, as well as everyday events (i.e., work, school) have been cancelled. We are moving almost everything online in order to carry out our normal tasks. Although most things can be done remotely from the internet, there is still the sense of disconnection from others. People have been disconnected within their own homes in certain cases where they have been quarantined from family members.
“How much longer is this going to go on?” is a question that has been asked by many and answered by few. Experts have speculated that we have not reached the peak and that this could go on for months. Months of isolation. Months. How is that going to impact us? Being isolated and disconnected is stressful. Not having a job or steady income is stressful. Fearing for our health and safety is stressful. We are living in a stressful time. And, when we are stressed, our immune systems are weakened (American Psychological Association, 2006) which means that we are all a little vulnerable right now. Right now, if you’re not even just a little stressed, I’d be surprised.
Now consider all of the people who felt isolated before the pandemic. Those with no social support. People who have no family. Those who have no homes. Those who lived in homes where they are being abused. Those who live in toxic environments. Now, they are being told that they must stay inside. They cannot leave their homes or go to the store unless it is for the bare essentials. Prior to the pandemic, it is possible that the only people they had contact with during the day was at the store or the doctor’s office. Who are they going to connect with now? I'm sure by just reading about it, you have a sinking feeling. We are all feeling this discomfort now. Although many of us have a good support system, it feels like are all fighting against an invisible force for an unknown amount of time, which can lead to feeling frustrated and exhausted.
Not only is there no end date to this, but we are being asked to reconsider our everyday choices, such as making a trip to the store. People are (or at least should be) second guessing their decisions and thinking through the potential consequences of their actions. This is exhausting and it has a name "Moral Fatigue". All of our everyday “simple” choices are now considered to be “high-stakes” decisions, where we weigh the risks and benefits, including putting someone else’s health in danger. Our brains are now working on overtime. Things that used to be simple are taxing and frustrating.
Disconnection from Work
Businesses nationwide have been temporarily shutting down for the time being, which has left many people unemployed or without income. Hari’s (2019) theory about disconnection from work as a cause of depression can be seen by millions of Americans. Whether people have been fired, let go, temporarily laid off, or have been asked to work from home, the way that Americans (and the rest of the world) work has been altered.
Now that I must work from home, I cannot connect with my students the same way I used to. I cannot answer questions in class. I cannot read my students’ facial expressions or body language to see if they are tired, upset, or not paying attention. And worst of all, I cannot check in with them personally on a face-to-face basis to see how they are doing. Despite the emotional loss that I feel, as well as the overall stress of having to make last minute changes, I still have a job. There are many who are not as fortunate. Having a job gives people a sense of purpose. Whether you work in the health care industry, service industry or even entertainment, each job has a goal. Our commitment to our job (even if it’s not a job that you love) is still a vital part of our sense of belonging and connection. The connection is not solely with other people, but with meaningful values and with the part of ourselves that helps us feel that we are growing and contributing.
Whether people have been asked to work from home, temporarily disbanded, or have been let go from their jobs, millions of Americans are inside their homes. They have been asked not to leave unless they need something vital. Globally, people have been released from their jobs and must find another way to find purpose and meaning during the day. What have people been doing? My guess (based on my own experience) is that they are eating more, watching more TV or movies, or possibly increasing their intake of alcohol. It has only been a week, but I imagine that this pattern will continue for another month. What does this mean for people with eating disorders or substance use disorders? Only time will tell.
How Do We Reconnect?
I would like to see this “lockdown” as an opportunity for growth. We have been given a gift (although it does not seem like one at the moment). For all of the Americans who work 40+ hour weeks and do not get to spend time with their families, this can be a blessing. Many of us complain how we wish we had more free time to do things. Although our choices of “things to do” has been extremely limited to things within our home, we have the ability to finish home projects, do some spring cleaning, or maybe even start a new family tradition.
I don't have a magic bullet to help anyone, but I do have some suggestions.
Have a consistent schedule. Wake up and go to bed at the same time every night. Even if you don't have a job or class to go to, it's important to maintain some level of "normalcy". It can be easy to forget what day it is if you don't have anything to look forward to!
Reach out to others. Text, FaceTime, Skype, Zoom. Do whatever you need to. Tell your loved ones that you are thinking about them. You don't need to send a long message. Who knows, that simple message could change someone's entire day.
Go outside. Do a grounding exercise. Stand in the grass with your bare feet and allow yourself to be present. Feel the cool breeze on your face. Use all of your senses to anchor you to the here and now.
Lastly, know that this (just like everything else) is temporary. It will pass. One day in the future we will be able to re-enter the world and go about our daily lives. We will return to work and school. Our friends and loved ones will visit us and we will go to the mall. We will embrace others and will (hopefully) be more appreciative of hugs. We will reflect on the 2020 pandemic and talk about how we "suffered" in our homes without toilet paper, or whatever else we choose to focus on. I encourage you to be grateful for the positive things in your life, and know that it will be ok. And if it's not OK, it's not over yet.