“The onslaught of dark, disappointing, and potentially traumatic information that is emerging and circulating on a daily basis is, not surprisingly, having an affect on the human psyche. Many folks I have spoken with have described experiencing a certain un-traceable darkness and confusion in their consciousness. I believe that on a series of subtle levels, the collective consciousness is in a very fragile, sensitive place right now. Whether we realize it or not, I think it is quite clear that the trauma of a pandemic, un-resolved racial and social injustice, a worsening climate issue, and incompetent leadership would be some of the main ingredients in this emotional and psychological unrest.
“The Covid-19 pandemic has been going on in the United States for months, and yet many questions still remain. The biggest one for many Americans is: When will life go back to normal? And, what will that new normal even look like?
As summer approaches, you may find yourself longing for events that you would typically look forward to, such as vacations, holidays or time spent with your family.
On social media, people who are currently sheltering in place expressed that it’s challenging to not have anything to look forward to or anticipate.
Without these usual benchmarks, you might feel off or sad. “Uncertainty doesn’t sit well,” Kevin Antshel, clinical psychologist and director of the clinical psychology program at Syracuse University tells CNBC Make It.
Here’s how to cope with not knowing what’s coming next.
Why humans hate the unknown
“The fear of the unknown is possibly the most fundamental fear of human beings,” Antshel says.
From an evolutionary perspective, humans have been able to survive because we’re able to plan. We’re socialized from childhood to believe that “there’s a predictable universe” and order in which things should happen, Antshel says.
“Extraordinarily high levels of uncertainty are really against how we’ve advanced as human beings,” he says. For example, under normal circumstances, you’d be able to assemble the resources necessary to achieve a plan, and then go implement it.
“When things don’t make sense, or they run counter to what it typically is, then we experience these high levels of negative feelings,” Antshel says.
What uncertainty feels like
We’re hand-wired to avoid uncertainty, because it makes us feel lots of negative emotions, Antshel says. The “vast majority” of people are experiencing some level of emotional distress or unpleasant emotions during this time, he says.
These feelings all come back to uncertainty. “Fear and anxiety really run hand-in-hand: The more things are uncertain, the more we’re going to fear, and the more we fear things, the more we are anxious,” he says. While planning for post-pandemic life can feel comforting, thinking too much about the future can also increase our anxious thoughts.
The more prolonged anxiety is, the more likely it is to manifest itself as depression, which is characterized by a loss of interest in things, hopelessness and helplessness, he says. It can feel like this difficult period will be going on forever, with no end in sight.
On top of this, you might find that you’re mourning the loss of events that you were anticipating, such as weddings, big work projects or graduation.
How to get comfortable with unpredictability
It’s important to think about “how we frame things to ourselves internally,” Antshel says.
Another helpful coping mechanism is to “engage in things that are goal-oriented, but are not necessarily goal-directed for the future,” Antshel says. Projects or hobbies (such as baking bead or doing a puzzle) that can give you a sense of accomplishment and allow you to have a certain outcome of certainty can be soothing.
And finally, it can be reassuring to understand that your feelings are very normative. “People who had never considered themselves to be anxious or depressed or now reporting these symptoms,” he says.”
With some 2.6 billion people around the world in some kind of lockdown, we are conducting arguably the largest psychological experiment ever;
This will result in a secondary epidemic of burnouts and stress-related absenteeism in the latter half of 2020;
Taking action now can mitigate the toxic effects of COVID-19 lockdowns.
In the mid-1990s, France was one of the first countries in the world to adopt a revolutionary approach for the aftermath of terrorist attacks and disasters. In addition to a medical field hospital or triage post, the French crisis response includes setting up a psychological field unit, a Cellule d’Urgence Médico-Psychologique or CUMPS.
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In that second triage post, victims and witnesses who were not physically harmed receive psychological help and are checked for signs of needing further post-traumatic treatment. In those situations, the World Health Organization recommends protocols like R-TEP (Recent Traumatic Episode Protocol) and G-TEP (Group Traumatic Episode Protocol).
Since France led the way more than 20 years ago, international playbooks for disaster response increasingly call for this two-tent approach: one for the wounded and one to treat the invisible, psychological wounds of trauma.
But we’re not setting up the second tent for psychological help and we will pay the price within three to six months after the end of this unprecedented lockdown, at a time when we will need all able bodies to help the world economy recover.
Estimated size of lockdowns around the worldImage: Statista
Unfortunately, we already have a good idea of its results. In late February 2020, right before European countries mandated various forms of lockdowns, The Lancet published a review of 24 studies documenting the psychological impact of quarantine (the “restriction of movement of people who have potentially been exposed to a contagious disease”). The findings offer a glimpse of what is brewing in hundreds of millions of households around the world.
In short, and perhaps unsurprisingly, people who are quarantined are very likely to develop a wide range of symptoms of psychological stress and disorder, including low mood, insomnia, stress, anxiety, anger, irritability, emotional exhaustion, depression and post-traumatic stress symptoms. Low mood and irritability specifically stand out as being very common, the study notes.
In China, these expected mental health effects are already being reported in the first research papers about the lockdown.
In cases where parents were quarantined with children, the mental health toll became even steeper. In one study, no less than 28% of quarantined parents warranted a diagnosis of “trauma-related mental health disorder”.
Among quarantined hospital staff, almost 10% reported “high depressive symptoms” up to three years after being quarantined. Another study reporting on the long-term effects of SARS quarantine among healthcare workers found a long-term risk for alcohol abuse, self-medication and long-lasting “avoidance” behaviour. This means that years after being quarantined, some hospital workers still avoid being in close contact with patients by simply not showing up for work.
Reasons for stress abound in lockdown: there is risk of infection, fear of becoming sick or of losing loved ones, as well as the prospect of financial hardship. All these, and many more, are present in this current pandemic.
The second epidemic and setting up the second tent online
We can already see a sharp increase in absenteeism in countries in lockdown. People are afraid to catch COVID-19 on the work floor and avoid work. We will see a second wave of this in three to six months. Just when we need all able bodies to repair the economy, we can expect a sharp spike in absenteeism and burnout.
We know this from many examples, ranging from absenteeism in military units after deployment in risk areas, companies that were close to Ground Zero in 9/11 and medical professionals in regions with outbreaks of Ebola, SARS and MERS.
Right before the lockdown, we conducted a benchmark survey among a representative sample of the Belgian population. In that survey, we saw that 32% of the population could be classified as highly resilient (“green”). Only 15% of the population indicated toxic levels of stress (“red”).
How stress under lockdown is affecting Belgians
In our most recent survey after two weeks of lockdown, the green portion has shrunk to 25% of the population. The “red” part of the population has increased by 10 percentage points to fully 25% of the population.
In general, we know at-risk groups for long-term mental health issues will be the healthcare workers who are on the frontline, young people under 30 and children, the elderly and those in precarious situations, for example, owing to mental illness, disability and poverty.
All this should surprise no one; insights on the long-term damage of disasters have been accepted in the field of trauma psychology for decades.
The phases of disaster responseImage: When disaster strikes, Beverly Raphael, 1986
But while the insights are not new, the sheer scale of these lockdowns is. This time, ground zero is not a quarantined village or town or region; a third of the global population is dealing with these intense stressors. We need to act now to mitigate the toxic effects of this lockdown.
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