In COVID’s Shadow

Several preliminary studies have been conducted examining prolonged psychiatric symptoms in patients who have had COVID-19.  Up to several months after complete recovery, a certain percentage of patients continue to experience fatigue, anxiety and depression.  It is not known if these prolonged symptoms are due to direct effects of the virus on the brain, or if they are psychiatric syndromes associated with the prior physical illness – respiratory problems, muscle aches, etc.  We will not know for some time the many ways in which SARS-CoV-2 affects different parts of the body and different bodily systems.

However we already see very clearly how this pandemic has affected our psychology.  Although much less publicized and discussed, our hospitals are being deluged by patients presenting with severe alcoholism, drug abuse and violence, particularly domestic violence.  Many individuals who previously struggled with a variety of emotional and mental problems, are experiencing decompensations not to mention those with no prior history who are presenting with new onset depression, anxiety and even suicidal thoughts.

It is not only the mental health departments who are seeing and treating these patients.  Between 20-50% of the medical beds in hospitals are occupied by patients with complex medical problems combined with alcohol/substance abuse and significant psychiatric problems.  And because so few rehabilitation and outpatient facilities are not accepting new patients, hospitalizations are lengthy.

Some of the underlying causes of these problems are well known.  Let’s review the more obvious ones.

Financial Stress – Increasing numbers of individuals have either lost their jobs, been put on furlough, have had their income severely decreased or cannot find a new job.  We all have bills to pay.  The financial stress is taking its toll on countless individuals.

Claustrophobia – Due to regulations regarding quarantine, isolation, limitations on the number of people allowed in one space, many individuals are now prisoners in their own homes for much oft the time.  Many are now working and for students, studying at home.  Children are not going to school.  So we are all stuck at home with each other in this most unnatural state and all getting on each other’s nerves.  We are not only feeling trapped physically, but also trapped socially.  Even though we may love our family and friends, it is not natural to be with them 24/7 and in the case of parents, having to constantly watch over them.  We are all stressed by this claustrophobia.

Social Contact – Over the last several months, our social contact has diminished enormously.  We are social “animals” and require interaction with others.  However it is incorrect to assume that the most important social interaction is with those with whom we are already acquainted:  our family, friends, neighbors and co-workers.  The critical interactions are with those who we do not know.  Each new interaction demands from us that we use and sharpen our perceptions, skills and abilities.  We do not grow if we are not challenged so we desperately need interactions with those we do not know and who do not know us.  The sudden decrease in our interactions with “strangers” has had a troubling and detrimental effect on us.  And as you’ve probably already now learned, Zoom just doesn’t cut it.

Above and beyond these obvious sources of stress, there are other more subtle and insidious ways in which the current pandemic is eroding our sense of well-being and creating even more stress, and distress.

Existential Dread – There is a constant hum in the background at every moment that there is something “out there” that can kill you, or kill someone you love.  It is inescapable and is a continual reminder to use of our mortality.  Of course we all know that we are not eternal and must die someday.  But it is not possible to live our lives constantly contemplating our end.  One can reduce the volume of the reminders that there is a potentially fatal virus out there that can kill you by limiting your exposure to the news.  Some people today even let you know at the outset, “I’m happy to speak with you but NO TALK OF COVID!  I need a break.”  And yet, despite our best efforts to turn down that volume, it is always not far from our conscious minds.  Every time we are about to enter the supermarket, we grab our face mask.  Reminder.  Every time we speak to a friend or family member who we haven’t seen in a while but cannot visit as of yet, we are reminded.  Every time we purchase something online, we are told that there may be a delivery delay “Due to Covid,” we are reminded again.  There is an endless list of casual thoughts and activities that do not permit us to forget that there is a virus out there that can kill us.  Its pervasive presence is unescapable.

Anyone Can Be Dangerous, Even You – How many times a day do you veer off your path to increase the distance between yourself and another person?  Moreover, how many times a day does someone, right after seeing you, veer off to avoid you?  If you were not previously aware of the impact of body language, you are now.  Physically avoidance of people is learned from a young age and is interpreted in your brain in a most negative way.  We avoid people we dislike or disdain, or fear.  Count how many times in a day your brain tells yourself that you have an aversion to people, either because you do not like them or because you’re afraid of them.  As much as your rational and logical brain knows this is not the case, our more primitive interpretation of this avoidance continues to subconsciously reinforced.

And now consider the subconscious message your brain is receiving multiple times a day when others avoid you.  “You are aversive.”  “You are scary.”  “You are dangerous.”  At the very least, it’s highly unpleasant to be avoided.  At its worst, it’s highly disturbing to imagine that your presence is ominous and threatening.  And of course your rational mind knows it is not true.  But that rational mind is constantly in overdrive to suppress that instinctive, unconscious reaction to the observation that others are avoiding you.

The Eyes are the Windows to the Soul – Consider how much communication relies on reading someone’s facial expression.  With masks, we an appreciate just how much we perceive and interpret based on facial expression.  If you were to stop and think deeply when speaking with someone wearing a mask, you will realize that you have less trust in your abilities to gauge and assess the reactions of others, and hence your response to them.  Some individuals naturally smile with every muscle of their face so that the mask has minimal effect on perceiving their smile.   But that is not always the case and then you are tasked with evaluating someone’s demeanor, reaction, temperament.  These days we only see their eyes.  In actuality, the eyes truly are the window to the soul.  However we also are hesitant about looking too deep into someone’s soul, particularly those who we do not know well, or at all.  Our primitive mind has negative associations with beings whose eyes are the only aspect of the face that is visible:  ghosts, demons.  Thus yet again, our rational minds are constantly at work to override those primitive associations and interpretations at looking upon a set of eyes, upon a masked person.

For Further Thought – What is the effect of spending much more time staring at computer screens?  Think about it.

During the pandemic, we must all tap into our inner strengths to cope with and surmount the very real challenges of economic hardship, illness, loss, claustrophobia and social isolation.  However we can all emerge from this pandemic not only with new insights, but with new strengths.  How can we change our approach so that we live in the moment and make the most of it in order to not be enslaved by the fear of our mortality?  Is our faith in our basic goodness, and the goodness of others, sufficiently strong so that we needn’t fear that others will perceive us as aversive or dangerous, and vice-versa?  And can we close our eyes and use our “mind’s eye?”  Can we cover our ears and listen with our hearts instead?

It is the wish of all that COVID disappear as soon as possible.  But until it does, there is much you can do to transform your life, even in COVID’s shadow.

One final note.  For those of you who didn’t understand the last two paragraphs, this blog piece was written just for you.