Part of the May issue of The Highlight, our home for ambitious stories that explain our world.
Governments around the world are returning some of the most serious aspects of quarantine. After being locked up and separated for months, friends and family will eventually have a chat again. Some employees returning to the office and public areas – from restaurants to movie theaters – will implement strategies to make repeat customers feel safe.
Few of us will be the same who come out of quarantine when we went in: people with pre-existing mental illness lost a lot of the routines that helped them deal with it, worsen their problems in the process. Many have experienced new difficulties, such as the loss of a job or the death of a loved one, which is likely to be the case could not mourn well. And everyone is forced to drastically change the way they live, work and even the most mundane tasks, such as grocery shopping for groceries.
If you come out of such circumstances, unique side effects will arise. Although some states have started to reopen parts of their economyWhile the virus is still active, for many people FOMO may have been replaced by FOGO – also known as the fear of going out. While some people are willing to rub with strangers, others will be worried to return to the social sphere, partly because without a vaccine, leaving our homes carries a real risk of infection. But concerns about resuming public life were also heightened by our months indoors, with the lack of exposure to people and places that only exacerbated our fear of the outside world.
“We will have to go through this quarantine status even if physical quarantine is lifted,” Sheva Rajaee, founder of the Center for Anxiety and OCD in Irvine, California, told Vox in April. Psychological stress is already visible in some countries. In Wuhan, China, where the first cases of Covid-19 were reported, the closure has been lifted – but restaurants are empty, active temperature control points mark the city, and some residents keep hiding inside, for fear of a second wave of outbreaks.
How Americans will adapt to the new normal is a question for everyone. Vox asked five psychologists, whose expertise ranges from disaster resilience to mental health epidemiology, what they expect to see in the coming months. Their advice for dealing with the unprecedented challenges, edited for length and clarity, follows.
Accept that your fears are normal
Roxane Cohen Silver, professor of psychological science, medicine and health at the University of California, Irvine
I spent about 40 years researching how individuals and communities respond to traumatic life events. This is unlike anything we’ve experienced before, for several reasons: there is an invisible threat. We don’t know how bad this will get. We don’t know how long this will take. And, most importantly, this is a global threat.
There are a few strategies that can help. None of them are perfect. People should moderate the amount of media they are working on; a solid diet of bad news is not psychologically beneficial. People need to understand that their feelings are normal and natural and they don’t go crazy. This is a very unusual and stressful and worrying time. You may feel anxious. And there are many, many, many people who suffer losses – and they are real and they should not be minimized.
But so much is beyond the control of the individual. It depends on the ability to test whether people have the antibodies to the coronavirus. It depends on whether there is a treatment. And if there is no vaccine, we need people who trust the authorities and science and tell us what is risky and what is less risky.
After 9/11, there were major concerns that people would never get on a plane again. So there were three things the government did that made people feel comfortable getting on an airplane: they introduced civilian civil aircraft, the airlines hardened the doors so that cockpits could only be opened from the inside, and they introduced screenings at the airport. That’s just one example of how our government agencies can run an information campaign to make people more comfortable.
Learn to deal with your emotional response to fear
Christopher Pittenger, director of the OCD Research Clinic at Yale University
I mainly work with people with obsessive compulsive disorder. They often struggle with uncertainty and difficulty managing what is dangerous and what is not. We are all struggling with that now. Their response to the pandemic was interesting. Some people with OCD certainly have a hard time, but others do surprisingly well. The fear of everyone’s uncertainty and their desire to prevent contamination is confirmed. And in this crisis, the ambiguity has disappeared. That clarity can be reassuring.
If we go back to go out into the world to socialize, it will pose a real risk. And we’ll all be faced with the question, how much of that risk am I willing to tolerate?
One of the things you should do is systematically go through a scenario and just accept that there will be no absolute certainty, and learn to master that emotional response to uncertainty. This is something we will do in therapy not only for OCD, but for many anxiety disorders. It is called exposure and response prevention. We go on and activate the emotional response – we watch the spider, let our hands get infected, whatever it may be – sit there and tolerate the emotion. What often happens is that there is a risk, which leads to fear, and that fear leads to more fear because we tend to assume, “If I am anxious, something dangerous must happen.” If we can learn to name the emotion and recognize it as signals that can sometimes be useful, but not that you are in danger, then we can try to break through that cycle of the fear or fear that feeds and learn to tolerate it. better.
Practice mindfulness and remove unhealthy routines
Rossi Hassad, epidemiologist and professor of psychology at Mercy College
If you ask a mental health expert today, they will say that a disaster equals post-traumatic stress disorder. We did not have that classification during the Spanish flu. But if you go back to anecdotal reports and a few stories from the 1918 and 19 epidemic, the description fits: Spanish survivors of the flu reported sleep disturbances, depression, mental distraction, dizziness, and difficulties at work.
Post-traumatic stress disorder is directly related to the intensity of a person’s exposure to the traumatic event. The prevalence is generally 30 to 40 percent among direct victims, 10 to 20 percent among rescue workers and 5 to 10 percent for the general population.
After a disaster, the number of cases of major depressive disorder also increases. There is an increase in substance use problems. And with the Spanish flu, the death rate in the US was positively correlated with the suicide rate. When there is so much uncertainty, there are feelings of hopelessness.
Most people are resilient and will get through this very well. If they have mild symptoms, they will bounce back emotionally. But some people need some form of psychological support, from self-care to professional care.
Mindfulness, as simple as it sounds, goes very deep. We encourage people to pay attention to how they consume the news. We want them to engage in healthy routines and be aware of the use of tobacco, alcohol and other drugs, which can deteriorate your mental health and physical well-being in the long run. And if people need more support, we want them to know that they can contact state and city health services, the CDC, and other organizations to get information about access to professional services.
Fight fear by distracting yourself
George Bonanno, director of the Loss, Trauma and Emotion Lab at Columbia University Teachers College
This is so unique. And it is not traumatic moment. It’s chronically stressful, so we start to fall apart physically, and the stress response doesn’t start to work properly, and then you start to get depressed or anxious.
The natural responses we have to side effects are adaptive, but they can be disconnected from an actual threat and become a common understanding of the world.
We try to find out what makes people resilient for 30 years. We’ve identified a lot of things: optimism, confidence in your coping strategies, mindfulness, social connection. But scientifically, all of these things have small effect sizes. Optimism may explain 3 or 5 percent of the resilience. Even if you add all these things together, you don’t get much of the story. The reason is that they don’t always work because life is complicated. There are no magic bullets. There are not three or five things you can do to fix the problem. We have to be creative.
Friends have already told me that they watch movies and [if they] see someone touch, they panic a little now – “Don’t touch that!” I imagine some people will be restless for some time after that, and it will be until there are more guarantees. In the meantime, we must use the tools at our disposal. We need social contact – people zoom in with their friends. Humor is very good. It is not a miracle cure, but smiling and laughing works. People have to distract themselves; there are now enough movies to watch. But the idea is whatever you do, if it helps you, as long as it doesn’t get long lasting or harmful, that’s great.
Participate to avoid feelings of powerlessness
Susan Clayton, environmental psychologist at the College of Wooster
Our behavior has changed so dramatically. At the moment, there is a real sense of unreality for many people. It used to be like, okay, we’ll stay in place for two or three weeks and it will all go back to normal. It soon became clear that this was not the case. Now if we go back to a different lifestyle, we have to go slow or else it can be stressful, especially if we reopen the economy before we get a vaccine or treatment.
The virus will force us to take baby steps. But it will be good for our mental health, as well as our physical health, to try not to get out of the pandemic all at once. I think some of the things we do are better – that we may want to keep doing – even as the pandemic worries subside: keeping more business meetings virtual, sleeping late, families spending more quality time together. The need to go slow encourages us to be aware and make more conscious choices. It’s like, “Okay, I’m going to do this one thing differently,” and not immediately return to all our old behaviors. We need to think about how this experience can positively contribute to who you are.
With both climate change and the coronavirus, people feel very helpless because it is this global problem, and they feel they cannot do anything as individuals will make a difference. But what the response to the coronavirus has shown us is that we can make quite dramatic changes when we need to. It’s helpful to get involved somehow. People can try to make their community more sustainable, or it can be political action, or it can be another group of people to meet and talk about these problems. Taking action can help overcome that feeling of powerlessness, which is good for your mental health.
Eleanor Cummins reports on the intersection of science and popular culture. She wrote about it earlier socially distant mockers and deceived celebrity pandemic social media for The Highlight.