The life we had before was not perfect perhaps, but it had an essential ingredient that gave us security: normality. Now that ingredient is gone. We have come to live in a kind of limbo in which we await – more or less impatiently – the return to that normality.
However, thinking that the coronavirus pandemic and this endless period of isolation that have turned our world upside down are not going to leave a psychological damage is simply naive. Postcoronavirus reality is not exactly pink, so we will have to prepare ourselves to face an uncertain future in the best way we can.
Disappointment phase: Sadness and emptiness after the impact of traumatic events
Thinking that we are going to go through a collective and individual trauma without paying a psychological bill implies taking up the bad habit of closing our eyes to a perspective that we do not like or scare us. “We tell ourselves that pestilence is a mere bogy of the mind, a bad dream that will pass away. But it doesn’t always passes awayand, from one bad dream to another, it is men who passes away”, as Albert Camus warned.
When we go through a traumatic situation, such as catastrophes and pandemics, we all go through what is known as the “disappointment phase.” In this phase, the illusion that everything was going to be all right vanishes. Optimistic slogans give way to sad reality. And the rainbows that animated us hide behind black clouds. The initial optimism that pushed us to resist and fight gives way to discouragement and pessimism.
The stress, which had given us the necessary strength to bear everything, begins to take its toll on us. We enter a phase of apathy and anhedonia. Physical exhaustion plants flag. And the world begins to seem uphill, very uphill.
Much of these changes have a physiological explanation. They are due to hyperactivity of the hypothalamic-pituitary-adrenal axis, which first gives us the almost superhuman energy we need to fight the threat but then takes it away from us, plunging us into depression, as a study by King’s College London revealed.
Of course, not everything depend on our physiology. In the phase of disillusionment – both communities and individuals – realize the limits of assistance. The gap between the need for help and the scarcity of help begins to grow, which usually generates a painful feeling of abandonment.
“The outburst of compassion”, typical of the heroic phase in the face of major catastrophes, “And the frenzied public relations demonstrations of politicians mitigate the effect of trauma for a time and provide temporary relief to people burdened by old debts who had, suddenly, been deprived of income. But all of this turns out to be a very short-lived truce”, wrote Zygmunt Bauman, referring to the way in which our society tends to deal with catastrophes.
Later, when aid groups leave, the media turns the spotlight on other news, politicians resume their habit of discussing banalities, and banks begin to claim the debt, despair and feelings of abandonment will grow in the population, especially among the most vulnerable.
As the world picks up its pace and many people return to that longed-for normality, others will fall behind. Either because they have lost their job or are suffering psychological consequences. They are the forgotten ones of the system. Those who slip through the fissures of society. And those people become perfect candidates for another pandemic to spread: depression.
The “perfect storm” that the coronavirus will leave behind
There are people who, right now, are looking at everything through a gray prism – and they are right. In the face of a health emergency that is also eroding our economy and has blown up the pillars that gave us security, it is inevitable to feel the pinch of vulnerability and insecurity.
We are going through a storm that attacks us from all fronts. There are those who are working under enormous pressure, exposing themselves day by day to contagion and the possibility of dying. And there are those who have lost their jobs and feel the sting of economic instability. There are those who have lost loved ones, unable to say goodbye to them, condemned to suffer their grief alone.
All of these people are experiencing, one after another, the emotional components that lead to a “perfect storm” for the onset of depression: sadness, irritability, exhaustion, and a feeling of emptiness.
Being isolated at home doesn’t help either. Confinement can trigger depression, especially for people who are completely alone. Imposed loneliness, the one we don’t choose, has been proven to be a risk factor for depression.
In fact, a study recently published in The Lancet revealed that the most common quarantine side effects are post-traumatic stress and depression. And it is not so easy to get rid of them: the symptoms can be maintained three years after the experience.
Also the loss of financial support leads to depression, as showed a study published in the journal Neuropsychiatrie. The deep social insecurity generated by the abrupt loss of income, added to the feelings of hopelessness, feeds a negative state of mind that can make us bottom emotionally and from which it is not easy to get out.
What can we do to prevent depression – individually and as a society?
“To prevent a catastrophe, you must first believe in its possibility. We must believe that the impossible is possible. That the possible always lurks. Tireless, inside the protective shell of impossibility, waiting to break in.
“No danger is as sinister and no catastrophe strikes as hard as those considered to be a paltry probability; conceiving them as improbable or completely ignoring them is the excuse with which nothing is done to avoid them before they reach the point where the improbable becomes reality and suddenly it is too late to mitigate their impact, and even more so to conjure their appearance. And yet, that is precisely what we are doing, or rather ‘not doing’, on a daily basis, thoughtlessly”, Bauman warned.
It is worth clarifying that right now, the level of stress, anxiety or sadness that we experience is a perfectly normal reaction to the events that we are experiencing and should not be confused with a mental disorder. Depression does not happen overnight. And it is precisely this that leaves us a margin of action to prevent it from becoming the next epidemic, as it seems to be happening in China, where 16.6% of people already report signs of severe or moderate depression, according to a study of the Chinese Psychological Society.
On an individual level, we need to learn to manage stress and assume loneliness as an opportunity to be alone with ourselves and reconnect with our feelings. This is a good time to learn to practice trascendental meditation techniques and delve into Buddhist philosophy because it helps us deal with uncertain times while maintaining our mental balance. Philosophy and psychology, now more than ever, can become your allies.
However, we cannot expect the individual to fight alone against the structural and systemic problems that are already endemic and weigh on our society. “It is never pleasant to be sick, but there are cities and countries that sustain us in disease, countries on which, in a way, one can trust. A patient needs tenderness around him, he needs to lean on something”, Camus explained.
If a society and a system does not provide that, it does not care about supporting the most vulnerable, both physically and psychologically and economically, it leads some of its citizens to the deepest depression. We need to know that we are not alone. That they have not abandoned us. That we can count not only on other people but also on an institutional support network. That comforts us, allows us to recover earlier and work together to rebuild our dreams.
We need to recognize that the initial plan failed. We have already left behind thousands of people, those who have lost what is most valuable: their life. Now we have to make sure that we do not leave behind the new victims of the social crisis. And if the system we have does not allow us to do it because it is too rigid to allow a loophole of humanity to enter, we will have to change it. Without excuses. Or we will be condemned to repeat the same mistakes.
Brooks, S. et. Al. (2020) The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet; S0140-6736(20)30460-8.
Cooper, B. (2011) Economic recession and mental health: an overview. Neuropsychiatr; 25(3): 113-117.
Pariante, C. M. & Lightman, S. L. (2008) The HPA axis in major depression: classical theories and new developments. Trends Neurosci; 31(9): 464-468.
Bauman, Z. (2007) Miedo líquido. Barcelona: Ediciones Paidós.
Cacioppo, J. T. et. Al. (2006) Loneliness as a specific risk factor for depressive symptoms: Cross-sectional and longitudinal analyses. Psychology and Aging; 21(1): 140–151.