Once The Pandemic Is “Over,” What Happens To Our Mental Health?

Whether it's the strain of being confined at home, concern about loved ones, or fear of layoffs, the COVID-19 crisis may have you feeling more depressed, anxious, stressed, or all three. Therapists say that this feeling may not pass once social distancing is lifted or a vaccine is available; it will take a long time for people to heal from the trauma of the coronavirus pandemic.

"Generation X and below are being tested like never before," Dr. Gregory Nawalanic Pys.D., a clinical psychologist with the University of Kansas Health System, tells Bustle. "This is our Vietnam, our World War, our Great Depression, and arguably the defining moment of our generations." Each of those events had mental health consequences for entire populations that lasted for years, even decades.

"Anxiety and apathy, as well as loneliness, are some of the mental health consequences that will persist long after the pandemic ends," the European Public Health Alliance said in a March statement. Dr. Helen Odessky, Pys.D., a psychologist, predicts a rise in post-traumatic stress reactions following prolonged social distancing.

Wellness advocate Fiona Lowenstein created a support group for COVID-19 survivors like herself; in an op-ed for The New York Times, she wrote that "Almost all [support group members] are experiencing mental health problems, including severe anxiety, panic attacks and depression, as they struggle to understand what’s next for them." Dr. Nawalanic says that, for people who have lost somebody to COVID-19, the fact that they weren't able to be present at the end of their loved one's life, or to hold a funeral may constitute a trauma. "That inherently compounds the sense of loss and complicates the grieving process," he says.

People not directly affected by the virus will feel its impact, too. Social-distancing policies will cause people to miss milestones like weddings or graduations, or family businesses to collapse. Relationships will change under the duress of isolation. "Prolonged quarantine can be a disastrous recipe for marriages that were already struggling, with financial stress, uncertainty about the future, lack of personal space, and fear about the disease contributing to rising divorce rates post-pandemic," Dr. Jasleen Chhatwal M.D., a psychiatrist and chief medical officer for mental health residential center Sierra Tucson, tells Bustle. Divorces and separations are known to cause a higher rate of mental health issues for some people, both directly after the separation and for years afterward.

The burden on therapists and other specialists in mental health will be very high long after COVID-19 cases peak. But it's very difficult to map out how many people will be affected and for how long — particularly because it's not possible to know right now when social distancing might end, or how bad the economic repercussions will be.

The International Monetary Fund (IMF) has said the world faces an economic recession that parallels the Great Depression in intensity, and may last for several years. Research shows that recessions create huge mental health challenges; a study in Psychological Medicine in 2013, for instance, found that economic downturns throughout the 20th century were associated with higher rates of depression, stress, and drug and alcohol use over time. The Institute for Fiscal Studies said in an April briefing that the coronavirus pandemic's influence on mental health might only become obvious after two years.

Previous pandemics show how serious the long-term consequences can be. Mental health facilities in Norway showed a significant increase in patients up to six years after the Spanish Flu pandemic. A study published in Canadian Journal of Psychiatry in 2003 after the SARS epidemic found that hospital workers continued to experience post-traumatic stress, depression, and anxiety a year after the pandemic.

There may be some relief in the medium term. Dr. Paraskevi Noulas Psy.D., a psychologist at NYU Langone Health, believes that people will react positively when workplaces and schools reopen, and routines begin to go back to normal. "That's why many people struggle at home; most people function well when there is structure and order," she says. For many, though, the world will be permanently changed.

The upside, Dr. Nawalanic says, is that these days, taking care of your mental health has less stigma attached to it. "Perhaps like never before, people can be comfortable and confident in reaching out for help and support," he says. "That is what is going to help to bring us through to the other side."

If you or someone you know is seeking help for mental health concerns, visit the National Alliance on Mental Illness (NAMI) website, or call 1-800-950-NAMI(6264). For confidential treatment referrals, visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website, or call the National Helpline at 1-800-662-HELP(4357). In an emergency, contact the National Suicide Prevention Lifeline at 1-800-273-TALK(8255) or call 911.

Studies cited:

Galea, S., Merchant, R.M., Lurie, N. (2020) The Mental Health Consequences of COVID-19 and Physical Distancing: The Need for Prevention and Early Intervention. JAMA Intern Med. doi:10.1001/jamainternmed.2020.1562

McAlonan, G. M., Lee, A. M., Cheung, V., Cheung, C., Tsang, K. W., Sham, P. C., … Wong, J. G. (2007). Immediate and Sustained Psychological Impact of an Emerging Infectious Disease Outbreak on Health Care Workers. The Canadian Journal of Psychiatry, 52(4), 241–247.

Sbarra D. A. (2015). Divorce and health: current trends and future directions. Psychosomatic medicine, 77(3), 227–236. https://doi.org/10.1097/PSY.0000000000000168

Zivin, K., Paczkowski, M., & Galea, S. (2011). Economic downturns and population mental health: research findings, gaps, challenges and priorities. Psychological medicine, 41(7), 1343–1348. https://doi.org/10.1017/S003329171000173X

Experts:

Dr. Jasleen Chhatwal M.D., psychiatrist and CMO, Sierra Tucson

Dr. Gregory Nawalanic Pys.D. psychologist

Dr. Paraskevi Noulas Psy.D., psychologist

Dr. Helen Odessky Pys.D., psychologist