Sunday, April 5, 2020

What Is the Pandemic Doing to Your Mental Health?

Will the coronavirus produce a mental health crisis? The question is burning up more than a few minds, especially those in the mental health field. Even those who know nothing about mental health. Even poor David Brooks is beginning to suffer from mental exhaustion.

So, naturally Brooks has decided to weigh in on mental health issues, issues about which he knows nothing whatever. It could be that he is exhausted from pretending to be an expert. Nothing will exhaust you more quickly than lying to yourself and the world. When you know nothing about a subject you are constantly stressed about the chance that you have missed points that would be obvious to any expert.

So, we read these stirring sentences in the latest Brooks column, from yesterday. Note the portentous tone of the first sentence, followed by a  more colloquial verb in the second sentence. This pretends to be good writing. It’s not. 

There’s an invisible current of dread running through the world. It messes with your attention span. I don’t know about you, but I’m mentally exhausted by 5 p.m. every day, and I think part of the cause is the unconscious stress flowing through us.

Note also the shift from the first person singular to the first person plural. Note the invitation to feel sorry for poor Dave-- aka, an invitation for empathy. As for the unconscious stress flowing through us, it’s a rather lame attempt at psycho wisdom.

This is a moment that calls for deeper conversations and emotional accompaniment. We’re all going through something together. We’ll be more resilient if we can see others experiencing it in the same way.

Ah yes, all we need is deep conversations and emotional accompaniment. I would say that this is girl talk; men and not a few women dread deep conversations. It causes people to feel disconnected, because it makes them feel like self-contained human monads. Emotional accompaniment sounds like something that would be fitting for a string quartet. It’s crap writing, at the least.

And yet, considering how many television hours are devoted to providing information about the virus, about the treatments and the cures, you wonder why Brooks declares it all to be  invisible.

And then Brooks finds a study conducted by a woman who shares his last name. He suggests that quarantine traumatizes, which is not the same as disrupts. Do you think that being quarantined is the same as being abused, bullied, assaulted, harassed or injured? 

A study by Samantha Brooks of King’s College London finds that quarantine produces a range of bad mental health outcomes, including trauma, confusion and anger.

For some people, of course, being cooped up at home consuming media produces abuse. One might add that nothing obliges anyone to consume television news all day long. I don’t watch it. So, turn it all and watch an old movie or a television series.

Many people are alone, consuming media all day. Others are trapped in homes with abusers and dysfunction. Alcohol and drug use is rising. In France, reported cases of domestic violence are up by about a third.

Psychological health in times of crisis is like a wrestling match. The situation throws stressors at you. The question is whether your coping mechanisms are strong enough to overcome them.

But, then Brooks puts on his doctor cap and tells us about the biochemistry of trauma, which he calls an existential feeling of unsafety. It's yet another barely literate locution:

The pandemic spreads an existential feeling of unsafety, which registers in the neurons around your heart, lungs and viscera. It alters your nervous system, changing the way you see and perceive threat.

It’s very hard to grasp what’s going on so deep inside. “All trauma is preverbal,” Dr. Bessel van der Kolk writes in his book “The Body Keeps the Score.” “Rational brain is basically impotent to talk the emotional brain out of its own reality.”

The expression “deep inside” is child talk. Evidently, the theory offered by the doctor is highly controversial, if not an example of crackpottery. By suggesting that the rational brain is impotent-- speak for yourself, Dave-- to talk the emotional brain out of its reality, Brooks is stoking depression. He is saying that there’s nothing you can do. Besides, the emotional brain does not have its own reality. Using the word “reality” in this sentence is clearly absurd.

The notion of the impotence of reason is rank sentimentality, the idealistic kind that has fought tooth and nail against empirical science, pragmatic politics and even conservative thinking. So we have a pseudoscientist appealing to reason to persuade you that reason cannot sway emotions.

The solution, Brooks says, is to turn yourself into a tuning fork.

The best way to combat this visceral sense of fear and disassociation is by having what Bonnie Badenoch, the author of “The Heart of Trauma,” calls “disconfirming experiences.” These are experiences of deep reciprocal attunement with others that make you feel viscerally safe.

And, again, he falls back on girl talk, deeply meaningful conversations that make you feel more vulnerable. Because, in the mini minds Brooks chooses to quote, the cure for feeling vulnerable to the virus is to share the vulnerability:

Creating these experiences takes effort. “Being together is not the same as being connected,” Columbia professor Martha Welch told me. She recommends that people engage in deep intentional and vulnerable conversations, in which they pause — for as long as 90 seconds — after something important has been said, just to let it sink in. “You have to have the feelings conversation,” she says.

She and the other experts I spoke with endorse anything rhythmic. Anything that will create an experience of attunement: singing, dancing, yoga, deep eye contact, daily rituals and games.

As it happens, daily rituals are helpful. As are games. Deep eye contact, you should save for your intimates.

Just in case you are tiring of the pretend wisdom of David Brooks, here is a study by Jonathan Kanter and Katherine Manbeck of the University of Washington.

They too believe that we are going to have an epidemic of clinical depression. They might have asked whether the countries that are practicing social distancing and even lockdowns are having such a wave of depression, but they did not.

Isolation, social distancing and extreme changes in daily life are hard now, but the United States also needs to be prepared for what may be an epidemic of clinical depression because of COVID-19.

We are clinical psychological scientists at the University of Washington’s Center for the Science of Social Connection. We study human relationships, how to improve them, and how to help people with clinical depression, emphasizing evidence-based approaches for those who lack resources.

We do not wish to be the bearers of bad news. But this crisis, and our response to it, will have psychological consequences. Individuals, families and communities need to do what they can to prepare for a depression epidemic. Policymakers need to consider – and fund – a large-scale response to this coming crisis.

I do not want to sound more cynical than usual, but this is certainly good for the therapy business:

While the COVID-19 crisis increases risk for depression, depression will make recovery from the crisis harder across a spectrum of needs.

Given depression’s impact on motivation and problem-solving, when our economy recovers, those who are depressed will have a harder time engaging in new goal pursuits and finding work. When the period of mandated social isolation ends, those who are depressed will have a harder time re-engaging in meaningful social activity and exercising.

When the threat of coronavirus infection recedes, those who are depressed will face increased immunological dysfunction, making it more likely they will suffer other infections. Depression amplifies symptoms of chronic illness. The inequitable distribution of the burden of the crisis will exacerbate existing racial health disparities, including disparities in access to depression treatment.

Here they make an important point. They recommend that we stop saying that depression is a biomedical condition and recognize some of its social causes:

How we talk about depression must change. The distress we feel is a normal human response to a severe crisis. Acknowledging and accepting these feelings prevents distress from turning into disorder. Describing depression solely as a brain disease increases helplessness and substance use among those who are depressed and decreases help-seeking. Emphasizing the causal role of our environmental context, in contrast, matches how depressed individuals across different ethnicities view the causes of their suffering, decreases stigma and increases help-seeking.

And then, we have this from Lenore Skenazy in Reason. She points out, based on work performed by other psychiatrists, that most people who suffer from traumatic abuse tend to recover, on their own. Human beings are resilient, she reports, and thus should unlearn the idea that they will all be so depressed and traumatized that they will never recover.

"We are far more resilient than we give each other credit for," says Dr. Samantha Boardman, founder of and assistant attending psychiatrist at Weill Cornell Medical Center in New York City. And the research proves it.

Beginning in the 1990s some psychologists finally started turning their focus away from dysfunction to study its good-twin opposite: how people cope. By some estimates, at least half the population has gone through some kind of real trauma. (And let's assume, by September or so, that could be a lot more of us.) And yet, writes John Tierney, co-author of the new book, The Power of Bad: How the Negativity Effect Rules Us and How We Can Rule It, four out of five trauma victims did not suffer from PTSD.

"In the long run, they typically emerged stronger," says Tierney. "Instead of being permanently scarred they underwent post-traumatic growth."

The reason most of us haven't heard of this positive turn of events, according to Tierney, is because good news never gets the kind of attention bad news gets. That's a big theme in his book: Twitter, cable TV, and even the human brain loves bad news and ignore most of the good.

So, don’t traumatize yourself about experiencing a trauma. Don’t get depressed about being depressed. And surely, don’t listen to the pearls of pseudo wisdom coming from people who have never worked in the mental health field.


Sam L. said...

What am I doing? I'm going mad, MAD, do yo7u hear??? MAAAAAAAAAAAAAADDDDDDDDDDDDDDDD.
(SLAP face.) Thanks, I Needed that. Don't mind me. Carry on.

Sam L. said...

"Will Coronavirus Change the World?"

Nah. Well, maybe a little, but there's a new pandemic everyday, and I'm used to that, so I'm OK, I'm "down with that". Life goes on. Get over it.

Ignatius Acton Chesterton OCD said...

This is a full-blown panic. I’m ashamed of how so many of my fellow citizens are reacting.

I’ve gone through a number of phases with all this. I was concerned, then skeptical, then angry, and now I’m just ashamed. Almost disgusted.

There is very little thinking going on. We now have 10 million people out of work. The true numbers are infinitesimal compared to the predictions. We are running computer simulations of what might happen, and then doing whatever the models tell us. There’s a lot more that happens in life beyond what a computer model can tell you. Like all bureaucratic predictions, they don’t take account for human agency and choice.

Dr. Fauci says today this will be “seasonal” in nature. You mean like the seasonal flu? We cannot go through seasons of this.

I am sad for how hard NYC is getting hit by this coronavirus, but I am also stunned that people are still crowding themselves into subway cars.

Something has to give. Someone needs to be an adult and quantify the risk — to give us all a metric that will show when we’ll get the “all clear” to return to our economic lives. Until then, this panic will continue, with no end in sight. That breeds hopelessness and despair.

This is NOT the Bubonic Plague. We have to LIVE our lives.

UbuMaccabee said...

I cut down a big pine tree, and then cut down all the parts for the outdoor fire pit, rebuilt all the raised planters, dug a 20’ trench with trench shovel and pickaxe and laid down a catch basin and a French drain, planted all new trees and flowers, opened up the pool, finished constructing my home studio in the garage and am at 100% professional efficiency, went for a series of long bike rides with an old friend, helped same old friend finish off his Japanese whiskey, has several excellent cigars, and have been out on the kayak at first light every morning, read Jack Dempsey on fighting techniques and Harold C. Goddard’s “The Meaning of Shakespeare.” Put a gazebo over my barbells so I can lift in the shade. Grilling meat and fresh vegetables every meal. Ms Ubu is equally involved; she’s still out there working. Next up: under deck roof followed by retaining wall and cement slab to put the hot tub on. Yeah, I’m this close to losing my marbles. How will we persevere?

This is the greatest opportunity since the Internet. Be ready. All the closed slots on the board are about to open up.

This seems like a good time to learn Spanish and maybe play the piano.

Ares Olympus said...

IAC, it doesn't look like an "all clear" can be in our immediate future, only slow incremental steps to opening things again, until an effective vaccine is developed and distributed. A failure of testing is the primary cause of this current over-reaction. Kids were on spring break barely 2-3 weeks ago. That's how unserious we were.

We need wider and faster testing so asymptomatic carriers don't spread it. We need essential workers to feel safe to stay home when they're sick rather than fear they'll lose their job or their find themselves unable to pay their rent. We need tests to know who is immune and who is most vulnerable. And the rest of us need to keep practicing social distancing and better hygiene than we're used to.

It is easy to learn the wrong lessons from any crisis, but one right lesson is that we can't be penny wise and pound foolish when it comes to pandemics, and how we face this "slightly worse flu" hopefully will make us more ready when the next killer virus arises. Consider this a practice run for the big one That will take out 100 million people if we're lucky a billion if we're not.

UbuMaccabee said...

"She and the other experts I spoke with endorse anything rhythmic. Anything that will create an experience of attunement: singing, dancing, yoga, deep eye contact, daily rituals and games."

I know something rhythmic you can do that did not make the list. Something that should be at the top of a man's list. I endorse it as an experience of attunement. You can even roll rituals, deep eye contact, and games into it. No singing, that would be offputting. Tantra yoga indeed.

Anonymous said...

Common sense tells [most of] us that airing our deepest fears and our problems, looking deep into their eyes, etc., will only annoy people.