With vaccine distribution increasing and states relaxing restrictions on indoor gatherings, many of us are contemplating the prospect of resuming activities long abandoned over the last year. Some people can hardly wait to board a plane for a Hawaiian vacation or gather at a favorite restaurant with friends; others are feeling, as one patient of mine put it, “not ready for things to go back to ‘normal.’”
And what does “normal” even mean in the current context?
We know from studies conducted after the quarantines imposed during the SARS epidemic that the mental health ramifications of even short (more than 10 days) periods of enforced isolation are not trivial. Reactions included post-traumatic stress disorder, avoidance behaviors, and anger, lasting in some people for several years. Research conducted in the aftermath of the COVID pandemic is already uncovering similar—and even more pervasive, given the duration—patterns.
The absence of in-person social interactions over the last year may make it especially hard to go back to seeing people face-to-face (or, mask-to-mask, as it likely will be for quite some time) for those prone to social anxiety. Avoidance is a prevalent coping mechanism, albeit not a healthy one. It might relieve anxiety in the short run but over time, avoiding triggers backfires because it prevents practice.
Returning to the office or seeing friends in the flesh might feel awkward because social skills have grown rusty. And heightened body awareness might add to the uneasiness. Wearing “hard pants” after a year of working from the couch in sweats can feel strange and uncomfortable, especially for those (22% by one estimate) who have put on some weight during the pandemic.
People with OCD may fear seeing even fellow vaccine recipients unmasked and cling to washing and decontamination rituals adopted early in the pandemic, even if they are no longer deemed necessary. The over-estimation of danger is a thinking style common to all anxiety disorders. And as one recent study showed, news reported by media outlets in the US skewed overwhelmingly negative—87% of COVID coverage in national US media, compared with 64% in scientific journals, emphasized bad news—adding to the atmosphere of threat for those hypersensitive to it.
Even in the absence of preexisting mental-health issues, nearly all of us will experience some degree of post-traumatic stress, complicating our return to a BC (Before COVID) life. The trauma of actual illness and of losses—of lives and livelihood for many—have left deep emotional scars. Navigating the reentry into the world will take time, patience, and understanding, of others and ourselves. We all are grappling with a confusing mixture of emotions: excitement, fear, and even nostalgia for the early days of quarantine, when decisions were more black-and-white and unambiguous, and a sense of being “in it together” prevailed. Current times present a much higher level of uncertainty, making life far more complicated.
Acknowledging difficult feelings and allowing them to surface rather than trying to push them away are important strategies for coping with any challenge to emotional equilibrium. The road to the new “normal” will be rocky. But cultivating an attitude of acceptance will make the path less treacherous.
In the last week, everyone I’ve seen virtually for therapy has voiced increasingly familiar complaints. They are bored; they cannot get motivated to work or study; they have no appetite or have put on pounds from mindless snacking; they cannot practice healthy sleep habits even though they know too much screen time before bed and staying up past midnight will make it harder to function at peak efficiency the next day.
A lack of interest and motivation, along with appetite and sleep changes, can signal depression. And, certainly, we all are experiencing what feels like a collective state of depression after nearly a year of living with the drastic changes raised by a global pandemic, a situation that appears endless to many of us.
So, if your mood is low and you are having trouble concentrating, take heart. You are not alone.
As we know from a large body of research on mindful self-compassion, acknowledging the struggle, rather than beating yourself up for going through a hard time, can help, especially when you can connect with a common humanity (“Life is different for all of us right now.”) Treat yourself with the same kindness you would offer a close friend or family member to ease the unpleasant feelings.
Other coping strategies include seeking out social interactions, even if they might be less satisfying through a virtual platform, and breaking out of the daily routine by creating some novelty. Try learning a language, experimenting with new recipes, or practicing a different exercise routine. If you have trouble pushing yourself to do anything right now, keep in mind a lesson psychologists have learned from behavioral activation for depression: just doing something – anything, in fact –can pull you out of the doldrums, even if nothing sparks your immediate interest.
That said, although your current feelings of ennui may be nearly universal, they still could signal the onset of depression. If you have had a history of depression, you may be more vulnerable than someone with no previous episodes. Be on the alert for warning signs: constant rumination, feelings of hopelessness, extreme changes in sleep and appetite, and persistent thoughts of self-harm or suicide. Please seek help if those symptoms persist or worsen.
If you are just weary from the daily dreariness and not clinically depressed, you might try observing your emotions through the lens of mindfulness. A common approach in meditation is to view your thoughts and feelings as transient, like clouds in the sky or a stormy weather pattern: they change from moment to moment.
I had the opportunity to practice observing my response to an actual meteorological event recently when I woke to a heavy snowfall. My first reaction was irritation at the inconvenience of it. “I won’t be able to walk the dogs without worrying about being pulled over on the ice.” “We’ll have to dig out the cars.” “It’s so annoying.”
But instead of continuing to wish it were different and getting upset about a situation I had no power to change, I decided instead to work on accepting the state of affairs. While I drank my coffee, I gazed out the window at the wooded path behind my house and noticed how peaceful it looked. I bundled up, took the dogs for a walk, and let them enjoy sniffing and digging in the soft mounds of snow. I laughed out loud watching Roland drag a shovel down the stairs and across the yard like a prized game specimen. I stopped my internal grumbling, and my mood lifted.
And, then, much to my surprise, the sun came out, it warmed up, and the snow melted. Of course, the puddles will freeze tonight when the temperature drops. And tomorrow, we will begin, again.
Thanksgiving is just a few days away. The approach of the holidays this year has trapped many of us between the proverbial rock and hard place. How should we celebrate? Is it OK to let down our guard and see family if we’re all being careful? Should we get on a plane? Is it worth risking putting our older relatives in danger of infection in order to be together?
If we were going strictly by the book, nobody would host or attend a Thanksgiving dinner. The CDC has advised us to avoid travel and not to spend time indoors with people outside our immediate household. Even so, most families are deciding how closely to follow the guidelines, calculating—and perhaps underestimating—the risks involved. .
We all want to hold onto cherished traditions and see the loved ones we’ve been separated from during these endless months of COVID. And, yet…
There is no right answer.
If you go ahead with your plans and get together with family for Thanksgiving dinner, you may feel guilty about ignoring the various governmental recommendations. And, even worse, you might have to live with the consequences if one of your parents or grandparents or aunts or uncles gets sick.
If you exercise the recommended caution and stay home alone or just with your immediate household, you will feel sad and lonely, and you may regret playing it safe when friends are posting pictures of their family get-togethers on social media.
Either way, you can’ t win.
Several of my patients with OCD have told me, “Now maybe people will understand how hard it is to live with OCD.” The back-and-forth, the doubt, and the emotional distress many of us are going through right now as we try to decide how to spend the holidays mimic what those with OCD struggle with on a daily basis.
So how do we cope? Approaching an upsetting situation with an attitude of mindful self-compassion can make it more bearable. First, acknowledge that this turmoil is really hard. Then, connect with the “common humanity”: millions of people are sharing the same, challenging experience. Finally, treat yourself with kindness. Accept your decision, whatever it is, and remind yourself, “You’re doing the best you can.”
And think about next year when, with luck and the possibility of a vaccine, we all will be able to bring back our old traditions and appreciate them, perhaps even more than ever.
This blog is intended solely for the purpose of entertainment and education. All remarks are meant as general information and should not be taken as personal diagnostic or therapeutic advice. If you choose to comment on a post, please do not include any information that could identify you as a patient or potential patient. Also, please refrain from making any testimonials about me or my practice, as my professional code of ethics does not permit me to publish such statements. Comments that I deem inappropriate for this forum will not be published.