Although some countries are beginning to ease lockdown, we're nowhere near turning the curve yet on this pandemic. We don't know what version of the virus we're facing, what exactly the symptoms are, and recovered patients are testing positive again. Anything any government implements is basically an experiment— it may go right, or it may go wrong. We simply don't know.
Whatever happens, we're not going to waltz back into "real life." New, unique mental health challenges will emerge as we transition into the next phase of dealing with COVID-19. Below are five of the main ones we can expect to face:
1. PTSD from quarantine
Before most of the world went into lockdown, the Lancet conducted a review on the psychological impact of quarantine and found post-traumatic stress symptoms, confusion, and anger.
It isn't just about having to stay in and work from home. Suddenly, we have to navigate our relationships with those we share our spaces with, and with ourselves. These are things that many people have been dealing with only at a wary distance or even actively running away from, but now it's exploding in our faces.
Some examples of this:
We realize we don't quite like the people in our lives. Perhaps we got together for the wrong reasons and now are staying together for even more wrong reasons. Or things took a turn for the worse somewhere along the path, but we felt we were too far along to bail.
We don't like our lifestyles—why are we hemorrhaging all that money on things that buy us status, that are balls-and-chains, while our lives are bereft of meaning?
We don't quite like ourselves. And we don't know what to do with the lack of mojo or the mind that always feels like a tornado. We may have Zoom calls or people sharing the same premises—we're not alone, but really, we're lonely.
Time is passing by slower and yet faster—it's confusing. Professor of philosophy Adrian Bardon tells Vox that time can feel slower during quarantine because our attention is turned inward, or it can feel faster because we feel as though we haven't done enough.
We judge ourselves for having little energy, for not finishing our tasks, or not doing the courses we excitedly signed up for at the beginning of lockdown.
We feel envious at others for seeming to have better lifestyles—balconies, home offices, governments, etc.—and we don't like being envious people.
What to do:
While it's easy to rationalize and thus bypass our feelings, the truth is, unprecedented times mean unprecedented larger-scale discomfort. That's OK. In the Pāli Canon, a collection of Buddhist scriptures, the Buddha spoke of the Sallatha Sutta, or the two-arrow paradigm. The idea is that we receive pain from two arrows.
The first arrow refers to what's happening. The second arrow, however, is what we wound ourselves with by judging ourselves.
The sooner we acknowledge our humanness, we can then ask the next question, "What can I do to take care of myself, right now?"
2. Invisible burnout
Business coach Christine Miles, M.S., M.Ed., recently polled leaders of over a dozen organizations, asking them how their employees are doing.
"The response has been overwhelmingly, 'I think they are managing pretty well.' When asking employees a similar question, their answers have been quite different," she tells mbg. "Each has expressed that some aspect of the lockdown is causing them significant stress or anxiety. We need to understand that people are not really OK and intervene now, or another epidemic is on the horizon."
We're not used to working from home. Some of us have zero desks, and suddenly we have to share space with boisterous children home-schooling too? Add cramped spaces, and it is hell. As it is, we are incinerating energy on hypervigilance when outdoors, wondering about the future, and worrying about toilet paper. Our energy supplies are even more compromised than ever.
The next phase of COVID-19 will involve a spike in burnout. Already, many people have experienced their bosses expecting them to work even harder now that they're working from home and across multiple time zones. Miles says that employees she's spoken with have "felt burdened with too many back-to-back meetings without sufficient breaks or time to get their actual work done. Furthermore, the lack of in-person interaction made them less effective in general."
We cannot expect ourselves to simply "get up and go" and instantly adapt to this new work-from-home setup. Endless Zoom calls and increasing expectations, coupled with the pressure to work harder lest we lose our jobs, has already led to burnout.
"People don't really know how to adapt their working style into their home environment," business coach Vanessa Bennett tells me. "People sit down longer, there's no incidental movement to go to meetings or get coffee, and the bathroom is a lot closer. So you're not getting all the release of neurotransmitters by incidental movement. Some people also have meeting burnout. It's not Zoom that's the issue. Everyone is overcompensating. And a lot of these issues were already existing in the office. Now it's simply amplified."
What to do:
Bennett suggests that we create decompression time between home and work, such as walking at the end of the workday. Try not to get sucked into working longer just because the computer's there.
Organizations have a role to play in mitigating this burgeoning burnout crisis too, says Miles: "Start by giving your employees permission to not be OK. Establish a group venue, facilitated by a trained professional to allow your employees to share what they are feeling and give them strategies on how to cope."
3. Financial stress
I've been craning my neck for a global recession for the last two years. It's part of economic cycles, like the four seasons. It happens. But coupled with the pandemic, some experts foresee we'll be faced with a recession worse than the Great Depression.
This does not mean giving up. Instead, it means we'll need to learn to master our financial stress because chronic stress will debilitate you physically and mentally.
For my doctorate, I ran a study on 202 individuals of managerial level and above who'd lost their jobs. Those who were anxiously preoccupied with their situation, or who coped by distracting themselves, had the worst outcomes. In contrast, those who were open to new solutions or could reframe their losses and resources had the best outcomes.
Granted, it is difficult in that moment of loss. Any crisis can force us to evaluate our relationship with our time, identity, self, relationships, and finances. For instance, we may realize that our job has become all-consuming in how we define ourselves, meaning we've had little time for our personal growth or the people dear to us. Or we may realize we're unnecessarily hemorrhaging money and are therefore disproportionately beholden to our job—and have been living in fear all the time anyway.
What to do:
Losing your job doesn't mean you will never work again, Bennett reminds. She encourages her unemployed clients to assume they'll definitely get a job in six months' time. This can help you stave off some of the stress and anxiety that can come from professional hardship and allow you to pivot to thinking about next steps: "So, what would you do in these six months to make sure you get there?"
It's also important to find ways to contain the financial stress: "Don't let it pervade every area of your life. It doesn't mean you can't exercise, you're a failure, or you can't do charity work. You may have more time with your family," she points out.
In addition to getting financially organized during quarantine, find ways to stay grounded while unemployed.
4. Domestic violence
Many reports suggest domestic violence is spiking due to COVID-19. It's heartbreaking. When both you and your abuser cannot go out and you're in prolonged close proximity, violence escalates. And yet, despite multiple calls from social and governmental organizations for abuse victims to get help, it's not enough.
"The amount of DV that we are seeing is the tip of the iceberg. So much of it is under the radar," psychiatrist Munidasa Winslow, M.D., adds. "Physical violence is one thing. There is a huge amount of other violence—emotional violence and gaslighting. Now that everyone is locked down, we should discuss how we can change things structurally. It's not simply a domestic affair."
The problem is that most people don't even know they're being abused. Things don't feel right, but they dismiss it or are well-trained to blame themselves. Emotional violence leaves people confused. There are no scars, they think, so it can't be that bad. And who would believe you even if you said anything? And because there are moments when things seem to be getting better or the abuser promises to change, victims want to give them another chance.
What to do:
There are things you can do to keep yourself safe while in lockdown while in an abusive relationship, such as regaining contact with your friends and family and creating an exit strategy. (Here's our full guide on how to leave an abusive relationship safely.)
Most importantly, if you're in this situation, know this: There are people in this world who believe you. There are ways to get healing. There is a future.
5. Survivor/thriver guilt
Camps have formed. There is resentment toward people who appear to have better resources to cope—whether it's gardens, balconies, pools, private islands, or yachts. Understandably, the anger must be redirected somewhere.
But this isn't helpful.
Perhaps you're coping a lot better than most of the people around you because you're used to working from home and Zoom meetings. Perhaps you have control of your day-to-day life and can easily pivot your plans. Maybe you've been through a lot worse in your life. Or perhaps you're in an industry or job that's actually thriving during these times. All in all, your life may seem more than OK. But you feel anything from slight twinges to full-blown pangs of guilt.
In my work, I've seen survivor's guilt play out in all sorts of ways. People who narrowly missed a disaster developed major panic attacks for decades, and then those who did not get HIV during the height of the AIDS pandemic felt so guilty, they engaged in risky behavior so as to contract it.
What to do:
It's OK to feel compassion for the plight of those who have less. It's OK to have more resources. And it's OK to thrive.
Sometimes you've been lucky to get where you are. Sometimes, it's by design—you've worked hard. You can't worsen your living conditions in order to please everyone. It's a senseless race to the bottom. It also depletes your psychological immunity.
In times like these, we can take care of each other. How can you, then, help someone else? How can you channel your gratitude for what you've been blessed with and champion someone else instead?
The path forward.
By recognizing the signs of these coming mental health challenges now, we can start to address them before they hit us full-throttle. Whether on a personal, a professional, or an organizational level, forewarned is forearmed. This is about partnering with reality by acknowledging there are things to fear.
In Taoist philosopher Deng Ming-Dao's words: "Fear is instinct but can turn to madness. Fear can be adviser but not king."
Perpetua Neo, DClinPsy
Doctor of Clinical Psychology