Mental Health in a Crisis

It took six weeks of lockdown for me to reach my breaking point. After months of denying the impending crash of my laptop, I discovered, suddenly, that it was no longer charging. Didn’t the universe know how important my work was, that I needed my computer more than ever— how could it fail me now? There had been warnings, flickers of malfunction in the system; then in a moment, the tension that had been fiercely bubbling below boiled over and everything unraveled at once. I punched a wall and said ugly things. Trying to spare my family, I stormed out into the yard and threw a deflated soccer ball against our house until fatigue overtook frustration. It was time to take a closer look at how this crisis was affecting my mental health.

Like a nightmare version of Groundhog Day, I awake and find that the world has not changed. My parents, sister, and I are bunkered down in my childhood home outside of New York City. Besides dog-walks around the block and the occasional errand, we’ve been isolated now for seven weeks, our lives on hold indefinitely. I have been shackled to an orthopedic boot for a stress fracture that developed after escalating my running routine during March’s stress; right now, I miss that outlet more than ever. With a yard and plenty of space, I know that we are lucky to be here — but even as spring shakes away the winter frost and the flowers begin to bloom, the morning sunshine seems washed out. I hear the absence of children playing in the streets. I try to resist the urge to immediately roll over in bed, look at my phone, and see how much worse off the world is today. Most days I am unsuccessful.

The week yawns on. We eat, clean, and wait for our next meal. One cup of coffee prepares me for another. I draft to-do lists that seem inexhaustibly long and try to remember whether it is Tuesday or Thursday. Showering has become a chore; there is no one to see, no reason to shave. My wardrobe consists mostly of sweatpants. I try to study for a medical licensing exam that was just canceled for a third time. Twenty-four undefined hours tower ahead and I count the minutes until I can take respite in watching Netflix. Yesterday’s best intentions sit quietly aside, untouched. I wonder if someone will recommend something new to watch today. It feels like no amount of energy will lift my ambition back to its feet. I turn the television on. More heartbreak, more numbers, more human loss. Venezuelan women in active labor are being turned away from hospitals. South Sudan has more vice presidents than ventilators. It seems like there is so much to cry about these days. I pour a third cup of coffee.

From the suburbs, we watch the streets of NYC become makeshift morgues as denial and homemade hoaxes tear through the internet like plague. The everyday heroism on the front lines seems drowned out by the old divisions in this country, re-emerging with a new vengeance. We do not all share the same values, nor solutions — we don’t even agree on the same problems. I curse politicians and wish the quarantine protestors would wear masks. The ugly side of the human spirit that trolls message boards feels less like a wicked impulse and more like our nature itself. I know it’s just a vocal minority, but they seem so loud right now. I try to remind myself that no one believes that they are the bad guy, and mostly everyone is trying to do the best that they can with the hand they’re playing with. At times, it feels like too much to believe.

Stress: I feel it contaminate my thoughts. The crisis is everywhere. We are torn between the desire to understand what is going on and the need to protect ourselves; yet at the end of our seventh week of lockdown, I feel the cumulative damage of house arrest growing. There is the constant nagging sense that something is wrong. These days, the slightest irritation cuts through my paper-thin skin. I am filled with envy by a man in a deodorant commercial walking on the beach with a pretty woman. The space between us feels so immense. I shuffle through the meaningless hours of my quarantined day wishing it were possible to hibernate. I wonder if I am depressed. Tossing awake at night, I try to imagine what all the other people are doing in their homes, and whether they are scared or sad or angry or just lost. I think about all the other anxious minds out there, tossing awake at night. We all feel like strangers now.

At heart, I am an optimist. With time and therapy, I have learned that this disposition is a defense mechanism against my own depressive tendencies — but what remains when our optimism is gone? I see our sinking heroes summoned back to work and I wish that we had more of them. I try to understand the compassion and strength that returns them to the front lines as protestors take to the streets. Social media clogs itself with misinformation and conspiracy theories crafted to discredit our scientific community and I am reminded once more that I expect too much from people, and that this all leads to disappointment. Familiar shadows cast themselves across my thoughts. I feel my characteristic optimism being replaced by cold cynicism — when will this end? — but this world needs no more cynics. How do we respond in a crisis? Do we bury our head in the sand and protect ourselves from a reality that is becoming increasingly hard to deny? Or do we turn to face the fray, even as it haunts our sleep?

The discovery that our lives can vanish without warning is challenging us in ways we do not understand when we did not expect to be challenged. It it not only the sick or our front-line heroes who are at risk; right now, in some form, we are all suffering. I reassure myself that I will probably be okay, that most of us will emerge from this pandemic physically unscathed — but there are so many who will not. Our best laid plans evaporate with the fallacy of American exceptionalism, exposed (yet again) by a threat that does not distinguish between boarders, ideologies, or creed. Common ground seems out of reach; we seem to hate and fear each other more than any other enemy. Looking inward, we find naivety and hubris sown deep within the heart of our young country and watered by decades of empty nourishment from our ideological echo chambers. The crisis unfolds and we witness not one country but 50 scrambling states struggling to fend for 330 million persons straddling the unhappy line between depression and denial, looking for meaning or order or something to help this all make sense.

At times, it can feel like the cure is worse than the disease. It is immensely more difficult to organize an effective national response when our most effective strategy demands that we surrender the very liberty, autonomy, and relations that give our lives meaning. The problem with social distancing is that it protects our physical well-being at the cost of our economic and mental health. Without the support of the usual coping mechanisms we rely on, everyone is vulnerable. Where do you turn when you’ve lost your job but have a family to feed? What do you do when the foundation of the life you’ve built collapses? As physical and emotional isolation compound financial insecurity, minor stresses are becoming major. Experts are worried that our current mental health infrastructure is insufficient to meet this need: a survey by the Kaiser Family foundation found that 45% of Americans are now reporting that the stress created by this crisis is affecting their mental health; calls to substance abuse and mental health service distress hotlines have gone up about 900% compared to a year ago; alcohol sales for March 21st in the US rose 55% in 2020 over 2019. We can only speculate about the consumption of television and unhealthy foods.

Everyday, we hear about the statistical toll this pandemic is taking, yet so much of this crisis is quietly happening behind closed doors. Anyone with a vulnerability to mental illness is especially at threat — but right now, our mental health struggles are so prevalent that to be in crisis is essentially a normal response. Our depression, anxieties, and dependencies are running rampant in confinement. Consider a previously healthy adult at the end of a long week: now isolated at home, they start to drink more often alone. What first seemed a sensible solution to the loneliness of those evening hours is becoming a tenacious habit over weeks of quarantine. Like short-cuts to satisfaction, our doses of dopamine sooth the same circuits that underlie our sense of connectedness and meaning — for a moment. Is it any wonder that when we are quarantined from each other, we cling to our favorite vices? Humans are inherently social creatures, dependent on each other for nourishment. When we are deprived of our support networks, everyone suffers (it is no coincidence that solitary confinement is used as punishment in American prisons). It is okay, I think, to lean on our vices a little right now, as long we understand why and how we should use them. However, the satisfaction they bring does not linger and soon we need more.

Without knowing when things will be normal again (or what the new “normal” will even look like), it is imperative that we actively maintain our mental health. Having lost many of our usual stress-relievers, we must adopt new ones. How will you cope with this still uncertain period? The question of how to best adjust is an individual one, and solutions to this pandemic are as personal as they are political. Self-care rituals are an essential component of maintaining our health and sanity and should be cultivated as part of our daily routines. There are no substitutes for physical and social activity. Hobbies are wonderful, but outlets like online exercise classes that keep you active or Zoom parties that connect you with loved ones are crucial. Anyone stuck inside during this crisis will further appreciate the inextricable link between our physical, interpersonal, and psychological well-being. In my orthopedic boot, I am jealous every time I see socially-distanced neighbors enjoying a walk outside together. Instead, I have been tending to my recent unsteadiness with guitar, yoga, and meditation (and, when they fail me at night, whiskey).

The silent majority of this country is struggling. Above all, what this crisis is asking of us is to tend to our pain so that we may take care of each other. My family only suffers from my moodiness, society has no need for my bitterness, and my heart is no stronger for this anger. Yet these frustrations can still be useful in calling our attention to feelings and needs as they arise, keeping us honest about the toll this insanity is taking on our mental health. Take stock of your emotional inventory throughout the day. Find an isolation partner and keep each other remotely accountable. In the labyrinth of mental illness, there are places so dark that even the idea of light seems impossible; in those places, there is nothing more valuable than having a friend to help show the way back out of the maze. You undoubtably know someone who is struggling right now. Whether this crisis is finding you back in your childhood home with a family you never thought you’d live with again or locked down in small, New York City apartment with only a little cat, we need to take care of each other more than ever.

Tomorrow, I will rise again to a world that is changed. I will greet the day and all the unwelcome news that it has to offer because I am a citizen of this world and I share in its well-being. There is a dose-dependent relationship between my exposure to media and the intensity of my anger. Let’s face it: this sucks — I can and should not do this all day. So after I have had my fill of bad news, I will do my best to put down the remote alongside my cynicism, and take care of myself and those nearby. When they protest quarantines, I will try to recognize that they also suffering, just like me. I notice stress as it arises, and with each breath, I try to let go of a little bit more. No amount of scheming will save our schedules. It doesn’t matter. The anxious, gnawing feeling that stalks my days and haunts my sleep isn’t just my pain — it is our pain. There will be time for post-mortems and finger pointing later. There are better things to do today.

On a different channel, there is a movie where a group of friends are out a bar. Laughing together, they seem so happy. I have had as many bad days in the past month as I’ve ever had, and the forecast for the coming month isn’t much better. On the bad days, my loved ones remind me that this, too, shall pass; tomorrow, they might need me. As strange as that movie world seems, now, it must also keep us going. Even if we have lost our naivety in this crisis, we must not lose our optimism. If the world is going to change, we need it now more than ever.

…As it turns out, my computer wasn’t actually broken. It just needed a new charger. All that frustration for nothing.