COVID-19: The Grief and Deterioration of our Mental Health

How are you feeling these days? The past several months have felt like a roller coaster that was not really enjoyable to ride. I took some time to look back over the past several months and reconcile how people were reacting and responding to everything. I looked at myself and how I was feeling during each phase. We have felt fear for our health, claustrophobic as we waited out stay-at-home orders, and frustrated over a lack of clear understanding of what was really going on in our country with this pandemic. The physical challenges have transformed into mental and emotional challenges. I finally came to the conclusion that this journey we have all been travelling through, mentally and emotionally, are actually the five stages of grief. The problem is, so many have not realized what they have been going through and we are now beginning to feel the deterioration of our mental health because of it.

Early in 2020, we heard about this new virus that was creating some trouble in China and could eventually find its way into the United States... COVID-19. Many of the leading experts, early on, had opinions that this virus was not easily transmitted and that it was being contained, but eventually it did get here. My mind immediately went to the SARS outbreak of 2003. According the World Health Organization, approximately 8000 people were infected and less than 800 people died with minimal exposure in the United States (8 reported cases in 2003). My mind then went to a more recent event, the Ebola outbreak of 2014. This outbreak was absolutely terrifying in that those who contracted the disease appeared to get very sick, very quickly, and died a horrific death. Between the years of 2014 and 2016, Ebola killed an estimated 11,300 people in West Africa (per the CDC), but again like SARS, had a minimal impact in the United States. Because these diseases did not really affect us in the United States, I tried to wrap my head around one more major pandemic that did impact our country, the 2009 H1N1 Novel Influenza Virus outbreak. The CDC estimated that the United States had in the range of 60 Million infections from April 2009 to April 2010. It was estimated that H1N1 had a mortality rate of 0.001% to 0.007% during the first twelve months of the pandemic. I recall how the world reacted and behaved during those three recent pandemics and came to the conclusion that there really was not much to be afraid of when it came to COVID-19. I, like many in the country, was in stage one of the five stages of grief: Denial

As we rolled through March 2020, the news progressively grew worse. Not only had the virus made it to the United States, it was spreading quickly and death counts were mounting. What was happening here? The United States does not suffer from something like this. The reality was crushing my over-sized ego and overconfidence right before my very eyes. Federal and state governments went into motion and began closing schools and locking down significant portions of the country. People willingly (and some not so willingly) followed the orders and restricted their movements and actions in order to “flatten the curve” to ensure hospitals were not overrun with patients. In many parts of the country (not all), the curve remained flat and populations of people became restless, while others remained cautious and nervous. As cries from many Americans to reopen the country became loud, others also became loud, as well, believing that we needed to remain closed. There was a strong separation happening in the country. The news media and politicians jumped on this division (from both political sides) and fanned the flames for the second stage of grief: Anger. There was anger that we were still being locked down, there was anger that some areas were reopening too quickly, there was anger that we did not have consistent and effective treatments, there was anger that the data given to the public was inconsistent and politicized, etc. Anger and outrage took over and rationalization of the situation was waning.

As April gave way to May, politicians were feeling increased pressure to reopen their states. The economy was suffering as millions upon millions of people were laid off, furloughed, or the businesses that they worked for simply dissolved. Federal and state governments were pouring money into the hands of people in the form of stimulus payments, unemployment benefits, and additional $600 unemployment “gap fillers”. PPP loans were disbursed and managed to keep many businesses afloat, but for some it would only be temporary as they desperately needed to reopen and needed their customers to be able to reenter the market and buy from them. The pressure mounted to reopen, but there was still great anxiety and anger in regards to the overall public health and safety, thus we entered stage three of the five stages of grief: Bargaining. States began to reopen, but with stipulations. There were limitations on which businesses could open, limitations on how many people could be in a location at a time, strong recommendations that people should wear face coverings, etc. States would reopen, but they would reopen in limited phases that would allow the economy to reopen, but would give some sense of safety for the overall public health. The politicians, along with members of our society bargained and compromised to try and get back to some level of normalcy.

The early summer of 2020 sent shock-waves through the country starting in June. Reopening restrictions loosened and large scale protests began taking place all over the country. By late June, cases began to spike again throughout the country. It was a sobering reminder that COVID-19 was still here. State and local governments began taking action by pulling back on some of the reopening measures. While things looked promising during late May into early June for progression toward normalcy, by late June and early July it appeared that we were starting to take steps backwards. While many reverted back to an angry state, others remained in the bargaining stage, but a great many people began to reach stage four of the five stages of grief: Depression. Depression kicked in as the realization was that the virus was still here and it is not going anywhere anytime soon. Depression kicked in as plans for reopening schools in the fall were not taking shape the way many had hoped. The reality had set in that the virus was going to limit or even eliminate sporting events, group gatherings, and continually affect many businesses that will not survive through 2020 because of the pandemic. Depression increased as doubt crept in about whether we would ever get back to normal and live the way we did only six months ago.

The nation has not reached the fifth stage, but it may be the most important: Acceptance. Acceptance is the most divisive because we cannot agree on what to accept. The only thing we can accept at this point is that the virus is here and it is not going anywhere (at least anytime soon). Beyond that, there is simply no consensus. Do we fully reopen and hope that an even greater increase in cases creates some level of herd immunity, do we hunker down and try to wait the virus out in hopes of a vaccine becoming widely available to the general public, or do we continue to take a measured and phased approach? Do we mandate wearing masks for the foreseeable future and maintain distance from people, do we attempt to go back to normalcy and see what happens, or do we simply make face coverings optional (but recommended) and allow people to make their own choices?  The fact is, every side of these options has a strong opinion that results in anger, frustration, and depression as there simply is not a consensus on what to do next, yet so many want to fight and argue that his or her point of view is the right one. This is where a deeper deterioration of our mental and emotional health comes into play, the inability to be empathetic or understanding to opposing views.

There is so much focus on the physical health and economics of the pandemic, but not nearly enough attention is paid to the mental and emotional side. Mental and emotional health may continue to deteriorate as the uncertainty continues to weigh people down. I can speak for myself when I share that these past few months have been some of the most difficult of my life. I have watched close friends struggle with not knowing what their future holds for their businesses and jobs. I have friends that are still not comfortable leaving their homes and struggle through waiting the virus out. I have struggled to explain to my eight year old daughter why she cannot see her friends or go to school. I have watched my daughter try to wear a mask then cry because she can’t breathe with it on, but trying to explain that her school is going to require that she wear it when she goes back. I have seen my wife go through the anguish of seeing her hours at work completely cut, then brought back a month later, to only cut her hours again. I have many friends and family in the healthcare and medical industry that battle with what they see in the hospitals, what they see in the news or social media, and not truly knowing what to believe anymore.

How do we help people get through this? The “In this together” mantra has begun to wear people out and is even beginning to irritate people. People are tired of the commercials and the public proclamations of "in this together". People want to vent their frustration, but what if a person vents to someone who disagrees with their point of view? The venting could become a fight or an argument, which is an indication of our overall mental and emotional deterioration. People are internally crying out for a conclusion of some sorts; a definitive direction that they can either embrace or be angry at, but at least know where they are going so that they can finally get to the acceptance stage, even if they do not consciously know it.

I conclude with this: I am no doctor, virologist, or epidemiologist; I am not a psychologist, psychiatrist, or therapist. My amateur and non-medical message is that times like these go beyond physical health and economics. Maybe we are tired of hearing that we are “in this together”, but we still need to embrace it. Even if we do not agree on the solution or direction to go in, we do feel many of the same pains and emotions. In a world where there is so much division, understanding how we feel and how we deal with those emotions is so important.  Maybe we cannot reach acceptance yet, but maybe we can accept that many people are feeling heavy emotions around the pandemic. Perhaps we can put personal opinions aside about what we could or should be doing and simply lean on each other for support to help heal some of the painful divide and separation we feel. More and more people are going into self-imposed isolation. Not physical isolation, but mental and emotional isolation. People are shutting down and avoiding the discussion out of fear that friendships and family will be lost over disagreements regarding what we should be doing and what the true severity of the pandemic is. It is time to stop trying to be “right”. There will be plenty of time to argue about who was right or wrong when it is all said and done.

We will eventually get to the final stage of grief by reaching the acceptance stage, but we cannot solve every problem today. Businesses are in trouble and we truly do not know what is next. Those things weigh many people down and at this point, there just are not enough answers or solutions, but in the meantime, maybe it is time to address the mental and emotional deterioration so many are feeling right now in other ways. It is time to swallow our pride and desire to be right about what we should do and get back to listening, showing empathy, showing support for people, and making sure those around us know that they are not alone in this. A few small steps today can go a long way toward the healing and recovery of our mental and emotional state in the long run, so let's control what we can control and take those important steps.