Depression

Depression and Pandemic Fatigue

"When is it all going to end?"

Posted Sep 09, 2020

Starting in March of this year, the world began an uncharted journey into a global pandemic related to a new virus called COVID-19. The pandemic abruptly changed the way we live, relate to others, and function on a day-to-basis. 

For many people, anxiety and depression are experienced to some degree as a response to this crisis. Fear, confusion, irritability, and sleep disturbance are all common reactions to trauma. 

The impact of the pandemic on the mental health of the global human population may have lasting, and profound reverberations for the distant future, long after physical manifestations of the pandemic have ended.

Pandemic Fatigue: When Is It All Going to End?

We are now into the sixth month of a pandemic that some public health experts believe will continue for many more months. As a result, people are experiencing what has been referred to as “pandemic fatigue.” 

And it seems to be impacting all of us. Recently, a neighbor who rarely speaks expressed her deep anxiety and frustration by shouting out, “When is this going to end?” 

Her sentiment is something we’re all experiencing to some degree. Although “pandemic fatigue” isn’t an actual clinical diagnosis, we can all appreciate various aspects of it. At the very least, this pandemic has us rethinking our overall mental well-being.

We are collectively experiencing an unknown threat. The medical/scientific community is struggling to better understand, treat, and prevent the new illnesses associated with this pandemic. And as we’re learning how to adjust to this new way of living, most people want to return to life before the pandemic. However, the virus has not yet released its hold on us.

Information Chaos

One of the things we’re struggling with is the daily influx of new and often conflicting information about the virus. Parents of school-age children are tasked with having to make difficult decisions about in-person or distance learning. Already stressed out and stretched to the limit, teachers are trying to navigate these difficult waters as educators while dealing with their own personal anxieties and concerns. Parents of college-age children are stressed out not only setting up their children to live away from home, some for the first time, but are worried thinking their child could get exposed to a serious virus and fall ill.

And for those returning to work, there is new concern, not only of getting sick but of how the pandemic is impacting their company’s financial future. The employee feels extra pressure to prove their role is valuable to their boss, yet may be feeling anxiety wondering if their health is at risk by showing up to their workplace.

Learning New Behaviors

While we are all working to prevent the spread of infection by employing new sets of behaviors which include wearing facial masks, social distancing, frequent hand sanitizing, distance learning, telehealth/telemedicine, and teleconferencing, the impact of the pandemic has physical, emotional, social, and economic dimensions. And this learning curve isn’t easy for some of us.

It is important to remain flexible as new data becomes available that guides public health policies.  Practicing prevention has always been a hard sell, as I learned from research for my forthcoming book on auto accident trauma. But as has long been said: “An ounce of prevention is worth a pound of cure.”

Open-Ended Disasters

In the field of traumatology, a traumatic situation that is ongoing and without a discrete endpoint is considered one of the most difficult to manage. This goes back to when my neighbor cried out, “When will this end?” No one has the answer to this pressing question. And when we’re in distress, we want to know how and when the pain is going to stop.  

Common Reactions

While you may think you’ve reached your limits for managing stress, and wondering if you need to seek professional help, it is worth pointing out there are some common reactions to trauma which include anxiety and depression. Depression is a common, ubiquitous mood disorder affecting many millions of people around the globe. Some degree of depression is a normal reaction to loss. The pandemic has brought with it numerous types of losses for all of us. Depression includes both mental and physical symptoms that interfere with one’s ability to function day-to-day.

Depression is a universal mood and comes in many sizes, i.e., levels of severity. Clinically, we talk about mild, moderate, and severe levels. Diagnostic terms to capture this gradient come and go. I believe many of us are now experiencing what would be referred to as a low-grade depression in response to the pandemic crisis. And if you were struggling with a condition, such as recovering from car accident-related injuries or were receiving cancer-related treatment, prior to the pandemic you may be experiencing an intense level of stress. And it may, in fact, be clinical depression.

In past diagnostic language, chronic, low-level depression would be called dysthymia. The term has been replaced with Persistent Depressive Disorder (PDD). Regardless of our clinical terms, here is a list of common symptoms of depression found in the DSM, our diagnostic manual.

What are the symptoms of depression we need to look for?

  1. Appetite or weight changes, poor appetite, or overeating
  2. Fatigue, having little energy, everything feels like an effort
  3. Feelings of hopelessness and helplessness
  4. Lack of enjoyment or pleasure in things
  5. Low energy and reduced motivation
  6. Restlessness
  7. Sadness, tearfulness, frequent crying
  8. Sleep problems—including trouble falling asleep, trouble staying asleep, or sleeping an excessive amount
  9. Thoughts of death or suicide, or that you would be better off dead, or of hurting yourself
  10. Trouble concentrating, focusing, and making decisions
  11. Feeling bad about yourself, seeing yourself as a failure or worthless, feelings of guilt
  12. Moving or talking slowly

If this sounds like you or someone you know, ask yourself these questions regarding the symptoms of depression and level of severity:

  • Are your depression symptoms making it difficult to do your work? 
  • Is your concentration and ability to focus compromised? 
  • Have your symptoms of depression made it difficult to take care of things at home? 
  • Do the daily tasks of household chores and responsibilities seem overwhelming? 
  • Are the symptoms of depression making it difficult for you to get along with other people?

Help is Always a Phone Call or Text Away

As clinicians, we are always mindful of the risk of self-harm that comes with depression. Remember that suicide is preventable if action to reach out for help can be taken.  Below this piece are 24/7 helpline resources that are available for free. Know that depression is a temporary state of mind that may last a while but that brighter days are ahead.

A Call to Action: Kindness, Tolerance, and Patience

The pandemic response clearly calls for needed emotional support and stress/crisis management for all of us. We all must work to reduce the transmission of the virus. As a leading infectious disease public health expert, Dr. Michael Osterholm, reminds us, we will get through this. Dr. Osterholm has a weekly podcast that I tune into frequently because of his helpful perspective and tips on coping with the pandemic. He encourages us to be skeptical of everything you hear (information chaos) and practice kindness, tolerance, and patience. 

We need to practice crisis communication which involves reflective, non-judgmental listening. Cut others some slack when they fall short of our expectations. And remember that smiling is infectious, even during a pandemic.

Note: Much of what was covered in this blog was discussed in an interview by Jeremiah Staes on August 25, 2020, on Daily Detroit.

Resources:

National Suicide Prevention Lifeline (800) 273-8255. Reach out for the support and assistance of a trained crisis counselor.

SAMHSA (Substance Abuse Mental Health Services Administration) (877) 726-4727. Their mission is to reduce the impact of substance abuse and mental illness on America’s communities.

SAMHSA Disaster Distress Helpline (800) 985-5990 connects you to a trained counselor for help coping with natural and made-made disasters, including the pandemic.

References

Suggested Reading

James F. Zender, PhD (2020).   Recovering from Your Car Accident.  The Complete Guide to Reclaiming Your Life.  New York: Rowman & Littlefield.