Jay Behel and Jennifer A. Coleman write in STAT that some experts are warning of a looming mental health crisis in the wake of the Covid-19 pandemic that we are apparently ill-prepared for, and journalists are amplifying this message.
Everyone, it seems, is depressed and there is a new health curve to flatten.
What do you think? Behel and Coleman believe these warnings are being overdone, and definitely overlook the potential for post-traumatic growth (more on that in a minute).
There’s no question that the Covid-19 pandemic, the largest global disruption since World War II, is devastating millions of people with unexpected illness, disability, or death; financial insecurity; postponed weddings or virtual graduations; and more. A recent census study of Americans estimated the rates of anxiety and depression to be as high as 35%. We are being warned that the pandemic may increase rates of post-traumatic stress disorder, since being exposed to actual or potential death is the very definition of trauma.
While it is valuable to report on people’s mental states, emphasizing the potential for anxiety and depression too much can devolve into fearmongering and backfire.
People respond to trauma in various ways. Most show resilience and don’t develop long-standing mental health problems after experiencing a traumatic event. This response makes our work as psychologists feasible, as we see patients who show resilience even when facing the unimaginable terror or trauma.
Post-traumatic growth is a concept similar to resilience, but distinct from it. It’s a term coined by psychologists Richard Tedeschi and Lawrence Calhoun in the mid-1990s. In essence, post-traumatic growth is positive change that occurs in the aftermath of struggling with a major life crisis or traumatic event. According to Tedeschi and Calhoun, perhaps 50% of people experience post-traumatic growth after enduring a trauma.
It looks different for each person. Post-traumatic growth is a process, not an outcome, and typically involves developing positive responses in these areas: appreciation of life, enhanced relationships with others, new possibilities in life, newly identified personal strength, and spiritual or existential change.
Viktor Frankl, an Austrian psychiatrist, wrote in his book “Man’s Search for Meaning” that people are able to thrive after trauma by finding or imposing meaning on the experience. As a survivor of the Nazi concentration camps, Frankl knew what he was talking about. If he could see growth in his experiences, then Americans should be able to see it in an epidemic that has altered daily life.
Post-traumatic growth often arises after a situation has ended. None of us has an idea when the pandemic and its effects will be over, so that uncertainty may keep us from moving forward. It’s all the more reason to get things back to what we defined as normal at the beginning of the year.
We aren’t recommending trauma or adverse experiences as a growth journey, or suggesting that Covid-19 is a good thing. It isn’t. It has overwhelmed millions of people around the globe. But filling the uncertainty with dire prophecies about declining mental health adds to the anxiety people feel and becomes self-fulfilling. People need to be comforted and the research on post-traumatic growth can help with that. Negative attitudes such as stigma and shame can prevent seeking help, which could prevent this type of recovery, whereas optimism, altruism, social support, and self-confidence may foster post-traumatic growth.
The paradox of this process is that experiencing loss, although devastating, may help some individuals focus on what they have, and be grateful for the small things. Learning about the many aspects of life that are out of our control allows us to focus on what is within our control and make meaning out of the situation and the decisions we make.
Vulnerability can often become the glue that binds together people and communities, building strength that was otherwise unimagined. A crisis like this pandemic may provide unsought opportunities to grow and find new ways to appreciate life. We may someday look back on this and see the first half of 2020 in a far different light than we do now.
Jay Behel is an associate dean of student affairs and associate professor in the Division of Behavioral Sciences at Rush Medical College in Chicago. Jennifer A. Coleman is a clinical psychologist and assistant professor with the Road Home Program for veterans and their families at Rush University Medical Center.