As we emerge from the closeted lives we have been living for the past year, trying to shed light on what the post-pandemic world will be like, we must start with a fundamental question: What will we be like? From a mounting number of public health professionals, the prognosis is not especially encouraging.
There are psychological and social costs to be reckoned with. As recently reported by Harvard Health, according to the American Psychological Association, we are in a national mental health crisis that could have repercussions for years to come.
"The past year has been hard on most of us. Who hasn't felt anxious? Who hasn't wanted to retreat from the world at times?" writes Bobbi Wegner, a clinical psychologist and lecturer at Harvard University, in a recent university blog.
Feeling helpless, out of control, stuck or judged? Feeling less safe? The intensity of such feelings could well lead to a condition known as agoraphobia. According to the Diagnostic and Statistical Manual of Mental Disorders, in prepandemic America, about 2% of adults and teens were diagnosed with this condition. The situation during the past year is sure to have triggered an uptick in cases.
"Someone who has agoraphobia might avoid places where they might be trapped (such as an office meeting) or put on the spot and judged — perhaps during a conversation at a party," writes Wegner. "They also may avoid situations or places that feel out of control, such as a trip with other people where they don't control the schedule and timing, or an open, public space like a park. As a result, people who have agoraphobia often fear leaving their homes." It can also lead to a racing heart, shortness of breath, chest pain, sweating and dizziness; symptoms associated with panic attacks.
"Their fear of a situation is out of proportion to its true level of risk," says Wegner. "Yet fearing public spaces as COVID-19 continues to spread is a normal response to such a threatening event."
It is a treatable condition. Yet, if left untreated, it can seriously limit the quality of a person's life. If you or someone you know is concerned about such anxiety, consult a mental health professional. A resource is the Substance Abuse and Mental Health Services Administration national helpline (800-662-4357).
Clinicians are also becoming increasingly concerned about the long-term consequences of a "shadow pandemic" that has emerged, brought on by the emotional burden of the pandemic, compounded by physical isolation. As has been reported, as the pandemic has accelerated, loneliness and isolation have intensified, leading to an alarming number of opioid overdose deaths. COVID-19 stresses also triggered drug addiction relapses. According to a recent ABC News report, in 2020, hospital visits for opioid overdoses rose 29%.
"Despite the growing medical consensus that opioid use disorder is a real, physical brain disease, many continue to believe addiction is a character flaw and that the only response is tough love," reports ABC. Peter Canning, a paramedic on the front lines of Connecticut's battle against opioids, points out that many people who become addicted fall into a pattern. It starts with a normal life. Then comes an unexpected injury. It is often followed by an opioid prescription from a doctor. Especially during the stress and isolation of the pandemic, it can spiral into a crippling addiction.
Also included within this shadow pandemic has been a growing plague of domestic abuse. According to ABC, the National Commission on COVID-19 and Criminal Justice reported an 8.1% increase in incidents after pandemic lockdown orders.
Such abuse also has detrimental effects on the health of children. According to a NationofChange report of a recent study by the American Academy of Family Physicians Foundation, 1 in 6 U.S. children between the ages of 6-17 years old suffers from a treatable mental health disorder. This includes anxiety, depression and attention-deficit/hyperactivity disorder. In the U.S., some states have experienced a spike in cases.
"Experiencing domestic violence is never an easy ordeal. Especially for young children, it can create lifelong lasting traumas that can lead to the development of severe insecurities within their personalities," writes Elaine Vanessa. "This can lead to life-long mental health effects similar to those who had experienced abuse directly." It renders a heavy blow to their self-esteem at a time when their personalities are molded.
Even before the pandemic, an epidemic of loneliness was on the rise in this country. By any measure, we are a lonely a lot. As reported by Jacob Sweet of Harvard Magazine, a 2018 report by the Henry J. Kaiser Family Foundation revealed that 22% of adults in the United States said they often or always felt lonely or socially isolated.
"A national 2019 survey led by health insurer Cigna found that 61 percent of Americans report feeling lonely," writes Sweet. Julianne Holt-Lunstad, a professor of psychology and neuroscience at Brigham Young University, goes so far as to say that the heightened risk of mortality from loneliness equals that of smoking 15 cigarettes a day or being an alcoholic, and exceeds the health risks associated with obesity.
"What the pandemic did was it froze our lives, right?" Robert Waldinger, professor of psychiatry and a psychiatrist at Massachusetts General Hospital, tells Sweet "It froze us in these weird positions where we're closer than we want to be to some people, and we're too distanced from others." These weak ties to others are believed to be another possible contributor to feelings of loneliness. He cites the relationship you might have with co-workers or acquaintances, or the guy you always get your coffee from at Starbucks, or the person who checks you out at the grocery store. Multiple studies suggest that these ties are meaningful and predominantly positive.
"If you're lonely, almost the last thing you want to do is reach out," says Karestan Koenen, Harvard professor of psychiatric epidemiology. "But you have to make yourself." Loneliness begets loneliness.
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