Data Proves Correlation Between Depression, Anxiety, and Disability
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Introduction
On March 11, 2020, the World Health Organization officially declared the spread of the new Covid-19 viral disease to be a pandemic. But it wasn’t until the following day, March12, that the stark reality of the new situation became clear to the 330 million residents of the U.S.A.
- Tom Hanks declared he and his wife, Rita Wilson, tested positive for SARS-CoV-2, the virus that causes Covid-19, and would be self-quarantining for two weeks.
- The National Basketball Association announced it was suspending its season after Utah Jazz center Rudy Gobert tested positive for the coronavirus shortly before tipoff of a scheduled match at the Oklahoma City Thunder’s home arena.
- And both Disney and Universal Studios stated they would be closing their theme parks in central Florida and southern California indefinitely because of the viral outbreak.
And we all went into lockdown.
Now, more than two months later, we’re talking “re-opening,” and one of the most-frequently mentioned topics in this conversation is dealing with the mental health consequences of what we’ve experienced.
Medical experts are taking this matter very seriously. A recent Journal of the American Medical Association editorial highlighted: “The worldwide COVID-19 pandemic, and efforts to contain it, represent a unique threat, and we must recognize the pandemic that will quickly follow it—that of mental and behavioral illness—and implement the steps needed to mitigate it.” And across the Atlantic, a survey in The Lancet Psychiatry “revealed widespread concerns about the effect of social isolation or social distancing on wellbeing; increased anxiety, depression, stress, and other negative feelings; and concern about the practical implications of the pandemic response, including financial difficulties”
Here at The Council for Disability Awareness, we thought that– especially since May is Mental Health Month— it would be helpful to take a closer look at this topic in the time of the coronavirus. I offered to take on that assignment, in no small measure because so many of my volunteer “side gigs” have a strong mental health component. In addition to being certified in Mental Health First Aid and QPR, I’m also a hospice volunteer and have served as a lay counselor in a faith-based caring ministry.
But I don’t want to give you a dry, academic lecture on the subject. I’ve learned from a long-time colleague that facts don’t change behavior and that you have to make your message personal. So, in that spirit, let me offer you instead Seven Things I Learned About Mental Health in the Midst of the Pandemic.
1. So much of it is about “the non-diagnosable stuff”
As part of my job, I attend a lot of webinars. A recent one had the catchy title: “Can We Flatten the Curve Without Crushing Our Mental Health?” It was my first exposure to psychologist Guy Winch, who makes a distinction between mental health, which he says “is about diagnosable conditions like depression and anxiety,” and emotional health, which “is about common experiences like loneliness, failure, and heartbreak, the non-diagnosable stuff.”
The non-diagnosable stuff. That really resonated with me. Just as, on the physical health front, we’ve learned that healthy habits (or the lack thereof) need to be addressed in order to reduce the incidence of diagnosed conditions like cancer or heart disease. So, on the mental health front, we need to focus on the emotional and attitudinal precursors of full-blown conditions like clinical depression or anxiety disorders.
When we look at the “non-diagnosable stuff” together with the “diagnosable stuff,” we’re actually getting closer to the ancient Greek concept of the psyche (ψυχή), which literally means “soul” and represents the unity of a person’s mind, will, and emotions. So, maybe we should use the broader term “psychological health” instead of “mental health.”
But since we’re doing this in conjunction with Mental Health Month, let’s stick with that term. Although the folks at Mental Health America (the organization behind Mental Health Month), do seem to be taking a broader view of health at the unified “mind-will-emotions” level. [Note: Check out their Tools 2 Thrive, for example, especially the one on “Owning Your Feelings.”]
Speaking of feelings: My next few learning points are around the three most common pandemic-induced feelings that I observed, both in others and in myself: fear, loneliness, and grief.
2. Fear is contagious, but there are things we can to bring its R0 down
Back in the 1990’s, I participated with a number of college classmates on a listserv (an early-internet precursor of online communities such as Facebook Groups). One of them, Doctor Ron, became a very successful psychotherapist, and he’d share insights gained from working with couples where one person was depressed and the other would “catch” the partner’s depression. He published a book on the subject called Contagious Emotions.
Contagious emotions? What a concept. It turns out it’s been extensively researched over the past quarter century. Doctor Ron was on to something.
In the midst of the current pandemic, the most contagious emotion seems to be fear.
In the midst of the current pandemic, the most contagious emotion seems to be fear. “Fear of the virus may be more infectious than the virus itself,” reads the sub-head of an informative Medium essay. “Traditionally, fear spreads primarily through person-to-person contact,” notes the author, but nowadays “we have a much more efficient means of transmitting anxiety: social media.” He then highlights a recent study where the researcher found people were more likely to share social-media posts containing “fear-arousing disinformation” – even if the people sharing them hadn’t checked their accuracy.
This gets at an essential truth: Fear can motivate us, but it also makes it harder to think clearly.
Sigal Barsade, a professor at the University of Pennsylvania’s Wharton School of Business, is an expert on emotional contagion in organizations. A few weeks ago, she wrote a piece for the Harvard Business Review on how important it is to keep emotional contagion under control during these times. Here’s her helpful advice for reducing what I’d call “emotional R0“:“For starters, cut down on how often
you engage with venues where fear feeds on itself rather than on the facts — social media, for example, or conversations with friends and coworkers who do more speculating and catastrophizing than sharing of evidence. Distinguish between people who are consulting sound information and those who are in a frenzy.
“That doesn’t mean burying your head in the sand. To the contrary, you should stay alert. But be wise about your sources. Turn to reliable health and behavioral experts . . . but don’t assume you need to do more than they advise, as this could intensify negative emotions in yourself and others.
“Second, just as you’re trying to protect yourself and everyone else from viral contagion with exemplary health hygiene, actively work to stem negative emotional contagion by exercising good emotional hygiene. Try to stay calm using whatever methods work for you. People will mimic that emotion, too. That can lead to positive emotional contagion . . .”
“Positive emotional contagion.” Now, there’s a concept! Let’s save that one for later. But for now, let’s talk about how to manage anxiety and fear during a pandemic.
3. To manage anxiety, it helps to think like a risk manager
I’m not a clinician, but I won’t let that stop me from sharing with you a conclusion I’ve reached after almost seven decades on this planet. What’s at the root of most anxiety is this: You’re confronted with a mysterious threat and you feel completely powerless in the face of it.
But it really wasn’t until the last two months that I realized how thinking like a risk manager was a good way to defuse anxiety.
For the vast majority of my work career, I’ve worked in the insurance industry. Insurance is grounded in the discipline of risk management, which is all about looking at threatening situations, learning more about them, and figuring out how to neutralize the harm they can cause. The more you know about a risk, the more you can do about it. And “doing” something about a risk runs a continuum that goes from elimination or prevention to mitigation or transfer.
But it really wasn’t until the last two months that I realized how thinking like a risk manager was a good way to defuse anxiety.
After most of us went into lockdown in mid-March, there was a period of time where I felt vaguely uneasy just stepping outside, or seeing other people walking towards me (even if they were way more than six feet away), or pumping my own gas (even wearing gloves). Why? All I really know was that something was lurking “out there” and that it had the potential to do me some serious harm. But then the years of being exposed to the risk-management mindset kicked in, and I realized that it was definitely in my power to learn more about what was “out there.”
So, following Sigal Barsade’s advice (cited above), I turned to reliable sources to learn more about the virus, how it spreads, who it affects and under what conditions. The more I learned, the clearer certain approaches to risk prevention and mitigation became. Case in point: an excellent blog post by Erin Bromage, a professor at University of Massachusetts- Dartmouth, weaves together details about viral load and early Covid-19 outbreak clusters to identify high-risk (“indoors, with people closely-spaced, with lots of talking, singing, or yelling”) and low-risk (outdoors, with appropriate social-distancing) situations.
But let me add a wrinkle to the “think like a risk manager” concept. “Emotions are the filters through which we see the facts,” says risk management expert David Ropeik in a recent informative piece on how our minds– our rather, to use the concept I introduced earlier in this post, our psyches– influence our perception of risk. So, understanding a “risk” entails not only figuring out the actual threat, but also being aware of the psychic filters that affect our perception of it.
And that’s what’s at the heart of risk-communication expert Peter Sandman’s formula Risk = Hazard + Outrage. The “hazard” is the actual threat; and the “outrage” is the collection of psychic filters through which we perceive the threat. Being aware of the “outrage factors” at play in a given anxiety-provoking situation should be an important part of your risk management plan.
But enough about fear and anxiety. In my next “Part 2” post we’ll move on to look at the emotional fallout resulting from having to socially distance ourselves from others and basically retreat into our homes.
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