Many Americans do seem to be experiencing something like this tension during the pandemic. People who define themselves by their work can lose a basic sense of self if that work disappears. In such moments, Hollis says, many people regress. Many also try to escape—whether by organizing an already well-organized sock drawer, baking bread they don’t even want, or endlessly scrolling through Instagram. Jarvis, the trauma therapist, is seeing similar escapist tendencies: “For someone’s response to a huge global pandemic to be like, I’m going to work out really hard, is just as pathological and sort of dissociative as if you went to bed and didn’t get up for five days.”
Read: America’s patchwork pandemic is fraying even further
For people whose response to the pandemic turns from acute anxiety into general malaise, Jarvis recommends facing the numbness head-on. It’s treatable, and not necessarily with medication. First, she says, create regimens of simple tasks that give structure to the day. The approach is working for Falcone, the acupuncturist. He starts every day with 30 minutes of stretching, no matter what. Then he walks his dog, makes coffee, and sits down to teach massage via Zoom. Deb Hawkins, the tech analyst, sent me a list of things she’s doing to help others and stay busy: She donated money to a couple of worthy causes, and made an appointment to give blood. She has created a small social bubble and signed up for an online ballet class. She says her sense of self is returning.
Small steps like these will not work for everyone, but they may help many in the subclinical realm to mitigate a dangerous slide. With the medical system already stretched thin, these could buy some time to build its capacity to care for the people who will emerge from the pandemic with severe and lasting symptoms. As important as preventive behaviors can be, human resilience has limits. Those will be tested for months to come.
The individual model of depression was never meant to address a significant percentage of a population. When the diagnosis seems to apply so widely, it’s not the people or the entire medical system that’s broken, but the social context. While many people will find ways to recalibrate their expectations and individual thresholds for joy in the pandemic, ultimately basic needs still have to be met. This means eliminating sources of anxiety, such as by ensuring financial, housing, and food security. In Colorado, Leiferman’s group is among those scrambling to help stem the tide of depressive symptoms. “Our nation is under stress. It may be that more people need [medical] treatment,” she says. “It may be that we need to, as a population, do more to relieve the stress.”
* This article previously misstated that the DSM is published by the American Psychological Association.
Listen to Jennifer Rapke join James Hamblin on an episode of Social Distance, The Atlantic’s podcast about living through a pandemic:
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