The belief that things are not OK is reasonable; the belief that nothing will ever be OK again appears to indicate a clinical condition. A gradual adjustment to our changed circumstance is the appropriate trajectory; the feeling that every day this becomes increasingly unbearable is a pathological one. There is the thinnest of membranes between sensible and unreasonable, spiraling anxiety. I know I have both, but trying to separate them is like untangling the Gordian knot.
We have two triggers for mental illness in the current crisis: sadness when we fear for our lives and stress when our emotional attachments decay as a result of social isolation. We as a country have not taken adequate steps to address either of these crises and fall particularly short on the second.
The spread of the virus cannot be mitigated for now, but the anticipatory fear it instigates can be tempered through the time-honored techniques of augmented medication and increased contact with therapists. It is not a weakness or a failure to seek such supports. Do what it takes to head off a breakdown. It is a lot easier to prevent than it is to repair, and we have good tools for psychic overload.
Isolation, too, has remedies. Zoom cocktails and FaceTime do not temper it adequately for many people, and it is to be determined on a case-by-case basis when the mental health benefits of seeing someone you love (even outside and six feet away) are greater than the physical health dangers of such encounters.
Fear of contagion has pushed people into behavior that exacerbates depression and anxiety and so can lead to suicide raising the mortality of Covid-19 among people who dont even have it. Lonely people can succumb to touch deprivation and need to be embraced. Dr. Tiffany Field, the director of the Touch Research Institute at the University of Miamis Miller School of Medicine, has argued that touch deprivation exacerbates depression and weakens the immune system; positive touch stimulates the vagal nerve and reduces cortisol, a stress hormone that can impair immune response. We should be figuring out when and how people deprived of touch can get the physical contact they need as safely as possible. It wont be completely safe but neither is their sensual deprivation. If people are dying from going untouched, then touch, however regulated, becomes a necessary remedy. It is neither expensive nor complicated.
These are the ways to transcend pathology. As someone who already had depression and anxiety, I didnt want a crash course in empathy, but Ive had one. I feel singularly well placed to comfort those who are taking their first deep plunge into depression, and I reach out daily to those who need contact, psychological or physical. It has become a calling for me.
I can help them assess what is pathological and remediable. I know these unwelcome alleyways and the paths out of them like the back of my hand. Its not that an antidepressant will make people unafraid of this mysterious and awful virus, nor that a single hug will mitigate their profound aloneness, but they can help.
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