En español | Not seeing family or friends. Losing your job or watching it transform beyond recognition. Getting a life-threatening disease or fearing you will. Having someone you know pass away.
Psychiatrists consider any of these events — which were especially common during the pandemic — to be potentially traumatic. For some, such high levels of prolonged stress may leave deep and lasting psychological scars, with the most extreme of these effects being post-traumatic stress disorder, or PTSD.
Not Just for Soldiers
PTSD often conjures images of shell-shocked veterans returning from war or someone witnessing a violent crime. But many experts believe a wide variety of situations can trigger this condition, whose symptoms range from extreme irritability and difficulty concentrating to insomnia, hypervigilance, nightmares, severe anxiety or even depression. These symptoms can come on right away, or they may take many months to develop, according to the American Psychiatric Association.
"In this past year, some people absolutely experienced PTSD,” says Bruce Perry, an adjunct professor of psychiatry and behavioral science at the Northwestern University Feinberg School of Medicine in Chicago and the coauthor, with Oprah Winfrey, of a new book What Happened to You? Conversations on Trauma, Resilience, and Healing. And he doesn't mean only those who were hospitalized with COVID-19.
All of us are at risk for such psychological trouble, says James Gordon, founder and executive director of the Center for Mind-Body Medicine in Washington, D.C., and the author of Transforming Trauma: The Path to Hope and Healing. “Everybody on our planet has been traumatized by this pandemic. We understand that every day around the world, thousands of people are dying from an illness who were not dying before,” he says, adding that having your life upended and facing uncertainty about the future are further distresses that can trigger a more severe response than you may expect.
That said, simply having a negative experience does not automatically lead to negative psychological effects. Some people have innate resilience to stressful events, says Cynthia Stonnington, a psychiatrist at the Mayo Clinic in Scottsdale, Arizona, who notes that some actually thrive, a concept known as post-traumatic growth.
What's more, the experience of trauma requires not only the event that activates our stress response in an extreme, prolonged way, says Perry, but two other factors that can differ greatly among people: our unique perceptions of that event and the effects that follow.
Problems can occur when a response meant to get us through a dangerous moment doesn't turn off. If you need to run from a wild animal, for example, your heart rate rises, your muscles tense, and you become hyperaware — all helpful reactions, Gordon says. But when the threat continues, or we perceive that it does, these same symptoms become chronic and disruptive.
How pandemics breed long-term stress
Other epidemics have revealed how prevalent this can be. When researchers queried residents of Hong Kong at the end of the SARS epidemic, which struck Asian countries especially hard in 2003 and killed nearly 800 people, 16 percent of respondents reported at least one symptom of PTSD, according to a study in Emerging Infectious Diseases.
Signs of looming trouble were evident in the U.S. the first months after COVID-19 hit, when a nationally representative survey by the University of North Carolina at Chapel Hill and Harvard Medical School found that more than 90 percent of participants had at least one symptom of emotional distress.
A big reason for this fragile psychological state is that humans are hardwired to soothe stress by being around other people. “We are meant to live, work and play in groups. Huge parts of our brain and body are dedicated to connecting with each other,” Perry says, explaining that the presence of others serves as unconscious feedback that we're safe. Of course, during the pandemic this past year, nearly everyone had less social support, with people living alone or those who had recently retired or lost their job most severely impacted.
Tips to try now to take the edge off
Fortunately, you can minimize the risk that emotional problems will linger after the pandemic ends. Experts advise incorporating these self-care steps into your life right now.
1. Get together with others. Make it a top priority to regularly meet with friends for walks, coffee or dinner, and make the effort to get back to your bridge game or volunteering as things fully open up.
2. Watch your breath. Meditation is one of the most powerful tools for trauma recovery, says Gordon, who has successfully used it with people in war zones. He prefers to call it “soft belly breathing,” because it needn't involve a specific process or ritual. His take on the practice? Just sit in a comfortable chair for 10 minutes and focus on the word “soft” as you slowly and deeply inhale and “belly” as you exhale.
3. Let your body move. Exercising is key to eliminating the stresses trapped in the body, Perry notes. Moving outside in nature is best, but even walking around your house for a few minutes every hour can work wonders, he says. Gordon recommends taking a few minutes to stand with your knees slightly bent while shaking your whole body, rag-doll style, to shed tension you may not realize you're holding on to.
4. Return to nutritional basics. During the pandemic, many of us have reached for creamy and salty comfort foods as a way to self-soothe. But trauma can damage the digestive tract, which is healed with a healthful diet emphasizing vegetables, fruits, lean proteins and healthy oils, Gordon advises.
5. Seek professional help. If you feel especially anxious or depressed or are using maladaptive coping strategies like drinking, it's important to reach out to a mental health professional, Stonnington says. Treatments like cognitive behavioral therapy (CBT) or eye movement desensitization and reprocessing (EMDR) are especially valuable for trauma.