Compassion in the time of COVID-19

These are strange and difficult times. “Unprecedented” is the word that keeps being thrown about, and man does it fit. Virtually every major sport being suspended. Schools shutting down, sometimes closing for the entire year. Panic shopping. Restaurants, bars, coffee shops, essentially everything, shutting down.

Despite ominous closures and a looming recession, there has also been an outpouring of support and human decency. Employers stepping up and paying employees even though the business is shut down. An NBA player stepping up and offering to cover the salaries of all stadium workers while the season is suspended. CEOs drastically reducing their salaries for the duration and paying frontline staff that aren’t able to work. Neighbors banding together and offering to bring supplies and help out the most vulnerable in our communities so that they can stay safely at home.

This is the sort of compassion we need in uncertain times like these.

There’s enough to worry about currently, and it certainly isn’t my intention to stoke additional fears, but I’ve been increasingly concerned about the ripple effects. There is a scary correlation between unemployment and suicide. For every percentage point unemployment rises in the US, the suicide rate increases by .99%. When the service industry shut down it left an estimated 240,000 people without a job. COVID-19’s effect on the economy has been brutal, which begs the question how much will unemployment rise as the recession we have been thrust into worsens?

Loneliness and isolation are major drivers for suicide and general mental distress. The entire country is now encouraged (for good reason) to self isolate and avoid human contact. I’ve already started to see the impact in my practice. Clients I work with struggling with depression, anxiety, isolation, and loneliness are already feeling the additional pressure, and opportunities to do something about those struggles have shrunk.

I want to be clear about a few things. I’m not in any way criticizing any public health decision. I am not an epidemiologist; I don’t have the knowledge and expertise to critique such decisions even if I were inclined to. I am also not attempting to proclaim that the sky is falling.

The point I am trying to get across is that we need more of the compassion that has been present in these uncertain times, and we will need it even after the COVID-19 pandemic is contained. The adverse affects of crises (health, economic, or otherwise) aren’t always immediately realized. The impact on one’s mental health may not be fully felt until weeks, or months after. Suicide doesn’t often come quickly after a stressful life event. It is often a longer term outcome of mental distress. Suicide is the extreme, worst case, outcome. For however much the suicide rate rises the rise in general mental distress with be significantly higher. Depression, anxiety, substance abuse, all likely to be on the incline already.

Frontline healthcare workers are feeling that pressure already. The general sense in that community is that there hasn’t been a more stressful time to be a healthcare provider for generations. Vicarious trauma isn’t a new idea for anyone in that line of work, but is one that is exacerbated currently. Hell, with many providers fearing for then own health and risk for exposure it may very well cross the line from vicarious into actual trauma. I don’t think it is alarmist or exaggerating to expect a wave of acute stress disorder and PTSD in healthcare providers when this is over.

The caution I would urge is that the affects of the resulting mental distress will endure long after the pandemic is over. Professional sports will come back, stores will re-open, and we’ll move back to a sense of normalcy in the not so distant future. But a return to normalcy doesn’t entirely eliminate the suffering.

One of the coolest phenomena from the quarantine I have heard from my therapy clients is how connected they have been despite not leaving the house for days or weeks at a time. FaceTime and phone calls have become routine over text and email. Reconnecting with old friends. More routine, albeit virtual, contact with friends and family. Real conversations too, not superficial ones about the weather and baseball scores. There’s this sense that we’re all in this shitty situation together, so we may as well be “together”. It is heartening to think that so many have decided “well, there really isn’t anything else to do, so I may as well reach out and be supportive”.

But what happens when the novelty of reconnecting wears off? Perhaps it won’t, but as we adjust to the minutiae of our new normal, and eventually transition back to normalcy, life will have the same tendency of getting in the way. Our need for connection certainly won’t diminish, even if our motivation to seek it out does.

On the other side of this we won’t need the same large overtures to help those around us take care of their basic needs. Goals will shift from survival back to living life.

That doesn’t mean the aftereffects of this will be any less painful.

It is pretty obvious right now that most of us are scared, hurting, angry, and struggling with any number of things. Those struggles won’t stop when they are less obvious.

Patience and compassion go a long way right now. In a strange way I think we will need them even more when this crisis is over. When someone we know acts out of character, maybe they are more irritable or less present than usual, it can help to ask “what are they dealing with that may be making them act this way?”. When we are working our way out of quarantines and back into a more normal life it will be even more important to ask ourselves and those around us how have we dealt with the inner turmoil this crisis brought up. Maybe we’ll need to ask ourselves if we are still dealing with it, and what we are still dealing with.