A Second Pandemic
It has been a more than three months since parts of the country began enacting “shelter in place” orders and words like “lockdown” and “quarantine” became common place. By and large it would appear these drastic, and seemingly necessary measures, had the intended effect of slowing the spread of COVID-19 and preventing the healthcare system from being overwhelmed. I use the term “overwhelmed” loosely, as I know many healthcare providers certainly were overwhelmed even if the system never met or exceeded maximum capacity.
Roughly a quarter of a year in varying levels of quarantine and we are still mired in ambiguity with no end in sight. Many areas of the country are re-opening, but that ambiguity looms and seems to beg the question “for how long”? In Colorado bars were given the go ahead to re-open, only to be told a week later they needed to close again. Other social hubs, like gyms and restaurants, remain open, but certainly haven’t returned to “normal”. I’ve had conversations with people that want to resume these activities, and gave it a shot, but just felt there was a risk that wasn’t acceptable. Just think about the logistics of keeping a fairly large, fairly busy gym sanitized in the best of conditions, and then imagine all the benches and barbells the highly virulent COVID-19 may be lingering on. You all know you’ve seen that guy at the gym that doesn’t wipe down anything he uses (side note: don’t be that guy, wipe your shit down!).
Part of the difficulty with the current ambiguity is fear of a second peak. Have we done enough to ride out a second wave with what we are doing currently, or will we all be back to “shelter in place” in another month? I have my worries about that, but what worries me (and a lot of other mental health professionals) even more is the thought that we may actually be in the middle of two pandemics. Obviously, one is COVID-19, but also a pandemic of loneliness.
You could argue we were already in a pandemic of loneliness before COVID hit. Billy Baker wrote a piece for The Boston Globe in 2017 making the argument that loneliness is the #1 killer of men. He also wrote a follow-up piece two weeks later detailing the outpouring of responses he received from men around the world about how the story summed up their own experiences perfectly. That story brought the prevalence of loneliness into the zeitgeist, but the consequences have been studied for decades. This recent meta-analysis from 2015 is a quick and scary summation of those consequences. A short takeaway was that lack of social connection can be as detrimental as smoking 15 cigarettes a day, for chronic alcohol abuse.
Both COVID-19 and loneliness hit men harder, and I don’t think this is entirely coincidental. Why COVID-19 is more deadly for men is one of its many mysteries, and I certainly don’t have the definitive answer that has eluded scientists and researchers trying to answer that very question. What I do know is that men tend to overestimate their health status, and underestimate their need for medical treatment. Men can also have a tendency to undervalue the importance of social connections.
I am not making an argument that men have suffered worse in recent months; more my point is to describe the idiosyncrasies of those struggles and bring some awareness to the potential consequences.
Pre-COVID I was already spending a considerable amount of time working with guys struggling with loneliness. The isolation, withdrawal, sadness, and depression that come with loneliness have been frequent topics in my office for many years. There’s the idea of “not alone, but lonely”, and I see plenty of socially active guys that still feel lonely and lacking a deeper sort of connection to their relationships. Without that connection the problems arise.
It was joked about early on that alcohol consumption spiked at the start of quarantine. What else are we supposed to do cooped up at home for all that time? I always thought those stories and anecdotes had a darker implication for men. The link between distress and alcohol abuse for men is well established. I don’t think the uptick in alcohol use can be chalked up to boredom alone. Hell, I don’t even know that boredom is the most likely explanation.
There is a certain distance that has established itself, and become necessary, in society. Both a literal and metaphorical distance. Social distancing has become a best practice. It is a practical and reasonable precaution for everyone to cut down on their social interactions, and to allow greater space between us. What toll does that extra distance take when there may have already been too much distance to begin with?
A quick aside before I go any further: it makes me crazy that something like wearing masks has become a polarized, politicized issue. I would have hoped that if anything could bring people together and get them on the same page it would be a (hopefully) once-in-a-lifetime global pandemic. But here we are. Don’t take anything I am about to say as an argument against wearing a mask. Wear a mask.
I’ve had some interesting realizations wearing a mask recently. I had taken for granted how much I rely on facial expressions for a variety of minor social interactions throughout the day. I often come across people in my community that I know, but don’t really know. Our kids go to the same school, I pass them while I am out running, I just know I’ve seen them around the community. Introducing myself and offering a handshake definitely isn’t the right move these days, and even pre-COVID not everyone wants to stop and take the time for that while they are moving through the neighborhood grocery store. My go-to for those quick encounters is a smile and nod to acknowledge we share some connection, but you can’t see a smile behind a mask. An attempt to acknowledge someone, to make a quick connection, goes unnoticed. Lonely while not alone.
Having kids of my own brought an exponential increase in the social interactions I have with small children. I noticed early on my beard can be off-putting for little kids (I was curious, and found there actually is some scientific support that kids don’t like beards). I don’t have some gnarly mountain man beard, or an epic Viking beard, but some kids don’t like the one I do have. That beard is now mostly hidden behind a mask when I’m out in public, but I’ve noticed a new response from kids. A more uncertain, quizzical look.
This more puzzled response got me thinking about how much we all rely on facial expressions, and how unaware of this we can be. There’s a ton of research around facial expressions, and it is a generally accepted fact these days that there are a handful of universal ones. There is some debate around the exact number, and exactly which ones are included, but it remains safe to say that there are a handful of expressions that everyone in a given culture will recognize and reflexively know how to respond to them. There is a level of connections built in to our facial expressions, and maybe something gets lost when those expressions are concealed by a mask.
I think those little kids were sizing me up, kind of thinking “I can’t see what this guy’s face is doing, I don’t really know what to think of him or how to respond”. These social nuances are new to kids and it can be obvious when they are exploring them. By the time we reach adulthood they are firmly ingrained in us. We don’t realize how much we rely on them, and we may not realize how much of a toll their absence can take.
I’ll say it again, nothing in here is an argument against masks (and it still pains me that I feel compelled to clarify that since even public health crises are polarizing these days). We are learning to live with COVID-19, there is a growing body of evidence to support social distancing and mask wearing are helpful and necessary, and this isn’t changing any time soon. It has been abundantly clear for a while now that we need to take COVID-19 seriously. However, I think we need to take the loneliness that is exacerbated by this crisis seriously as well. It needs to be acknowledged, both within ourselves and with each other.
This goes doubly for men. Loneliness affects women as well, but men tend to engage in behaviors that foster, and then perpetuate, loneliness. So, to any guys reading this, remember John Donne’s book: “No Man is an Island”. If loneliness is creeping in acknowledge it, own it, and do something about it. Reach out, however you can these days. If you are reading this and know a guy you think might be struggling… reach out. Men aren’t always good at asking for help (don’t just take my word for it), and when someone close to them reaches out if can very well be the difference between action and suffering in silence.