INTRODUCTION
3. INDIVIDUAL RESET
3.2. Mental health and well-being
the only news, news that was inevitably almost exclusively bad. Relentless reports of deaths, infectious cases and all the other things that might go wrong, together with emotionally charged images, allowed our collective imaginations to run riot in terms of worry about ourselves and our closest loved ones. Such an alarming atmosphere had disastrous effects on our mental well-being. Furthermore, media-amplified anxiety can be very
contagious. All this fed into a reality that for so many amounted to personal tragedy, whether defined by the economic impact of income loss and job losses and/or the emotional impact of domestic violence, acute isolation and loneliness or the inability to properly grieve for deceased loved ones.
Humans are inherently social beings. Companionship and social
interactions are a vital component of our humanness. If deprived of them, we find our lives turned upside down. Social relations are, to a significant extent, obliterated by confinement measures and physical or social
distancing and, in the case of the COVID-19 lockdowns, this occurred at a time of heightened anxiety when we needed them most. Rituals that are inherent to our human condition – handshakes, hugs, kisses and many others – were suppressed. Loneliness and isolation resulted. For now, we know neither whether nor when we might return completely to our old way of life. At any stage of the pandemic, but particularly towards the end of lockdowns, mental discomfort remains a risk, even after the period of acute stress has passed, something that psychologists have called the “third- quarter phenomenon” [152] in reference to people who live in isolation for a protracted period of time (like polar explorers or astronauts): they tend to experience problems and tensions towards the end of their mission. Like these people, but on a planetary scale, our collective sense of mental well- being has taken a very severe knock. Having dealt with the first wave, we are now anticipating another that may or may not come, and this toxic
emotional mix risks producing a collective state of anguish. The inability to make plans or engage in specific activities that used to be intrinsic parts of our normal life and vital sources of pleasure (like visiting family and
friends abroad, planning ahead for the next term at university, applying for a new job) has the potential to leave us confused and demoralized. For many people, the strains and stresses of the immediate dilemmas that followed the end of lockdowns will last for months. Is it safe to go on public transport? Is it too risky to go to a favourite restaurant? Is it
appropriate to visit this elderly family member or friend? For a long time to come, these very banal decisions will be tainted with a sense of dread – particularly for those who are vulnerable because of their age or health condition.
At the time of writing (June 2020), the impact of the pandemic in terms of mental health cannot be quantified or assessed in a generalized way, but the broad contours are known. In a nutshell: 1) individuals with pre-existing mental health conditions like depression will increasingly suffer from anxiety disorders; 2) social-distancing measures, even after they’ve been rolled back, will have worsened mental health issues; 3) in many families, the loss of income consecutive to unemployment will plunge people into the
“death of despair” phenomenon; 4) domestic violence and abuse, particularly against women and children, will increase as long as the
pandemic endures; and 5) “vulnerable” people and children – those in care, the socio-economically disadvantaged and the disabled in need of an above- average level of support – will be particularly at risk of increased mental distress. Let us review below some of these in greater detail.
For many, an explosion of mental problems occurred during the first
months of the pandemic and will continue to progress in the post-pandemic era. In March 2020 (at the onset of the pandemic), a group of researchers published a study in The Lancet that found that confinement measures produced a range of severe mental health outcomes, such as trauma,
confusion and anger. [153] Although avoiding the most severe mental health issues, a large portion of the world population is bound to have suffered stress to various degrees. First and foremost, it is among those already prone to mental health issues that the challenges inherent in the response to the coronavirus (lockdowns, isolation, anguish) will be exacerbated. Some will weather the storm, but for certain individuals, a diagnostic of
depression or anxiety could escalate into an acute clinical episode. There are also significant numbers of people who for the first time presented symptoms of serious mood disorder like mania, signs of depression and various psychotic experiences. These were all triggered by events directly or indirectly associated with the pandemic and the lockdowns, such as isolation and loneliness, fear of catching the disease, losing a job,
bereavement and concerns about family members and friends. In May 2020, the National Health Service England’s clinical director for mental health
told a Parliamentary committee that the “demand for mental healthcare would increase ‘significantly’ once the lockdown ended and would see people needing treatment for trauma for years to come”. [154] There is no reason to believe that the situation will be very different elsewhere.
Domestic violence has risen during the pandemic. It remains difficult to measure the precise increase because of the high number of cases that
remain unreported, but it is nonetheless clear that the rise in incidences was fuelled by a combination of anxiety and economic uncertainty. With the lockdowns, all the requisite ingredients for an increase in domestic violence coalesced: isolation from friends, family and employment, the occasion for constant surveillance by and physical proximity to an abusive partner (often themselves under more stress), and limited or no options for escape. The conditions of lockdown magnified existing abusive behaviours, leaving little or no respite for victims and their children outside of the home.
Projections from the United Nations Population Fund indicate that if domestic violence increases by 20% during periods of lockdown, there would be an additional 15 million cases of intimate partner violence in 2020 for an average lockdown duration of three months, 31 million cases for an average lockdown of six months, 45 million for an average lockdown of nine months, and 61 million if the average lockdown period were to last one year. These are global projections, inclusive of all 193 UN Member States, and represent the high levels of underreporting characteristic of gender- based violence. All told, they total an additional 15 million cases of gender- based violence for every three months a lockdown continues. [155] It is hard to predict how domestic violence will evolve in the post-pandemic era.
Conditions of hardship will make it more likely, but much will depend on how individual countries control the two pathways through which domestic violence occurs: 1) the reduction in prevention and protection efforts, social services and care; and 2) the concomitant increase in the incidence of
violence.
This sub-chapter concludes with a point that may seem anecdotal but that has gained some relevance in an era of relentless online meetings that could expand in the foreseeable future: are video conversations and mental well- being bad bedfellows? During the lockdowns, video conversations were for many a personal and professional lifesaver, allowing us to maintain human connections, long-distance relationships and connections with our
colleagues. But they have also generated a phenomenon of mental
exhaustion, popularized as “Zoom fatigue”: a condition that applies to the use of any video interface. During the lockdowns, screens and videos were so widely solicited for communication purposes that this equated to a new social experiment conducted at scale. The conclusion: our brains find it difficult and sometimes unsettling to conduct virtual interactions especially if and when such interactions account for the quasi-totality of our
professional and personal exchanges. We are social animals for whom the many minor and often nonverbal cues that normally occur during physical social interactions are vital in terms of communication and mutual
understanding. When we talk to someone in the flesh, we don’t only concentrate on the words they are saying but also focus on a multitude of infra-language signals that help us make sense of the exchange we are having: is the lower body of the person facing us or turned away? What are their hands doing? What’s the tone of their general body language? How is the person breathing? A video conversation makes the interpretation of these nonverbal cues charged with subtle meaning impossible, and it forces us to concentrate exclusively on words and facial expressions sometimes altered by the quality of the video. On a virtual conversation, we have
nothing other than intense, prolonged eye contact, which can easily become intimidating or even threatening, particularly when a hierarchical
relationship exists. This problem is magnified by the “gallery” view, when the central vision of our brains risks being challenged by the sheer number of people on view. There is a threshold beyond which we cannot decode so many people at once. Psychologists have a word for this: “continuous partial attention”. It is as if our brain were trying to multitask, in vain of course. At the end of the call, the constant search for nonverbal cues that cannot be found simply overwhelms our brain. We get the feeling of being drained of energy and left with a sense of profound dissatisfaction. This in turn negatively affects our sense of mental well-being.
The impact of the COVID-19 has given rise to a wider and deeper array of mental health problems affecting greater numbers of the population, many of whom might have been spared in the immediate future had it not been for the pandemic. Viewed in these terms, the coronavirus has reinforced not reset mental health issues. However, what the pandemic has achieved with respect to mental health, as in so many other domains, is the acceleration of
a pre-existing trend; with this has come heightened public awareness of the severity of the problem. Mental health, the most significant single factor affecting people’s level of satisfaction with their lives, [156] was already on the radar screen of policy-makers. In the post-pandemic era, these issues may now be given the priority they deserve. This indeed would constitute a vital reset.