BACK TO NORMAL: Responding normally to an abnormal situation.
Submitted by Christine Whelan
Oct 28th, 2021, VOL. 3 ISSUE 5
Returning to normal. We’ve been waiting for this for a long time now. Why then, is it not easy?
Experts suggest we try to be gentle, kind, and patient with ourselves. There are some good reasons we may not feel back to our normal selves yet.
So, to understand what we’ve gone through and what the effects can be, regardless of how strong, brave, or smart we are, we are also allowing ourselves to be human.
We now live in a land of never-been-done-before. This has been my personal mantra for about a year now.
Emerging From Pandemic Life: Set Realistic Expectations
According to theconversation.com, uncertainty and unpredictability tied to the current coronavirus risks can naturally cause feelings of anxiety or ambivalence when letting go of an established habit, like wearing masks. So, be ready for some anxiety and realize it doesn’t mean something is wrong – it’s a natural reaction to a very unnatural situation.
Chances are you won’t always agree with the people in your life on where to draw the lines about what’s safe and what’s not. So, expect some awkwardness, frustration, and annoyance – everyone’s creating new patterns and adjusting to changed relationships. This should all get easier with time and practice, but having realistic expectations can make the transition smoother.
Post Traumatic Stress Disorder
Ian Gotlib, Ph.D., a professor of psychology at Stanford University stated in an Elemental article, “The people who are at the highest risk for developing depression and anxiety are those with the most stressors and the fewest resources. This includes people who have lost their jobs or are facing financial insecurity, as well as people who live alone or who have small children.
Other studies have found that nearly one in five people who’ve recovered from Covid-19 are diagnosed with a mental health condition in the months immediately following, including anxiety, post-traumatic stress disorder (PTSD), and depression. People grieving the loss of a loved one are also at greater risk for a subsequent mood or anxiety disorder.
“You should expect higher levels of anxiety, depression, and PTSD in those who are specifically exposed to danger or death,” Yuval Neria, Ph.D., a Professor of Medical Psychology in the Departments of Psychiatry and Epidemiology at Columbia University Medical Center commented for a previous article. “So, frontline workers, health care workers, essential workers who are exposed to higher levels of stress or even traumatic events” are especially at risk.
For people who haven’t witnessed death from Covid-19 firsthand, Neria says the pandemic is not a typical traumatic event, so a diagnosis of PTSD is unlikely. “It’s not time-limited; it’s not geographically limited; it’s not culturally limited. It’s all over, and it’s lengthy, and it’s kind of amorphic,” he says. “Usually, traumatic events are very clear where the threat is coming from. Here, the origin of the threat or the nature of the threat is not clear at all. It’s a very different experience altogether.”
Even those who have been lucky enough to escape either personal illness or work on the front lines are not unaffected. According to Neria, we’ve all experienced tremendous levels of stress just by the nature of living through one year of a pandemic, and that takes a toll on the brain.
Collective or mass trauma is trauma that involves and impacts entire groups of people, communities, or societies. The World Health Organization stated that unlike previous collective traumas, such as that caused by World War II, the collective trauma caused by the pandemic affects “each and every individual on the surface of the world.”
The WHO expects that we’ll see its effects on the mental health of individuals and communities for many years to come.
Post-traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares, and severe anxiety, as well as uncontrollable thoughts about the event. (mayclinic.org)
Science takes time, so concrete studies and statistics will be slow to roll in. The patterns and data collected from past events are what have been looked at recently.
According to Sandro Galea, MD, a Physician and Epidemiologist who studied people’s mental health in the aftermath of 9/11, hurricanes, civil unrest, and other earth-shattering events, stated in Elemental article, not only has the pandemic changed all of us, it has changed our brains.
What Chronic Stress Does to the Brain
The human body is made to deal with stress. Short-term stress. When under threat, our body’s automatic response is to raise our heart rate, cortisol, and adrenaline levels, shifting its energy resources so that we can escape the threat, or stay and fight. Fight or flight. But, it’s normally a very short response that gets shut off when the threat goes away. An adrenaline rush lasts up to an hour after a stressful event.
Under chronic stress, the adrenal glands are no longer releasing a pulse of cortisol into the bloodstream. It’s a continuous stream.
James Herman, Ph.D., a professor of psychiatry and behavioral neuroscience at the University of Cincinnati and Director of the Laboratory of Stress Neurobiology says. “Chronic stress can impair memory, it can impair cognitive processing, and it can even impair the ability of the brain to control stress responses.” So, it can be a downward spiral.
Our Brain Under Chronic Stress
According to experts, four brain regions that appear to be particularly affected by chronically high cortisol levels are the:
- amygdala, which triggers fear and anxiety responses (for crisis – fight/flight);
- hippocampus, an area important for learning and memory, as well as mood and emotion regulation (for everyday);
- prefrontal cortex, the brain’s executive center involved in things like future planning and impulse control (logic).
- And then we add in the hypothalamus, the brain’s hormone command center.
Now, bear with me a moment.
During times of chronic stress, a disruption in the balance between these brain regions can occur. The prefrontal cortex and the amygdala become less connected, and there is greater than normal activity in the amygdala and less in the prefrontal cortex. As a result, there’s nothing holding the amygdala back from constantly sounding the alarm, so we get more stressed out over more things. The amygdala relays that stress signal to the hypothalamus to start the chain of events to release even more cortisol from the adrenal glands, creating a vicious cycle.
This could be why we see some people these days seemingly always ready for a fight.
“What happens with stress is that you lose synaptic structure in the prefrontal cortex. The result is like removing the brakes on the amygdala, allowing the amygdala to go into overdrive,” Herman says. “The amygdala is being told to grow, whereas the hippocampus and the prefrontal cortex have been told to retract. It’s very interesting biology, how you kind of shift the emphasis of the brain toward a mode that is more associated with fear and negative affect.”
The bottom line, this can create a constant state of fight or flight. Survival mode.
The Unique Stress of Loneliness
One reason so many people may be turning to drugs and alcohol during the pandemic is that one of our primary, healthier coping mechanisms to help deal with the negative impacts of stress has been taken from us — our social support.
“Humans are a social species,” says Julianne Holt-Lunstad, Ph.D., a Professor of Psychology and Neuroscience at Brigham Young University. “Our brains have evolved to expect proximity to others. Throughout human history, we’ve had to rely on others for survival, and when we lack proximity to others, particularly trusted others, in essence, our brains have to work harder.”
Without close proximity to others, the body’s stress response might be higher. Loneliness and social isolation are also stressful in and of themselves, and they are experienced in the brain as being in a state of general threat, triggering the release of stress hormones.
“When you’re holding someone’s hand who you trust and know and love, your brain seems to see the threat cue differently than it does when you’re by yourself,” Coan says.
Get It Out Of You — And Do It Out Loud
Dr. Jessi Gold from Washington University School of Medicine in St. Louis suggested that we are not going back to normal as much as moving forward. She says, we need to talk about it, what we have experienced and are experiencing. We need to get it out of us.
“We all have been through different things we need to start talking about out loud. Speaking out loud is a part of moving forward.” Gold says we have been living in a constant state of fear of COVID-19 for over a year.
One psychologist in a npr.org, mental health section, article on post-pandemic days was quoted, “I think it’s hard for people to understand because we have been waiting for this for so long that it feels like we should be excited.”
Another psychologist commented, “The pandemic really shattered people’s assumption of their safety and security.” This can be life-altering.
I know a lot of people get annoyed with this saying, but it fits. It is what is it. Post-pandemic days present new challenges. But, as the experts all agree, it’s real, but it’s all workable.
We have the power to heal ourselves. We first just need to be aware of what we need to heal from.
Please, be patient and kind with yourself. It’s suggested that we bring some of what we found comfort and solace in during the pandemic to our new norm.
A Few More Points From the Experts:
- Set your own boundaries with yourself and others around you; what you are comfortable with.
- It’s important to acknowledge the grief and losses of the past year and a half.
- Remember, returning to normal requires change, which is also stressful.
Again, please remember, you are responding normally to an abnormal situation.
And, you got this.