Dr Joanne Stuart
Updated: Aug 30, 2022
Disorder vs Stress Reaction
Firstly, before I talk about how the pandemic may have had a significant effect on individuals, I would like to clarify a few things about the difference between a normal ‘stress’ reaction to an abnormal event and a ‘disorder’. A ‘disorder’ is a cluster of symptoms, severe enough to have a significant effect on our ability to be able to function. This ‘cluster’ of symptoms is seen time and time again and then extensive research carried out before the decision to warrant a ‘disorder’ status. To explain further: you will all have heard of the term ‘Post-Traumatic Stress Disorder’. An individual is diagnosed with this disorder when they display a cluster of different recognisable symptoms following a traumatic event, including things such as nightmares, flashbacks, a significant change in beliefs, a change in mood, such as a constant state of severe anxiety or low mood. For many individuals, their whole life is shattered and they feel that they need to pick up the pieces and start again.
Generally, following a trauma, most individuals will naturally get better from a mental health perspective, within about one year. There are a multitude of reasons why some get over a trauma quicker than others but I shall not elaborate on that here. There has not been enough time or research carried out to date for us to know whether Post-Pandemic Stress Disorder exists. Never-the-less, for many individuals the pandemic has been a time of significant stress, trauma and flux. For many, it will take months or even years to return to normality. For those who have lost individuals to Covid-19, their lives may never be the same. For some, however, the pandemic has been a positive experience and I will turn to that first.
Positive Impacts of the Pandemic
Positive impacts of the pandemic have been discussed extensively. Those who always felt they had no time to spend at home or with family. Those who felt life was too busy with no time to reflect or slow down. Those who prefer time alone than time spent with others. Those who have been able to use this time to build a skill. Those who have, in the end, found that a change of career has been positive for them. Those who have benefited from working from home, rather than commuting. The list goes on.
From a psychological point of view, those who have the support of family and friends around have fared better. Alternatively, individuals who are more introverted, in other words, they get their energy from being alone, have found the pandemic easier to cope with.
For many, however, the pandemic has been difficult and for others it has caused a stress reaction that may take some time to overcome and for the brain to return to normal levels.
Negative Impact of the Pandemic
Research suggests that 18 to 24-year-olds, full-time students, unemployed people, single parents, those with enduring mental health conditions and those with long-term disabling health conditions, have found this to be particularly difficult.
18 to 24-year-old have generally just left school and are either off to university or looking for employment. For those who started university in 2020, the normal process of fresher’s week, parties, meeting new friends and socialising, turned in to lectures on-line and strict social distancing rules. For many, being away from home for the first time and stuck in a room with little opportunity for building a social network, has been very difficult.
From an evolutionary perspective, our ability to be able to work and look after ourselves, is fundamental to our survival and when this is threatened in anyway, our fear network is triggered. So, not only was this a difficult time for those starting out on the road of employment but many lost their jobs because of the pandemic. Whole areas of industry were wiped out. Many small businesses, or businesses that could not function within social distancing rules have suffered. Individuals have faced financial hardship beyond anything they have ever experienced and this worry and anxiety about how to survive or provide for families has caused a severe stress reaction.
Another group that have struggled during the pandemic have been families but especially single parent families. Looking after young children can be relentless and the break that nursery or school gives, helps parents survive. With schools closed and young children to teach or entertain and work to carry out both at home and through employment, many have felt overwhelmed.
Obviously, those with enduring mental-health conditions already have enough to cope with and adding a pandemic to their issues has sent many spiralling into dark and difficult places. Issues surrounding the fear of contracting covid-19 have fuelled the fear that many with health anxiety or Obsessive-Compulsive Disorder, have. Where all around us we are reminded of how easy it is to catch the disease and how difficult it is for us to know how it will impact on us physically, a constant state of fear has been difficult to bear.
Finally, for those with underlying health conditions, this time has been particularly difficult. The level of stress and anxiety related to catching the disorder, or a loved-one catching it, has created a constant and daily struggle with anxiety.
Isolation from friends and family has made this time particularly difficult for many.
As already mentioned, social support is fundamental to mental health.
Post-Pandemic Stress Reaction and ways to get back to normal
As mentioned in the introduction, many individuals who have found the pandemic difficult and have noticed an increase in stress or anxiety, will, as things return to normal, find that their anxiety returns to normal levels. It is best to remember this: accept that things may be difficult at the moment but keep in mind that it is likely things will naturally return to normal. This helps us to worry less, which can be a maintaining factor in anxiety.
For others, however, the impact of the pandemic will be more enduring and if they are struggling, I would recommend they speak to their GP about help that is on offer, both through the NHS or privately.
From an evolutionary point of view, our anxiety system or fear network has developed and endured because it has helped us survive. Ideally, it helps us to face a threat and then when that threat is past our system has the time to return to normal. One thing that has happened during the pandemic is lots of small traumas or on-going stressful events. One way of looking at this is if we think of living in a warzone. Daily stressors or threats cause our brain to shift on to ‘high alert’ and it can take years of calm for our brains to realise that the danger has past.
If you find that your anxiety system seems to be triggering or you feel you are on ‘high alert’ every day and this is not improving, then there are many ways to help. I have written lots of articles on managing anxiety and there are many apps and websites available with information. Here are a few suggestions:
1. Rebuilding our lives:
When coming out of a traumatic situation, it can seem that rebuilding our lives is like climbing a mountain. If we look up at the mountain (or look at what we have to achieve) then we feel overwhelmed. What we can do instead is put a plan in place about some ideas of how to return our lives to how they were and just take one step at a time. Do not think about how far you need to go – just focus on that next step.
2. Thinking element of anxiety and stress:
The pandemic may have caused a state of feeling we are on ‘high alert’ all of the time. Intense levels of stress and anxiety does not help anyone. It is important for us to help our brains understand whether danger is real – in other words are we about to be attacked? Or is the danger just something that our minds are making up? Your brain may be telling you to focus on all of the things that could potentially go wrong. Although this helped us in hunter-gather times, it is less useful now. If the danger is not there in front of you at that very moment then try to change your focus of attention. You can do this by playing a game, doing a crossword, watching something, talking to someone – anything that takes your mind off from thinking about what could possibly go wrong. Many people think that being aware of everything that could potentially go wrong helps them to be prepared. This is actually not the case because we can never know what difficulties we may face in the future or how we will deal with them at the time.
3. Physical element of anxiety and stress:
The physical elements of stress and anxiety are generally experienced as tension, shallow breathing, raised heartbeat, etc. There are many ways to reduce physical elements of stress and anxiety. You could set a reminder on your phone to come on every hour. Check your body for signs of stress and try to do some breathing exercises or relaxation. Meditation is another way to reduce physical tension. Exercise is an important de-stressor - you need to physically stress your body for happy hormones to be released and these happy hormones have a direct impact on reducing the stress hormones. Having a freezing cold shower – just for 30 seconds – has been shown to reset our body. Also, and far more pleasurable in my opinion, is a hot bath.
4. Finding a balance:
Life is about finding a balance between work, rest, exercise and play. When we are getting over a difficult time, it is really important to prioritise things that make us feel better. There are things that we have to do – we need to work to provide for ourselves and our family; we need to look after our children and pets (if we have them), we need to eat and drink water; we need to sleep; and we need to clean ourselves. Apart from that, everything else is something that we feel we need to do but actually we do not. When trying to reduce stress and anxiety, we must prioritise the things that make us feel better, even if that sounds crazy when we look at our ‘to do’ lists.