Emotional responses to the Pandemic. Where are we?

There is something that I definitely noticed in my practice in the last weeks. Several new patients who very recently decided to start therapy , as well as existing clients, wondered why they have been feeling worse when the lockdown restrictions were lifted than when the country was in full lockdown mode and they were barely leaving the house.

I think this graph may help understanding these feelings.

Phases of Disaster, Samhsa, Adapted from Zunin & Myers as cited in DeWolfe, D. J., 2000.

In this post, I will not focus on individuals and families that were affected by a death of their loved ones as the psychological responses to such traumatic events are quite different. I will refer mostly to people who have experienced the Pandemic in an indirect way.

When a community undergoes a global adverse event- in this case the Coronavirus pandemic- there are emotional lows to be expected but also highs.

In the "honeymoon" phase for example people may feel more connected to their friends, family and experience a general sense of solidarity. A stronger sense of community may emerge. In April and May, people came together , they clapped at the NHS workers every Thursday and met their neighbours for the first time. Many volunteered to help individuals who needed to shield and were not allowed to leave their home at any time.

Past the peak and an initial weird enthusiasm for an out-of-ordinary phase, different feelings are common which can be experienced as lows: low mood, depression, apathy.

It is a bit tricky to know in what phase we are at this moment and it does change from a country to to the other. But in the UK and probably in other European countries, people are going through similar experiences: the lockdown measures have progressively eased in the last 4 to 8 weeks. Here in London we can now even go to pubs and restaurants, shop, finally meet in parks, gardens and even at home (in small numbers).

So how come so many people are experiencing more difficult feelings than in the lockdown?

If we look at the graph, we can assume that as things stand now, we are somewhere in between the "disillusionment" phase and the "reconstruction". Now that we are again in the outside world, we may be more directly facing the differences between the "before" and "after" the pandemic hit us at a global scale. The comparison hits us more than when we were home. Being around feels a bit foreign, we cannot hug or be affectionate with each other, which is very relevant especially for people who live on their own. We may have started to notice that we do not feel the same way as we used to in similar circumstances and that creates discomfort and confusion. The old normal seems to be gone and the new normal is not yet defined. It will take some time and after months of uncertainty, some people may have run a bit out of patience. They may want things to go back to as they were quite fast, possibly after the summer.

For some, the lockdown had the positive effect of minimising or even cancelling the pressure they felt in "normal times". It is likely to be the case for people suffering from prior anxiety and depression. All of a sudden during the peak of the pandemic everyone was at home, nobody was meeting anyone, having fancy jobs or exciting trips, parties. There were no such pictures crowding their social media. Therefore it is quite possible that many experienced a sort of relief: "everyone is in the same sea, I am not missing out on anything". No FOMO. Going back to busier lives may feel like a sensory and emotional overload, it takes some re-adjustment (again).

There were some positive effects of the lockdown too for many families who normally are so used to stressful rushing routines. They probably discovered the benefits of slowing down and living more in the "here and now". Anticipating that stress levels may soon go back to "normal" could create some sadness or a sense of loss. It may be hard to let that phase go.

The re-opening phase and restarting is also not looking the same for everyone. Some may feel quite certain about their jobs, some are working even harder than before, looking forward to a break before a possible burn out. On the contrary, employees who have been put on furlough may start to wonder if they have a position to come back to in the next weeks or months. Self-employed may be significantly concerned about not having work coming in in the foreseeable future.

In a nutshell: we may know a little more about the virus , it may have lost some "viral power", the NHS seems to be coping better with it and all of the above are excellent news and there are several reasons to be optimistic. Nevertheless, a considerable level of uncertainty remains around many other aspects of our individual and society lives.

Furthermore, the last months have required coping with fear, anxiety, separation, loneliness has likely exhausted the capacity of emotions regulations.

Post-lockdown anxiety seems to be an emerging recognised phenomenon. It is not just the factors described above that play a role but also a genuine fear of getting closer to the risk of getting the virus with the restrictions being lifted. How can I keep healthy? is it really safe to go to a restaurant and mingle with people?

There is no magic trick. Ideally, some patience and and ability to still hang in there until we can get back to more "normal" lives and feelings. But as I mentioned before it may be hard to keep patience after months of lockdown and emotional rollercoaster. I feel you. It is alright to feel fed up and to worry about the next phase.

The good news is that normalising negative feelings you may experience right now helps avoiding the inner tendency of self-blaming and the spiral of negative thinking such as "why am I not feeling better? Why am i feeling more low than before? What is wrong with me? ".

These negative thoughts have the power of being more harmful to our mental health than the psychological effects of the lockdown.

Some quick tips:

• Change of scenery: try to diversify your physical context as much as you can. Brains need thoughts to be reshuffled and in order to do that they need new inputs, including visual inputs. Looking at the same road and same park is not going to help having more positive thoughts.

• Broadening the range of activities: What are you allowed/ can you afford to do know that you were not weeks ago? What can you do slightly differently?

• Connecting: friends, neighbours, family, people who need our help. Pretty much anyone. We all need to start socialising again.

• Ask for help if you are struggling: friends, family, volunteers, therapists, GPS, health carers, osteopaths etc.

• Looking after your well-being again: doing the check ups planned before the pandemic started, eating healthily, EXERCISE. Make the most of every sunny day.

Most importantly, it is crucial to remember that re-adjusting is a step-by-step process. You do not have to be back to "business as usual" mode tomorrow, you have some control over it.

Some questions may be helpful to ask yourself: What would I like to take with you from the lockdown phase? What habits would you like to keep and implement? Transitions are less worrying and alienating the more we learn to integrate old and new experiences.