Some experts are warning of a looming mental health crisis in the wake of the Covid-19 pandemic that we are apparently ill-prepared for, and journalists are amplifying this message.

Everyone, it seems, is depressed and there is a new health curve to flatten.

We believe these warnings are being overdone, and definitely overlook the potential for post-traumatic growth (more on that in a minute).

advertisement

There’s no question that the Covid-19 pandemic, the largest global disruption since World War II, is devastating millions of people with unexpected illness, disability, or death; financial insecurity; postponed weddings or virtual graduations; and more. A recent census study of Americans estimated the rates of anxiety and depression to be as high as 35%. We are being warned that the pandemic may increase rates of post-traumatic stress disorder, since being exposed to actual or potential death is the very definition of trauma.

While it is valuable to report on people’s mental states, emphasizing the potential for anxiety and depression too much can devolve into fearmongering and backfire.

advertisement

People respond to trauma in various ways. Most show resilience and don’t develop long-standing mental health problems after experiencing a traumatic event. This response makes our work as psychologists feasible, as we see patients who show resilience even when facing the unimaginable terror or trauma.

Post-traumatic growth is a concept similar to resilience, but distinct from it. It’s a term coined by psychologists Richard Tedeschi and Lawrence Calhoun in the mid-1990s. In essence, post-traumatic growth is positive change that occurs in the aftermath of struggling with a major life crisis or traumatic event. According to Tedeschi and Calhoun, perhaps 50% of people experience post-traumatic growth after enduring a trauma.

It looks different for each person. Post-traumatic growth is a process, not an outcome, and typically involves developing positive responses in these areas: appreciation of life, enhanced relationships with others, new possibilities in life, newly identified personal strength, and spiritual or existential change.

Viktor Frankl, an Austrian psychiatrist, wrote in his book “Man’s Search for Meaning” that people are able to thrive after trauma by finding or imposing meaning on the experience. As a survivor of the Nazi concentration camps, Frankl knew what he was talking about. If he could see growth in his experiences, then Americans should be able to see it in an epidemic that has altered daily life.

Post-traumatic growth often arises after a situation has ended. None of us has an idea when the pandemic and its effects will be over, so that uncertainty may keep us from moving forward. It’s all the more reason to get things back to what we defined as normal at the beginning of the year.

We aren’t recommending trauma or adverse experiences as a growth journey, or suggesting that Covid-19 is a good thing. It isn’t. It has overwhelmed millions of people around the globe. But filling the uncertainty with dire prophecies about declining mental health adds to the anxiety people feel and becomes self-fulfilling. People need to be comforted and the research on post-traumatic growth can help with that. Negative attitudes such as stigma and shame can prevent seeking help, which could prevent this type of recovery, whereas optimism, altruism, social support, and self-confidence may foster post-traumatic growth.

The paradox of this process is that experiencing loss, although devastating, may help some individuals focus on what they have, and be grateful for the small things. Learning about the many aspects of life that are out of our control allows us to focus on what is within our control and make meaning out of the situation and the decisions we make.

Vulnerability can often become the glue that binds together people and communities, building strength that was otherwise unimagined. A crisis like this pandemic may provide unsought opportunities to grow and find new ways to appreciate life. We may someday look back on this and see the first half of 2020 in a far different light than we do now.

Jay Behel is an associate dean of student affairs and associate professor in the Division of Behavioral Sciences at Rush Medical College in Chicago. Jennifer A. Coleman is a clinical psychologist and assistant professor with the Road Home Program for veterans and their families at Rush University Medical Center.

  • Please, for everyone’s sake, just stop. Please stop talking and think for a second about what you’re saying and who you’re saying it to.

    You think warnings about mental health problems caused by this crisis are “overdone?” Maybe they are, but I’m pretty sure “shut up about your problems and look on the bright side!” is not a good tonic for that.

    You want to talk about “post-traumatic growth?” Well, let’s look at some of the things you consider necessary for achieving that – specifically, “altruism” and “social support.” In the U.S., today, we don’t have either of those things. What we have are landlords slavering to evict people who can’t pay rent, businesses demanding that “essential” workers come in sick, idiots who won’t wear masks to save their own lives, let alone others, public health experts who solemnly declared that poverty and misery were the only ways to deal with this pandemic, a government that never provided remotely enough assistance, and a president who’s a mass-murdering monster. Unless you can magically change that state of affairs – which you have no impetus to do, as you’re well-off professionals yourselves – there’s not going to be much chance for growth.

    You think people should be “grateful for small things?” Consider how that sounds when the “small things” are all you’ve ever had to feel grateful for. Consider also how it sounds when you’ve been hard at work for over a decade, trying to demonstrate that you’re capable and responsible enough to deserve a bit of the big things, only to have people (who’ve already got theirs, natch) tell you “well, those opportunities don’t exist for you anymore, but you can be grateful for the small things!” Trust me: it doesn’t sound particularly good.

    You say that we may someday look back on this time differently. And who knows, maybe we will. But I lost a decade of my life to the 2008 financial crisis, and I’m now getting ready to lose another decade to this pandemic. I can only imagine the future has far worse in store. And I refuse to shut up and pretend to be happy about it.

    • Thank you, you bring up some really good points. I think most people, and society in general, either have not come to understand what this pandemic will mean for the world in the long term (let’s just say ‘bad’), or they are in denial. The sooner we wake up, the better. And waking up means seeing things as they really are, no matter how hard it is.

  • I am a living example of the benefits and potential of “Post Traumatic Growth” and a validation of the work of Richard Tedeschi and Lawrence Calhoun.

    I wrote a book about my 40 years of experience providing health care in crisis countries around the world that is very appropriate for the COVID crisis. I suffered decades of PTSD from making rationing decisions in Central Africa in the late 1970s, and as PTSD was not even recognized at the time, my recovery has followed the learning curve of PTSD understanding. During my long career I had repetitive exposure to traumas in places like Afghanistan during the war, Haiti after the earthquake, and Liberia during the Ebola crisis.

    I recount the story for the lesson of what can happen during long-term repetitive traumas, and as an example of the long-term recovery process of Post Traumatic Growth.

    “The Post Traumatic Growth of a Guardian Healer” is available on Amazon in print and on Kindle. The Kindle version is available at cost so it can reach a wide audience in this time of need.
    greg@health-mgt.com

  • We all have a story.
    If people understand how difficult living with COVID-19 is, one can only imagine living with COVID-19 and a history of lung cancer. Very difficult. My comfort is although I feel isolated articles like this let me understand that my fear and pain is only human and most importantly, I am not alone.
    Thank you for your information. It stimulates me and keeps me alive and I am convinced that I will grow even stronger once this COVID-19 is over. But we can not put our guards down. It is vulnerable people like myself that need to be protected so that we can help others when the crisis is over, with our stories.

  • Governments, especially Uganda should recruit professional counselors to enable them handle the psychological aspects that occurs after every traumatic events of which are the ones killing instead of the virus.

    • As I spent my career working in countries facing similar (or worse) challenges, I started to put ideas together for PTSD recovery that are extremely cost efficient. As an example, I developed a training course for new rehabilitation hospitals for “war wounded” in Libya. It was based on “Peer Counseling” and using existing care providers to act as guides. Sadly, I was forced to leave when militias got out of control before I was able to deliver the course.
      Since that time I have learned many additional techniques and a more clear model of Peer Counseling. I hope that soon USAID or other donors will finally see the need for PTSD recovery and back the spread of this program. The costs would be negligible as it uses existing resources. Unfortunately, because of long-term damage from a virus I picked up during the Liberian Ebola crisis, I am no longer able to travel internationally. Remote guidance is possible to get things going.

  • “According to Tedeschi and Calhoun, perhaps 50% of people experience post-traumatic growth after enduring a trauma.”
    And that means “perhaps” 50% don’t.
    And to say that “It’s all the more reason to get things back to what we defined as normal at the beginning of the year.” is pure nonsense. “Things” will never be “back to normal” – as in how it used to be. At least not for a very, very long time…I’m pretty sure most psychologist would agree that it is better to tell people the truth, rather than feed them a bunch of namby-pamby, wishful thinking pablum.

    • I think it is best to be positive. Although 50% may not experience “growth” they may stay the same. Also, mental health is not an ‘all-or-none’ issue. It can fluctuate day by day and even minute by minute.

  • The title! Why use the phrase Mental Health but end it with Post Traumatic Growth?
    Should the editor or both the highly esteemed authors have written-Human ‘s
    Traumatic Experience with Covid 19 Virus Can Lead to Post Traumatic Resilience

Comments are closed.

A roundup of STAT’s top stories of the day in science and medicine

Privacy Policy