Many of COVID-19’s adverse effects on mental health are proving to be cumulative. The effects of being confined in total or relative isolation are like a psychic rust: at first just a few reddish spots here and there, then an unsightly peeling of every surface; and in the end the total collapse of structures that once looked indestructible.
Being alone for a month can be almost relaxing if you are not preoccupied with the Angel of Death who seems to be stationed outside your front door. Being alone for a year is an altogether different experience, one associated with eremitic deprivation and a more desperate madness. Personal loss and financial woes exacerbate the problem.
The prediction had been that the birth rate would skyrocket as the quarantine proceeded because people with nowhere to go would lose themselves in erotic diversions. Instead, the birth rate has fallen dramatically because people who are stuck dealing with each other all day every day and who have no social breaks to mingle with others are in no mood for sex.
What seems to have escalated is the divorce rate. Suicide and depression appear to be up, too. People who have always been paragons of sanity are experiencing a jumpy frustration that borders on clinical anxiety; people who were already anxious are paralyzed. 2020 would likely have been a good time to invest in alcohol-related stocks or recreational marijuana dispensaries — because all anyone wants is escape, literal or figurative.
Some blurry resolution is finally coming into view. How much of a denouement it will be seems to change every day: The vaccines are available to certain people; the vaccines may soon be available to everyone; they work to sufficient or maybe insufficient degrees against the viral variants; we won’t get out of the woods until nearly everyone is vaccinated; getting vaccines to the developing world is critical; we can be safe in our privileged bubbles.
I recently received my second jab of the Moderna vaccine, and will soon have such immunity as it confers. I have already made plans that hinge on this change. I will go to the place where I used to get my hair cut for the first time in over a year. I will see friends, a few at a time. I will embrace my elderly father, who is likewise vaccinated. I will even take my family skiing and stay in a hotel.
I will do it all warily, however. I can feel the pull of abandoning all caution and also the opposite pull toward maintaining paranoia. I wouldn’t feel comfortable in a crowded theater, or at a dance party. I still feel some hesitancy about public restrooms. I won’t board a plane to Europe even if European countries decide they are willing to let me in. I know that this code of behavior is ridiculous, that a flight is probably no more dangerous than a hotel in Vermont, that dance parties are probably no more hazardous than the hair salon. But I remain in the thrall of habit and superstition.
Since 9/11, Americans have become accustomed to security rituals of dubious effect that nonetheless retain symbolic potency, such as putting one’s shoes into the airport scanner. Rituals of COVID-19 prevention may come to feel symbolic, too. Of course, donning masks makes an enormous difference to personal and public health. Post-vaccine, though, will I be wearing them to protect myself and others? Yes — but also because the idea of leaving my house without one now seems downright weird.
When I was reporting from Afghanistan in 2002, shortly after the American invasion, a prominent women’s rights activist there told me that she had dreamed of burning her burka as soon as the Taliban fell, yet she was still wearing one. “Once you get used to being invisible,” she explained, “the prospect of being visible again is very stressful.” N95 masks are not burkas, but taking them off at this point seems like tempting fate.
Like many people who grew up in the Great Depression, my grandmother couldn’t abide waste, and she saved odd bits of string for which she had no use. It was the mentality of her era, though she had in fact lived comfortably enough through the Depression. Those impulses did not stem from rational fear, but from a neurosis about the possibility of deprivation: She would always know that having enough at the moment was no guarantee of future sufficiency.
It’s hard to know how the pandemic will affect us over the long term, but we will not emerge from it without some comparable, persistent, low-grade anxieties. We won’t save bits of string and inelastic rubber bands, but we will do something equally pointless. We might be suspicious of travel; we might be panicked by crowds; we might put on masks long after herd immunity has made them all but gratuitous. Collective trauma affects both the group mentality and that of individuals. We might be ill at ease if our children live or work in tall buildings with crowded elevators.
Those children may think us ridiculous, but we have learned that liberties that appear immutable can be constrained, that freedom of movement is conditional, that scourges can sweep across an unsuspecting world completely out of the blue, that what seems mundane today may be impossible next month. It will take decades to outgrow these qualms, and, of course, by then there will presumably be other crises, now neither anticipated nor imaginable, that will channel anxieties we haven’t yet conceived.
As for the shift back from divorce to reproduction, that, too, is likely to be gradual. I am not aware of people returning abruptly to carnal pleasures two weeks after their second shot. Which changes in us born of COVID are temporary and which are permanent? That is an impossible calculus. We can be sure only that we will never be the same.
Depression, once considered an exotic mental illness, has become the default state of many, if not most, Americans. This pandemic too shall pass, but it will leave a residue of despair that will keep therapists and psychiatrists amply occupied for at least a generation.