Post-Pandemic Stress Disorder (guest post by Dr. Dennis Ortman)

The following guest post by Dr. Dennis Ortman, psychologist, former priest, and MSI Press author, will form the basis of a forthcoming book on coping with pandemic conditions, called The Pandemic and Hope.

POST-PANDEMIC STRESS DISORDER

 By Dennis Ortman, Ph.D.

  

I have a fantasy. President Trump will eventually announce victory over the Coronavirus. He will declare, “We have won the war. We have shown our greatness as a nation in working together to defeat this invisible enemy.” He will then express gratitude to all the healthcare workers, who risked their lives, those who supported all the essential services, and the entire nation. He will also report remarkable progress on a vaccine and treatment. American ingenuity again triumphs. Hopefully, this day will come sooner than later. 

However, while the war may be won on one front, another remains, the inner battle against fear. We cannot rest on our laurels. Many have aptly compared this epidemic to the bombing of Pearl Harbor and the terrorist attack on 9/11. Our nation was traumatized by these events, and the effects have persisted to today. Franklin D. Roosevelt, ever the realist and wise politician, said, “There is nothing to fear but fear itself.”The lingering effect of the Coronavirus epidemic will be similar to the aftermath of Pearl Harbor and 9/11. We have been traumatized again. We are in shock, trying to cope. I call our survival reaction to this extraordinary event “post-epidemic stress disorder.”

DROWNING

I had first-hand experience of the aftermath of World War II as a child. My father served in the army for three years, surviving seven campaigns. He returned emotionally disabled. Then, they called it “battle fatigue.” Today, we diagnose it “post-traumatic stress disorder.” In his day, little treatment was offered to the returning soldiers. My father found his own treatment in a bottle. He drank to quiet the demons. He would never talk about the war, except when he drunk. The few stories he told impressed upon me the overwhelming horror he endured. Ninety percent of his group of enlistees was casualties. He suffered survivor’s guilt. He also experienced flashbacks. One time he was playing golf with his brother. A plane flying overhead backfired. My father immediately dived to the ground for cover. My uncle laughed, and my father responded, “Weren’t you in the war?” My uncle served in America. I read about the war to know my father better and learned that in North Africa, where he fought, German Stukas regularly strafed them while they were exposed in the desert. The soldiers had a motto, “Dig or die.” 

Some of my patients tell me they are eating and drinking more to cope with the disruption of their lives due to the epidemic. I am observing signs that we have all been traumatized to some degree by this invisible, deadly, relentless enemy and are trying to manage the best we can. I can see the terror in their eyes. Our initial panic, I fear, is transforming into paranoia, seeing dangers everywhere. Even though the external war is over, the inner battle rages. Being traumatized is like drowning in a sea of frightful thoughts and emotions and struggling to stay afloat. These are some of the symptoms I observe that suggest many of us are suffering from post-epidemic stress disorder:

Life threatening event: A massive earthquake sent a tidal wave around the world, and no one knows how many or how intense the aftershocks and flooding will be. The attack by the Coronavirus took the whole world by surprise. It came suddenly with a deadly vengeance, first in China, as far as we know. It has proven to be extraordinarily contagious and rapidly spread to Europe and now America. Soon it will invade the southern hemisphere as the flu season begins in that half of the world. Each night President Trump announces how many countries have been affected. The last count was 182. The numbers of those who are infected and dying are staggering, in the thousands .

This invisible, silent, deadly enemy has not only invaded our bodies. It has attacked our minds, and resides there like a killing cancer. The experts admit knowing little about this strange new bug. They watch its progression carefully, trying to unravel its mysteries. Their uncertainty and admission of powerlessness to treat it feeds further our fears of its deadly presence. We are told it can live on surfaces for hours and days. People can be infected without symptoms and be carriers. The germs are airborne, and we are advised to wear masks. So we see dangers everywhere and must keep our distance to avoid spreading the disease. Even our loved ones can unwittingly bear the virus that can kill us. The TV news relentlessly presents horrific images of the death and mayhem in the disease’s wake.

Fear and Helplessness: Our natural reaction in the face of this overwhelming threat is fear and a sense of helplessness. These reactions serve our need for survival. They make us withdraw to protect ourselves. Our fear is magnified as the scientists tell us how uncertain they are about the nature, course, and treatment of this disease. They are baffled by how contagious and deadly it is. Their admission of a lack of vaccine and treatment makes us feel even more defenseless and vulnerable. We are told to keep a social distance and stay home. But we are not sure where and when we will be safe. The experts say, “The virus will tell us.” So we can only watch and wait, huddled in fear in our homes. The news and social media flood us with information. In the present culture of misrepresentation, we are not sure what to believe. For example, one blog said that the virus resides in the grass, and that we should not cut it to stir it up. 

Intrusions: As hard as we try to avoid it, our minds are flooded with terrifying thoughts, feelings, and images that make us feel like we are drowning. We may try to distract ourselves by limiting how much we watch the news. But everyone is talking and thinking about COVID-19. Horrific images of hospital deaths are emblazoned in our imaginations. The virus attacks the mind as much as the body. We cannot avoid fearful thoughts, imagining the worst, or the stark images of death we view on TV. These thoughts and images ignite powerful emotional reactions of terror. We think about how terrible it would be if we or our loved ones became infected. What would we do? How would we cope? Would we survive? These anxious thoughts also invade and disturb our sleep, sometimes causing nightmares. Worse yet, if we or a loved one has been infected and hospitalized, the hospital will never be the same for us. If a loved one died or we had a near-death experience, seeing the hospital may trigger a reliving of the horror of the illness.

Avoidance: Whenever we experience something threatening, we naturally recoil to protect ourselves. It is instinctual. If it is too hot in the kitchen, we get out. Being in public is too hot for us now. We are warned to stay home, keep a social distance. It is appropriately called “lockdown.” Those who ignore this mandate can be fined for congregating. Initially, groups of 50 were banned, and now groups of five or more. We are told to keep at least six feet from one another and to wear face masks. The message: safety only in isolation. As time goes on and this message becomes engrained in our psyche, we may withdraw more and more from social interacting. As the travel industry was irrevocably changed by 9/11, so social congregating may never be the same after the Coronavirus. The fear of contamination may linger. We will avoid each other, and our lives will shrink. 

Emotional Distancing: Just as we were told to keep a social distance to protect ourselves, we emotionally distance ourselves from our natural reactions to the illness for safety. To cope with overwhelmingly painful feelings, we instinctively live in emotional lockdown. However, in shutting down the painful feelings, we also deaden the experience of happiness, peace, and joy. Already there are signs that many of us are eating and drinking more in quarantine to manage our fear and boredom and comfort ourselves. Our children, who cannot get together with their friends, stay in touch through video games or play alone. Their preoccupation with these games is already taking on an addictive quality. As time goes on and the fear is unabated, the lure of these escapes will increase. The ready availability of marijuana will make that drug more attractive to dull the pain. The opioid epidemic that has already raged out of control may yet escalate, as an easy escape. 

Hypervigilance: People have described war as weeks of boredom and moments of sheer terror. Since you never know when the attack will come, you must be alert and vigilant every moment. Otherwise, you could be caught unaware and die. The brain adapts to living in this constant stress. The physiological changes can be measured. After the war, soldiers react as if they are still in the war zone. In the same way, we have become hypervigilant in this war against an invisible enemy. Warned of dangers everywhere, we take extraordinary measures to keep safe. While taking my daily walk, I observed a young woman walking on the shoulder of a busy road to avoid getting near anyone on the sidewalk. Which is more dangerous: the sidewalk or road? Fear-possessed, we cannot think clearly enough to distinguish reasonable from irrational caution.

As we tread water in the high seas of our epidemic fears, we may lose hope. However, there are ways of learning to breathe under water. 

BREATHING LESSONS

The Coronovirus attacks the lungs, filling them with fluids. We then drown. It kills by literally taking our breath away, so we expire. Anxiety also attacks the lungs. Panic causes a shortness of breath. We feel like we are suffocating on our negative thoughts and feelings and believe we will die. The word anxiety, anger, and angst have the same root word which means “constriction, narrowing.” Breath means life. Without breathing, we die. Furthermore, breath also signifies the spirit, which is life-giving. The spirit is a spirit of love which is expansive and frees us from prison of our fears. This epidemic is affecting the whole of our being, our bodies, minds, and spirits. Consequently, a full recovery must address these three areas. 

For our physical safety and health, the scientific community and government have a two part strategy. To keep from spreading the virus, we have been given a stay-at-home order and mandate to keep a social distance from one another. I hate this term. In reality, we are keeping a physical, not social, distance. We need to keep socially connected to survive this ordeal. I have been asking my patients whether they experience this confinement as more a prison or a retreat. One patient responded, “Neither. I see it as a service to myself and others. I am doing my part to keep us all safe. It is a sacrifice, but it is something I am willing to do.” Ironically, by physically isolating himself he feels more connected to others through his self-sacrificing service.

Since we currently lack a vaccine or specific medications to treat this virus, the second strategy is symptom relief to keep the patient alive. If the breathing is compromised, respirators are needed. One of my patients who contracted the virus told me he was given over-the-counter medications for his fever and aches, an inhaler for breathing, and instructions to rest. In short, he was told to let the body heal itself. There is a chiropractic clinic next door to my office with a sign that expresses this therapeutic belief: “The power that made the body heals the body.”

For our mental/emotional health, we also need to be stabilized by finding a place of refuge. The stay-at-home order reflects the wisdom needed for healing the soul. We need to find our home within ourselves and among our loved ones. We need to become connected both to ourselves and others to stay afloat. Spending time alone with ourselves and our loved one provides an opportunity to look deeply within ourselves to discover our inner strength and power to overcome our fears. The above sign applies: “The power that made the mind heals the mind.”

When we are flooded with fear, the anxious mind with all its negative thoughts takes over. We forget that we have another mind operating, which I call the wise mind. It is our higher consciousness, our inner higher power, the better angels of our nature. There is a voice of reason that may seem a whisper amidst all the mental noise. I ask my patients to act against their urge to flee from their fearful thoughts and to lean into their fears. I tell them: “Fear is just an object in the mind, a thought about terrible things happening in the future. But the future does not exist, so the thought cannot be a reality. You only believe the danger is real.” Certainly, there are real dangers, and fear alerts us to them so we can take reasonable precautions. However, when anxiety takes over, the dangers become exaggerated in our minds. I then invite my patients to examine closely their fearful thoughts with their wise minds, asking themselves:  How real is the danger? What reasonable precautions can I take? What can my worry accomplish?

Untangling the mental knot of their fears, they can begin to think about what they really need in the moment. Instead of reacting, giving enormous power to their fears, they can begin to make conscious choices based on their desires. I tell my patients: “Your fear is uncomfortable, but not dangerous. It will not kill you. The real harm is if you let it control you and your life shrinks.” Together we explore what they really need in the current situation. I encourage them to act on their values, not their fears, so their lives will expand and not contract. In this process, they discover the healing power of their own awareness. They learn the truth expressed in the Tao Te Ching (46): “There is no greater illusion than fear…Whoever can see through fear will always be safe.”

For spiritual healing, it is remarkably coincidental that the peak of the epidemic is occurring on Easter Sunday. We have journeyed through our Lenten penance of keeping a physical distance, sacrificing our routines and familiar activities. Now we hear a message of hope. Although the victory is not yet won, it is nonetheless assured. Christ has risen from the dead. Life overcomes death. Even if you are not Christian, this message of hope is universal, written in the change of seasons. Spring always follows the bleakness of winter. 

The Easter Season Scripture readings capture what needs to be done to enliven our spirits. For example, the Gospel of John (20:19-31) recounts how the disciples huddled in a closed room (lockdown) after Jesus’ death for fear that the Jews would kill them also. Suddenly, unexpectedly (like the virus), Jesus came and stood in their midst. He said, “Peace be with you.” Then he breathed on them and said, “Receive the Holy Spirit,” and instructed them to be forgiving. In a similar way, we Americans are huddled in fear of COVID-19. If we are open to it, God’s Spirit will sneak into our hearts to dispel our fears and enliven our hope. That Spirit will inspire us to be forgiving of ourselves and others. We need compassion for ourselves in these difficult times. Furthermore, we can anticipate, especially in this election year, that political blame and conspiracy theories will be tossed around. We will need to be forgiving of all the revealed faults and fault-finding to heal from this national trauma. 

“The power that made us heals us.” That power is Love, the Holy One, who dwells in our hearts. Catch your breath, catch the spirit, and be healed.

Dr. Ortman is the author of three popular MSI Press-published books -- all of which have information relevant to dealing with a pandemic (and many other areas of life):

Anxiety Anonymous

Anger Anonymous

Depression Anonymous

Dennis Ortman, Ph.D., has been a clinical psychologist in private practice in the Detroit Metropolitan area for over 20 years, specializing in treating those with addictions and those who have suffered the trauma of infi delity. Before becoming a psychologist, he was a Catholic priest in the Archdiocese of Detroit for 14 years. He received a doctorate in clinical psychology from the University of Detroit-Mercy and a graduate degree in theology from the Gregorian University in Rome, Italy. With graduate degrees in both psychology and theology, he works with patients on issues at the borderline between psychology and spirituality, employing a mindful approach to therapy. He authored six books on recovery from addictions and infidelity.  He also lectures around the country on utilizing the wisdom of Freud and Buddha in treatment. He is married and has six stepchildren and five step-grandchildren.