“What If the Pandemic Ends and I’m Still Anxious and Depressed?”

“What If the Pandemic Ends and I’m Still Anxious and Depressed?”

Follow these three principles to build back a life you love.

Posted June 7, 2021 By: Seth J. Gillihan Ph.D.

KEY POINTS

• Pandemic-related restrictions have challenged us in unprecedented ways.
• Many of us will continue to struggle with our mental health after the pandemic.
• Mindfulness-centered cognitive behavioral therapy offers three powerful ways to reclaim health and happiness.

My personal quarantine and mental health collapse began long before the COVID pandemic. A prolonged illness forced me to reduce my weekly activities to the essentials: cooking, grocery shopping, a few hours of work, the daily duties of raising young kids. I had even started seeing my remaining patients from home by video conference, half a year before therapists everywhere were Zooming with their clients.

The social isolation during this period was profound. One of my most vexing problems was difficulty with my voice. At home, I communicated with my wife and kids primarily through nods and gestures, and rarely spoke with anyone about my internal world. Predictably I fell into a deep depression as my world constricted. I had frequent thoughts of ending my life, though thankfully my desire never led to action.

COVID-related restrictions have diminished the worlds of countless people in ways that are startlingly similar to what I experienced. Many of us have spent endless hours alone in a virtual world, staring at a screen as we worked from home. Zoom meetings came and went, but the scene never really changed.

I worry about my own children’s mental health, since we know from longitudinal studies that children who experience social isolation and emotional difficulties are more likely to develop conditions like anxiety and depression later in life. I’m also aware that my history of depression increases the likelihood that my kids will face their own mental health challenges at some point.

Mercifully I found my way back from depression through the steady love and support of family, along with effective treatment—a version of the same mindfulness-centered cognitive behavioral therapy that I offer to patients. CBT is well-established as a first-line therapy for common conditions like depression. These approaches can be the key to unlocking life again.

Think: Cognitive Therapy

I addressed my thoughts—the cognitive part of CBT—by questioning the false stories my mind was telling me, like that I was pathetic for being sick. We don’t have to make ourselves believe happy thoughts; it’s often enough simply to recognize that our minds are creating thoughts, and to acknowledge that what we think isn’t always true.

Act: Behavioral Therapy

I also used behavioral activation, the inverse of quarantine: gradually doing more activities that are rewarding because they’re enjoyable or they bring a sense of accomplishment (both of which are lacking in depression). For example, I started gardening during this time, which checked both of these boxes. Plan to go slow as you get back to life, giving yourself time to ease into it. Also, be sure that the activities you choose are ones you actually want to do; make the cost low and the reward high so it’s easier to follow through.

Be: Mindfulness

I practiced mindful presence, as well—the third pillar of CBT—by letting go of my habitual judgments of myself and my situation, and instead opening to what each moment offered. When we manage to embrace life just as it is, we can find a profound peace that’s independent of our circumstances.

Society-wide behavioral activation has already begun throughout the U.S. Schools, office buildings, restaurants, and other businesses are reopening, and we’re able to resume many of our everyday activities. My younger two kids recently started full-time, in-person school, and our son is playing tennis again.

Human beings are remarkably resilient, and the removal of pandemic-related restrictions may lift the cloud that’s been hanging over our lives. But for many people both young and old, more than a year of social distancing will cast a longer shadow. Many of us will continue to struggle despite the resumption of normal activities.

This is what I would tell any child or adult who’s feeling hopeless and dispirited even as the world opens up again:

Think: Your mind will tell you all kinds of stories at a time like this. The most upsetting thoughts can feel the truest, but will almost certainly be false. You are not a burden, even if it feels that way. Sometimes we even think the people we love would be better off if we were dead. I promise you that will never be true. If you have those kinds of thoughts, you don’t have to carry them alone. Please tell someone you trust who can help you.

Act: There are life-giving activities you can do that will make you feel better, which might seem hard to believe right now. Many of them are exactly the ones you won’t feel like doing—simple things like going for a walk or seeing a friend. I know at times the idea of doing anything will feel like too much, but even the smallest step can make a real difference. Prioritize activities that connect you with the people who make you feel more alive.

Be: Pause for a moment each day to take a slow, easy breath in and out. Feel the place deep within you where love is always available. Most of all, remember this: You are going to be OK—not because everything’s going to go the way you want it to, but because you will find the strength to meet every challenge.

Here are three simple practices to get you started, adapted from the CBT Deck for Kids and Teens (and suitable for all ages):

Think: How Bad Would It Be?

Sometimes our brains tell us something really bad is going to happen. But the reality is that it usually won’t be as bad as we fear. Instead, it will simply be a challenge we can deal with. So if you’re worrying about something today, picture yourself taking care of whatever it is. Remember that you are built to solve problems.

Act: Make It Imperfect

Sometimes we don’t want to try a new activity because we’re afraid we’ll mess it up. But it’s OK to make mistakes. Think of something you’ve been wanting to do, like a new sport or hobby. Plan to do it even if it’s not perfect. If you worry about getting it wrong, remember your goal: to do the best imperfect job you can.

Be: Breathe and Relax

When you need to unwind and release tension, sit in a quiet room with your eyes closed. Take three slow, calming breaths, counting to five each time you breathe out. Now, squeeze your hands into fists. Then let your hands totally relax. Take three more calming breaths. Repeat the hand squeezes one more time. End with three more easy breaths. Then just notice how you feel.

It’s not a personal failing to struggle with your mental health due to the pandemic. It’s an understandable reaction to a really strange and difficult time. As hard as it may be right now, these challenges can make you grow in ways you haven’t imagined.

References

Gillihan, S. J., & Gillihan, A. J. L. (2021). The CBT deck for kids and teens. Eau Claire, WI: PESI.