All of us can relate to what it’s like to feel stressed—it’s a natural and inevitable part of life. Although painful and difficult, many stressors are temporary, and we typically can bounce back with few lasting effects. However, when adversities arise unexpectedly, are extreme, are long-lasting, and/or far-reaching, it’s understandable for us to feel the physical and emotional effects. Virtually every one of us has shared the experience of a stressor that came out of nowhere. COVID-19 has turned nearly everything we hold dear on its head. Shelter at home measures, for which we have all bravely committed, have cost many of us our jobs and our livelihood, not to mention disrupted the order and routine that offered us comfort in our everyday lives. Quite a few of us have been forced to decide whether we continue to work in the caring professions or at an essential job that keeps our society moving, even when it increases our exposure to the virus. The COVID pandemic has touched many of us personally—some of us may have lost a loved one because of this virus.
Sylvia is a nurse who works in the respiratory intensive care unit of a local hospital. Since the beginning of the crisis, she has cared for many patients who have required invasive ventilation; thankfully, many of them were able to leave the hospital alive. However, she has also offered care and comfort to many patients whose lives were taken by COVID—while their loved ones desperately said their goodbyes remotely. Sylvia also needed to self-quarantine away from her husband and children, without missing a shift at work, before testing was finally available to determine her exposure to COVID.
Jamal is a transit bus driver who is presently taking his second pause in self-isolation because a passenger on one of his recent bus routes tested positive for COVID-19. Jamal lives with his elderly grandmother, who is in good health, but because of his self-isolation, she has needed to take on more duties including shopping outside the home and preparing meals for him. So far, neither of them has shown any signs of the virus, but he is increasingly worried that his grandmother is being put in harm’s way and his income, which supports both of them, is strained during the self-isolation.
Until recently, Dennis worked part time as a server at a restaurant and also drove for Uber and Lyft. When the restrictive sheltering at home rules were imposed, he was immediately laid off from his restaurant job, which was his primary source of income, causing his bills to pile up. Filing for government assistance was difficult and the relief took weeks to arrive. Further, his overall income is a fraction of what he was earning before. Dennis made the tough decision to give up his apartment and move back in with his parents, until the quarantine measures are lifted or he finds steady income in some new position in which he might be able to work from home.
Likewise, Adhira was working in a retail position that was deemed not essential. Her income was providing support for her elderly parents who had joined her from India 2 years ago. Within 3 weeks of her losing her job, Adhira’s father contracted COVID and spent nearly two weeks in the respiratory intensive care unit; thankfully, he was able to overcome the illness, but now the bills are piling and Adhira has not yet found consistent income.
Finally, there is Becky, who works in a law firm as an “Admin” for one of the law partners. When the shelter at home orders were enacted, she initially adjusted to the changes and set up her home office. Becky is a single parent living with her two young children. When the state shuttered all the schools, Becky had to take on the added burden of home-schooling the children, while keeping up with her many job responsibilities. Becky has found herself very scared about the possibility that she or her children could contract COVID. As a result, she spends a lot of time consuming news and trying to figure out how she can make sure she and her children are safe. The decision to go to the store is very troubling for her—she gets frozen with worry as she contemplates what might befall her and her family when they are to leave the house.
Chances are, one or more of these scenarios will feel all too familiar to you and the cumulative physical, emotional, social, and financial impact this crisis has caused is likely leaving you distressed, which is the term we use to characterize the wear and tear such profound experiences can cause. Even if your COVID experience might be different from one of these examples, it would be completely understandable if you have been noticing your own troubling thoughts, intense feelings, and negative consequences. As we move on from the immediate impact of COVID-19, many of us continue to carry in our minds this event, which can take great stores of mental energy to manage and can leave us feeling exhausted and despondent.
In distressed moments, we often experience prolonged anxiety and depressed mood. Prolonged anxiety is characterized by almost constant worry and a sense of apprehension that is difficult to control. Virtually everyone can describe personal examples of times they have felt anxious and worried. It’s a natural part of being human. Anxiety is an emotion associated with a sense of future danger, misfortune, and dread. This means that we can become anxious about things that may or may not actually be harmful or that might never come to be. Nonetheless, anxiety helps us survive by signaling that an outcome is important to us and mobilizing us to act to prevent a possible negative event from happening. When depressed mood is present, it is often accompanied by low energy, sleep or appetite disturbance, loss of interest in things that one once found pleasurable, difficulties concentrating, and a sense of despondency in their lives. Sadness is a common emotion in depression, which acknowledges an important loss or an unreachable goal, allowing for disengagement.
Over the next eight sessions, conducted twice weekly over a period of four weeks, you will meet with an individual ERT therapist who will inquire about how your experience of the COVID pandemic has negatively impacted your life, and you will learn about the ERT model of distress. Your ERT therapist will also teach you skills to notice when you are getting caught in a negative loop of distress and how to free yourself from it.