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Dealing with 'post-pandemic stress': A doctor's guide

While we may be experiencing a temporary spate of optimism as Covid rates plummet, living in a state of hypervigilance for two years has taken a toll on our individual and collective well-being, says Dr. Lucy McBride.
A woman leans in frustration
The American Psychological Association reports that stress among Americans has reached “alarming levels.”Al Seib / Los Angeles Times via Getty Image file

We’ve all seen the videos. A flight attendant waits patiently as an unruly passenger screams, gesticulates, and refuses to put on a mask. Other passengers shift uncomfortably in their seats. Minutes later, police officers arrive to escort the agitator off the plane to the scattered cheers of relieved travelers.

Watching the clip, we tend to identify with the begrudged passengers. We might find ourselves asking, “How could anyone be so selfish and strident? ”But after two years of a global pandemic, we may have more in common with the recalcitrant passenger than we’d like to admit.

The American Psychological Association reports that stress among Americans has reached “alarming levels.” The social, economic and political upheaval of the last two years combined with the losses and uncertainty of Covid-19—not to mention the existential crises of war in Ukraine, climate change and fundamental risks to our democracy—is nothing short of trauma.

No two people will have the same pandemic story, nor will the same events affect anyone exactly the same way. But it’s not a coincidence that the rates of obesity, opiate overdoses, and alcohol-related deaths are up during this tumultuous and socially isolating time.

And while we may be experiencing a temporary spate of optimism as Covid-19 rates decrease and related government mandates are lifted, living in a state of hypervigilance for two years has taken a toll on our individual and collective well-being.

It’s what some medical professionals, including myself, are calling “post-pandemic stress” which is not an official diagnosis (nor does it mean that Covid is gone!) but is characterized by anxiety, mood instability, and mental exhaustion that is interfering with quality of life.

Lucy McBride, M.D., is a practicing internist in Washington, D.C.
Lucy McBride, M.D., is a practicing internist in Washington, D.C.Courtesy of Dr. McBride.

Of course, it’s entirely normal to feel on edge or have trouble sleeping, for example, after traumatic events. It’s also important to recognize that trauma not only affects us emotionally; there are compounding physical and behavioral ramifications. We seek control. We try to self-soothe.

I have witnessed the full spectrum of this trauma response among my patients. Some lean on friends; others seek solitude. Some rigidly adhere to strict diets; others binge on alcohol or sugary foods. Some grieve quietly; others lash out on social media—or at flight attendants—in anger. As trauma specialist Dr. Gabor Mate said, “Trauma is not what happens to you, it's what happens inside you.”

A year ago, we dipped our metaphorical toes into the pool of pseudo-normalcy. Some people dove right in, only to be jolted back to reality with Delta. Others patiently waited for the free-swim whistle to plunge back into life. Then Omicron came, tearing through vulnerable populations and blanketing the country with immunity and a heavy dose of fear.

Even with the BA.2 variant becoming dominant, this time we’re told it’s different. Sharply falling Covid-case rates are paired with widespread (albeit imperfect) protection due to the combination of vaccinations and prior infection. Many are opting not to mask up in public spaces, and employees are back to morning commutes and happy hours. Even the president removed his mask at the State of the Union Address, ushering in a new era of acceptance that “COVID zero” isn’t possible.

Yet nothing is normal. Covid-19 has irrecoverably altered our world—and us along with it. As we emerge from the trauma of the past two years, we will be forced to confront our broken sense of security, our vulnerability and fear, and our new precarious reality. Isolated on screens and masked for two years, we’re being forced to confront each other. We also must reckon with our own unhealthy behaviors.

No matter how one processes loss, this transition out of this pandemic requires us to face uncomfortable truths about ourselves. As a society, we must accept that we’ll never be done protecting our highest-risk populations from Covid-19; that each of us has a unique set of medical vulnerabilities and risk tolerances; and that addressing the structural problems that got us here—from faulty ventilation systems in public buildings to the absence of paid sick leave—will take time and collective resources to fix.

As individuals, we must face our self-sabotaging behaviors and more appropriately direct our angst. Just like the federal government has limited resources, so, too, do human beings under duress.

Healing from this psychological toll requires embracing our vulnerability in situations outside of our control. We can better manage transition, both individually and collectively, by first acknowledging our own trauma response. It requires accepting that we will not have the answers to everything, and that some questions don’t have a clear answer. To do so, we must abandon absolutism and embrace the practice of “holding paradox.”

Holding paradox involves the reframing of our mindset to view issues as “both-ands” instead of “either-ors.” It’s about abandoning black-or-white thinking. It’s about approaching each day with an open, curious mind, instead of the impulse to predict, control, or win every argument. The art of holding paradox is the birthplace of civil discourse, creativity and social change. It’s an essential skill in these highly polarized times.

Abandoning all-or-nothing thinking empowers us to transition through pandemic and war with hope and vigilance in equal measure. In a world that seems to move from one unending crisis to the next, paradox creates space for restorative acceptance in the midst of harsh polarity—and increased empathy for those around us.

As we continue to transition out of the pandemic, we’ll see the unruly plane passenger at school board meetings, at the dog park, and in our social media feeds. It’s easy to dismiss their behavior as “other,” but acknowledging the universality, whether it manifests on an airplane or in a tweet, releases us from judgment and opens the door to recovery.

As Dr. Gabor Mate also said, “We may not be responsible for the world that created our minds, but we can take responsibility for the mind with which we create our world.” Even as we walk the path of transition at different paces, we must center empathy and give ourselves and each other permission to be human—hopefully without the public meltdowns.

Lucy McBride, M.D., is a practicing internist in Washington, D.C. A trusted and recognized voice in patient care, she is the author of a popular Covid-19 newsletter working to increase awareness of the intersection of mental and physical health. Sign up on her website and connect with her on Twitter, Facebook, Instagram and LinkedIn.