I was recently asked if I thought the pandemic is a national trauma. The answer is a simple “Yes.” By the standards of the DSM-5 (Diagnostic and Statistical Manual), the volume used by mental health professionals to guide diagnosis and treatment, the COVID-19 pandemic meets the criteria for trauma.
Not all stressful events meet those criteria. The DSM-5 definition of trauma requires “actual or threatened death, serious injury, or sexual violence” (italics mine). Stressful events not involving an immediate threat to life or physical injury (such as a divorce or job loss) are not considered trauma in this definition.
COVID-19 does threaten everyone in the U.S. (indeed, everyone globally) with death. That is not an overly dramatic statement. The number of deaths by COVID-19 in the U.S. keeps climbing. At this writing, more than 65,000 Americans have died. Projection of the number of future deaths is difficult because of the lack of solid data and because how well people will comply with social distancing guidelines going forward is unknown and unpredictable. One model used by the White House projects close to 82,000 COVID-19 deaths in the United States by August 4, assuming the country implements full social distancing until the end of May. That assumption is a big “if.”
But does exposure to the trauma that is COVID-19 mean that you will develop Post Traumatic Stress Disorder (PTSD)? Probably not.
According to data from National Comorbidity Survey Replication (NCS-R), An estimated 3.6% of U.S. adults had PTSD in the past year, despite the fact that it is estimated that 70% of adults in the U.S. have experienced a traumatic event at least once in their lives.
Why do some people develop Post Traumatic Stress Disorder in response to trauma while the majority do not? The answer lies with the number and strength of one’s coping skills. PTSD develops when the trauma of a huge stressor overwhelms someone’s ability to cope.
When a person under the high stress of a traumatic event has a variety of reliable coping skills, they can manage a traumatic event and not develop symptoms. Due to some combination of temperament, upbringing, adult development, or just plain luck, they have the attributes and skills necessary for coping. Years from now these individuals will remember the pandemic as a rough time to go through but not as something with enduring negative effects.
The differences between those who cope and those who develop PTSD are many. Some people are by nature more sensitive to stress than others. Some are chronically under such high stress their resilience is already taxed. People suffering from medical or mental illness or substance abuse; people who are living in abusive relationships; people who are homeless or at risk of homelessness; and those who cannot isolate due to overcrowded living situations and lack of money and resources are among our most vulnerable groups. None the less, many have been fortunate enough to have a core of inner strength, a history of coping with duress, and a strong support system and will manage the epidemic without developing PTSD.
Those who do develop symptoms of PTSD are not at fault. No one decides to be vulnerable. No one decides to be overwhelmed. People who become symptomatic with PTSD need practical assistance and supportive mental health care, not criticism.
6 Ways to Prevent PTSD
If you were born with a more relaxed temperament, if you already have reliable inner coping skills and a supportive social circle, the risk of developing PTSD is low. Work on maintaining and developing your skills for coping. Here are the top 6:
- Recognize and validate that you are grieving life before COVID-19. Being upset, sometimes in denial, sometimes irritable or angry or sad, are all normal stages of grief. Let yourself feel and express your feelings.
- Work on getting to acceptance: We may never get back to whatever we thought was “normal.” Appreciate what you have. Love the people you love. Be grateful for your health and ability to manage. Accept that being “okay enough” is a reasonable goal.
- Be positive about social distancing: Until there is a vaccine, routine testing, and contact tracing, this is what is. Engage in practicing social distancing as a survival tool for you and everyone around you.
- Stay connected: Social distancing doesn’t mean staying socially distant. Stay connected with others through technology, safe distancing while going on walks, or talking to neighbors from your balconies or driveway. Write letters. Make phone calls. Join support groups and interest groups online.
- Accept the challenges of life as it is for now. People who thrive are those who see difficulties as problems to solve. It’s difficult to stay at home. It’s hard to home school or manage kids who can’t see their friends. It’s challenging to stretch your budget and stretch out what’s in the pantry. Put your creativity and imagination to work to find ways to manage.
- Be a helper: Those who support others are generally mentally and physically healthier than those who don’t. Sew masks. Volunteer to tutor your neighbor’s kids online to give mom or dad a break. Check in with people who live alone or are lonely. Look around for needs you can help answer while still staying safe.