The Covid-19 pandemic began in the latter months of 2019 and continues on today - in 2021. It's been two years since the pandemic began, and it will likely linger on for three years unless an "endemic" is declared.
For many people, the pandemic has been stressful, and for many others,
the pandemic has been traumatic.
When the trauma is systemic, global, and ongoing, such as with pandemics or world wars, domestic violence cases, human trafficking traumas, immigration/migration traumas, and secret childhood maltreatment traumas (never reported so therefore ongoing), it is said to be continuous traumatic stress.
Continuous traumatic stress differs from post-traumatic stress by the first term in those two phrases - the former being "continuous" (very present, almost daily), and the latter being "post" (in the past).
There were publications about
continuous traumatic stress in special journals back in 2013, but they could very well apply now - in this present-day pandemic. According to the American Psychological Association,
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Continuous traumatic stress offers one possible way of describing the psychological impact of living in conditions in which there is a realistic threat of present and future danger, rather than only experiences of past traumatic events, and foregrounds the difficulties of addressing past exposure in the context of an accurate appraisal of the potential for current and future harm.
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In the context of continuous traumatic stress among
racial trauma survivors, whose historical traumas and systemic traumas have continued to present traumatic stress among the lives of those affected, the American Psychological Association has the following tips offered to those who experience such systemic widespread traumas. These tips can certainly apply to the racial traumas that Asians have experienced in the past (Yellow Peril, slave trades with both African Americans and Chinese Americans, Internment Camps for the Japanese), but they can also similarly apply to ALL PERSONS EXPERIENCING PANDEMIC TRAUMA, which is a form of continuous traumatic stress - and perhaps, on a continuum scale, much more severe than "pandemic stress."
Here are the tips from the APA that can apply to many forms of continued traumatic stress, including racial trauma and pandemic trauma. REPLACE "RACISM" WITH "PANDEMIC TRAUMA" or "PANDEMIC STRESS" unless pandemic-related racial trauma is also something you are struggling with on top of pandemic trauma:
1.
PANDEMIC Example: I'm afraid all the time of death, of others dying, of contracting or spreading disease.
PANDEMIC Example: I can't concentrate or enjoy life anymore because I can't stand how long this pandemic goes on, and I lost hope in the pandemic ever ending. I don't know how this will affect my life, my children's lives, my career, and my relationships. I fear the life I knew is completely over.
2.
PANDEMIC Example: I'm angry about how politicized and weaponized this pandemic has become, and how the news and society perpetuate it. I'm angry about how we can't process this in the open with anyone, and how therapists aren't trained yet to treat it because of the lack of communication on these very issues, the politics involved with all the various struggles, etc.
PANDEMIC Example: I'm angry about losing many relationships, and about people dying from Covid-19 in my life. I'm angry that the people who survived it are now so different because they struggle with long-Covid and can no longer afford to hang out - physically or financially. I'm angry about how this pandemic has changed all of us.
3.
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PROTECT YOUR MENTAL HEALTH
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3a.
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Limit your media intake. News coverage and video of people being assaulted, harassed, or even killed because of racism can cause trauma and trigger negative reactions. Take breaks from the news and social media when you can.
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PANDEMIC Example: Take a break from certain political discussions, political news, pandemic-related news, negative news, etc. Set aside just one hour a day or even one hour a week to read such negative news and/or engage in negative topics if these topics are distressing you.
PANDEMIC Example: Set boundaries with yourself and others to limit political conversations.
3b.
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Tap into social support and connection. Lean on friends and family and participate in culturally affirming activities. Connect with your faith community, neighbors, or other support networks.
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Ergo:
Find your tribe - or healthy tribalism as an adaptive coping response to systemic traumas, historical traumas, and continuous traumatic stress.
AN EXAMPLE OF
ADAPTIVE TRIBALISM - "Tribalism is human nature."
PANDEMIC Example: If you are Asian and experiencing anti-Asian racial traumas, seek support from Asian communities who understand the culture for which you struggle with anti-Asian biases, hate, bigotry, discrimination, etc. (such as the "model minority myth" - which differs drastically from other minorities of other races and ethnic backgrounds experiencing racism).
PANDEMIC Example - If you are a religious conservative, or if you are a progressive liberal, find those with like-minds, like-values, like-beliefs and seek support from them regarding your own personal (tribal) experiences, struggles, traumas, and more. Avoid being stressed out with endless debates by finding your tribe and getting the validation and support you need, especially in times of great divide, war, or community violence.
3c.
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Take care of yourself. Eat healthy food, get enough sleep, and move your body. Those basic principles will give you strength to get through another day.
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PANDEMIC Example: Cut down on unhealthy food and begin eating healthier foods to boost your immune system. If you need more help, seek support online, seek medical support, and/or see psychological support.
PANDEMIC Example: Work on sleep hygiene routines, and keep those routines consistent. If this doesn't work, seek therapy or medical advice to help with this.
PANDEMIC Example: You don't need to exercise to get movement in your body and get your blood flowing. You can do house chores, bed yoga, pacing, etc.
3d.
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Let yourself feel hope. While it can be difficult to tap into hope at such times, it’s important to acknowledge small signs of change and believe that those small changes will lead to something better.
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PANDEMIC Example: Vaccines offer hope that at least most severe infections and death from Covid-19 will be best managed with vaccines and boosters. Studies have already shown progress in this area, even though there may be breakthrough cases and/or cases from mutations.
PANDEMIC Example: Social distancing and mask-wearing have offered hope in terms of keeping ourselves and others safe from severe and massive doses of virus. Studies have shown that the viral load counts toward whether or not someone receives infectious doses of virus that can lead to disease, and how severe such disease will be. The lowered the dose of virus, the lowered the risk of severe infection.
PANDEMIC Example: There are safety protocols in place to help us socialize and work in person - with precautions, of course.
3e.
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Seek therapy. Racial trauma can lead to serious mental health consequences such as depression, anxiety, or even PTSD-like symptoms. If you are struggling, talk to a racial trauma-informed therapist about what you are going through. They can help you work through your feelings and strategize ways to cope.
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PANDEMIC Example: In this case, talk to therapists who understand continuous traumatic stress and how it differs from post-traumatic stress. Perhaps speak with therapists about pandemic trauma and how it differs to you in terms of it being more intense than the "pandemic stress" being spoken about in the news and other media outlets.
PANDEMIC Example: Also talk with therapists who may understand racial traumas if you are any person with any background (minority or majority) experiencing racism - either as the victim, victim-offender, or offender. There are therapists who can help those who grew up in racism - whether you were a victim, offender, or both.
Here are some references related to the pandemic being a traumatic stressor:
Bridgland et al. (2021). Why the COVID-19 pandemic is a traumatic stressor. PLOS ONE, https://doi.org/10.1371/journal.pone.0240146.
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The COVID-19 pandemic does not fit into prevailing Post-traumatic Stress Disorder (PTSD) models, or diagnostic criteria, yet emerging research shows traumatic stress symptoms as a result of this ongoing global stressor. Current pathogenic event models focus on past, and largely direct, trauma exposure to certain kinds of life-threatening events. Yet, traumatic stress reactions to future, indirect trauma exposure, and non-Criterion A events exist, suggesting COVID-19 is also a traumatic stressor which could lead to PTSD symptomology. To examine this idea, we asked a sample of online participants (N = 1,040), in five western countries, to indicate the COVID-19 events they had been directly exposed to, events they anticipated would happen in the future, and other forms of indirect exposure such as through media coverage. We then asked participants to complete the Posttraumatic Stress Disorder Checklist-5, adapted to measure pre/peri/post-traumatic reactions in relation to COVID-19. We also measured general emotional reactions (e.g., angry, anxious, helpless), well-being, psychosocial functioning, and depression, anxiety, and stress symptoms. We found participants had PTSD-like symptoms for events that had not happened and when participants had been directly (e.g., contact with virus) or indirectly exposed to COVID-19 (e.g., via media). Moreover, 13.2% of our sample were likely PTSD-positive, despite types of COVID-19 “exposure” (e.g., lockdown) not fitting DSM-5 criteria. The emotional impact of “worst” experienced/anticipated events best predicted PTSD-like symptoms. Taken together, our findings support emerging research that COVID-19 can be understood as a traumatic stressor event capable of eliciting PTSD-like responses and exacerbating other related mental health problems (e.g., anxiety, depression, psychosocial functioning, etc.). Our findings add to existing literature supporting a pathogenic event memory model of traumatic stress.
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Kira et al. (2021). The effects of COVID-19 continuous traumatic stressors on mental health and cognitive functioning: A case example from Turkey. Current Psychology, https://doi.org/10.1007/s12144-021-01743-2
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Abstract
There is a need to accurately assess the specific impacts of the various traumatic stressors caused by COVID-19 on mental health. The goal was to evaluate the impact of different types of COVID-19 stressors (infection fears, lockdown, and economic stressors) on mental health and cognitive functioning. We used a sample of 262 Turkish adults. We administered an online questionnaire that included measures of COVID-19 traumatic stressors, PTSD, depression, anxiety, executive function deficits, and cumulative stressors and traumas (CST). The analyses included correlations, hierarchical regression, path analysis, and PROCESS mediation analysis. All COVID-19 traumatic stressors types and their cumulative load predicted PTSD, depression, anxiety, and executive function deficits after controlling for previous cumulative stressors and traumas and COVID-19 infection. COVID-19 lockdown’s stressors were the strongest predictors, compared to COVID-19 fears and economic stressors. Path analysis and PROCESS mediation results indicated that COVID-19 traumatic stressors had direct effects on working memory deficits, direct and indirect effects on PTSD, depression, and anxiety, and indirect effects on inhibition deficits. Anxiety, depression, and inhibition deficits mediated its indirect effects on PTSD. The results have conceptual and clinical implications. COVID-19 continuous posttraumatic stress syndrome that includes comorbid PTSD, depression, anxiety, and executive function deficits is different and does not fit within the current trauma frameworks. There is a need for a paradigm shift in current stress and trauma frameworks to account for the COVID-19 continuous global stressors and for clinical innovations in intervention to help its victims.
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