With more than 500,000 dead and no clear end in sight, some have found tools for coping with loss and stress are no longer working.
Stephanie Schroeder, a writer and peer support specialist, has been working 35 hours a week at a New York City homeless shelter for most of the pandemic. Schroeder spends her days up close with vulnerable populations including homeless women with a lifetime of trauma and mental illness, she says who are feeling some of the harshest effects of the virus.
When her days are done, she returns home and tries to decompress by talking with her sister on FaceTime, listening to music, scrolling through social media, or eating dinner with her partner. But, she says, I do lie on the couch and stare at the ceiling a lot. These days, shes totally burnt out and experiencing a lot of secondary trauma. Shes grateful for the privileges she has, but trying to get through the pandemic has proven challenging.
Nearly a year into it, Im not sure what I can do to feel good. All my reserves are depleted, she says. She doesnt know who to ask for help or of what kind of help to ask for.
But Schroeder, who has bipolar disorder, has taken steps to care for her mental health before. Pandemic grief is something different. Ive been in therapy for decades and know very well how to ask for the help I need. I just dont think the help exists.
More than 500,000 people in the US have died from Covid-19 mothers, fathers, and grandparents, friends, and neighbors. Thats on top of the jobs, homes, and school days, as well as the favorite restaurants, music venues, and stores, that have been lost or shuttered in the economic fallout. Like Schroeder, some have arrived at a new nadir of the pandemic, where the tools previously used to cope with the unprecedented loss and stress no longer seem to work. Instead, many Americans are reaching a new level of profound collective grief, for those lost and for an entire way of life that appears increasingly unlikely to resume as it once was.
And the losses keep coming. Covid-19 positivity and death rates continue to climb, and distribution of the new vaccines, a rare flash of hope during this dire time, has been mired by logistical issues. Health care workers are increasingly leaving their jobs due to fear and a lack of support; grocery workers are no longer getting hazard pay and dont feel protected from the virus while on the job. Teachers are being stretched to their limits. People are losing their homes. An estimated 30 million Americans could face eviction if moratoriums expire; many dont know when theyll be able to have secure housing ever again.
These conditions, combined with the duration of the pandemic, are causing many people to struggle with the loss of their resilience muscle, says Sherry Cormier, a psychologist and bereavement specialist who authored the book Sweet Sorrow: Finding Enduring Wholeness after Loss and Grief.
Back in March, we had a lot of zest. We thought we could get through this and rise to the challenge. But the longer this goes on, the climb gets harder and harder, Cormier says. We are definitely in a mental health epidemic.
Nick Francis, a filmmaker, says he didnt experience severe mental health issues before the pandemic. But in August 2020, when Francis was quarantining at home alone in Oakland, California, he lost one of his closest friends; just before Christmas, his grandfather died. Neither death was caused by the coronavirus, but the inability to mourn with others in his community has hit him harder than he could have imagined. The loss and his continued isolation from others has left him feeling like some sort of a golem, he says, a creature designed to continue to function, continue to write, create, to live but each part slowly replaced with something artificial and mechanical until there is nothing left but engines and gears.
Francis is not alone. The 2020 Stress in America survey, conducted by Harris Poll on behalf of the American Psychological Association, found that 19 percent of the nearly 3,500 adult respondents said their mental health was worse than at the same time last year. (The poll was conducted from August 4 to 26.) And, like Schroeder, 60 percent said the number of issues America faces was overwhelming to them.
Mourning the death of a loved one or being thrown into economic uncertainty is doubly difficult when people are forced to reckon with it alone. But even the small things can have a crushing cumulative effect on mental health, as many have had to give up parts of their lives that once seemed guaranteed going to a friends house, eating in a restaurant, or even taking an unmasked walk.
Laura Sinko, a postdoctoral fellow at the University of Pennsylvania and a mental health nurse with expertise in trauma recovery, told Vox that the grief around Covid-19 has a far bigger footprint than we might think. She cited one study, published by the Proceedings of the National Academy of Sciences in July 2020, which estimated that every death from Covid-19 will leave approximately nine bereaved.
But, Sinko adds, the effects extend beyond the number of lives lost. What about the other things we grieve for the deaths unrelated to Covid, the missed milestones with family and friends, the lack of accountability from systems supposedly put in place to protect us? she asks. The layers of cultural trauma we experience on top of our personal losses can feel all-consuming. We are isolated. We are lonely. And we are all, in some way, grieving.
At the beginning of the Covid-19 pandemic, I was also panicked, terrified, and lost. But I knew I needed to find a way to cope, especially since I have bipolar disorder and was recovering from a recent suicide attempt.
To escape constant thoughts of suicide or to at least gain distance from those thoughts I found that I had no choice but to rally. I helped distribute personal protective equipment to front-line health care workers, started a mutual aid fund at Howard University for survivors of sexual violence, and, like others, gave astronomical tips to Instacart delivery workers who were risking their lives to bring people food and being underpaid and mistreated for it.
For a while, it felt like my community and I were working together, filling the gaping holes of care and responsibility left by the Trump administration. In the middle of the pandemonium, we at least had the small comfort of solidarity.
Many of us tried to save each other and tried to save ourselves. People gathered in parks 6 feet away from each other, longing to embrace but having to be content just to see each others faces. Some baked bread, cooked, cleaned, crocheted, and Zoomed to the point of exhaustion. Others refused to wear masks or continued to live their lives normally, whether out of denial, boredom, or a lack of resources to take these steps.
A year later, not much has changed. A year is a long time to keep baking bread.
As winter drags on, people must reimagine the ways theyve been surviving the pandemic, says Apryl Alexander, a clinical and forensic psychologist and an associate professor at the University of Denvers Graduate School of Professional Psychology. With economic strain and cold weather comes the loss of many of the activities online shopping and outdoor activities that were giving us distractions and connections, Alexander says.
Meanwhile, federal and local governments alike have failed to close down businesses and large gatherings and provide economic support, or even sound medical advice. The Covid-19 death toll in the US is more than 100,000 people higher than it was when I started working on this story just weeks ago. That number is unfathomable to me. The desensitization I feel from the constant death is also unfathomable. Death has also made me desensitized to it.
It is important to know that despite the governments rampant neglect, there are people doing good work and we need to try to hold on to hope.
Collectively, we are living in a time of deep tragedy, but grief can teach us how incredible our capacity to love is, says Sinko. We must hold space for ourselves and connect with those around us during these times of uncertainty, even as our resilience rapidly fades.
I am trying not to succumb to that, says Francis. Instead, he says, he is trying to relearn how to live.
For the young, particularly members of Gen Z, the new grief threatens to consume formative years. The Stress in America survey found that 34 percent of 18- to 24-year-olds said their mental health has gotten worse nearly double the overall percentage of respondents who said the same.
Debora, who asked that Vox withhold her last name for privacy reasons, is missing her first year of college due to the pandemic and says the crushing loneliness has taken an incredible toll.
Shes experiencing symptoms of major depression which can include disruptions in sleep or eating patterns; feelings of guilt, hopelessness, sadness, anxiety, and irritability; and even suicidal ideation but social media conversations about mental illness have made her reluctant to say shes clinically depressed.
I dont want to self-diagnose because apparently people dont like that very much. But I think I may be depressed, she says. Despite her symptoms, Debora hasnt been able to access mental health resources she simply cant afford it, and she doesnt want to add an extra expense for her parents.
Covid-19 has led to a rise in therapy alternatives, including online programs, as people seek to address the new grief. Rich Birhanzel, a senior managing director at Accenture who leads the companys global health practice, says, Younger consumers both millennials and Gen Z are especially open to engage in virtual behavioral health services. But even some of the least expensive online therapy programs can still cost between $65 and $150 a session, an insurmountable expense for many young and/or marginalized people.
Thats another reality of the coronavirus pandemic: While there is a collective trauma, that trauma has affected people differently, Cormier says, especially teenagers and people of color like Debora, a Black woman and first-year college student.
Kalen Kennedy, a doctoral candidate at Marquette University and a clinical therapist who specializes in pediatric psychology, told Vox that one of the most prominent characteristics of this new stage of grief is that the were all in this together feeling is gone, having been replaced by desensitization.
Combined with the feeling that many people are living their lives as though everything is back to normal traveling, eating out, even going to clubs it makes your distress and grief feel more individual than collective, Kennedy says. When grief feels individual, that can present as more severe depression.
It doesnt help, Kennedy adds, that the government speaks about the pandemic in a way that makes us feel like its our responsibility to fix it ourselves, but the government isnt really doing anything but blaming us.
The result is a culture of shaming, only amplified on social media, that has strained or even ended relationships, friendships, and family relations. But how long were people going to stay at home, sitting in their grief, before they decided to come out, regardless of the risks?
Its this uneven experience of this pandemic that makes even excellent news, like the approval of Covid-19 vaccines, feel fraught. Questions of priority of distribution feel overcast by grief and uncertainty and injustice.
And how will it feel when one person in a household or a friend group gets a vaccine and others dont? What will that do to end the loneliness and fear, when only one of your loved ones is protected? And with most of us not receiving the vaccine for many months months in which we must remain isolated, focused on surviving how long will it be before we get some semblance of our lives back?
Former acting US Surgeon General Kenneth Moritsugu an early advocate for exercise as a form of self-care and health management during the pandemic tells Vox that as a scientist, he views the vaccines as fabulous, lifesaving news. But he acknowledges that many mght still feel despair and exhaustion.
My wife, myself, and our teenage daughter are feeling exactly the same sense of exhaustion: How long do we have to be here, practicing these isolation techniques? he says.
Sinko says we need policies that address our grief, including how to safely memorialize our dead. While we need to give ourselves permission to mourn our losses, we also need policies to support healthy processing to avoid a rise in disenfranchised grief, she said. This means universal paid bereavement time, socially distanced and virtual community mental health support, and careful contact tracing and consultation with public health experts as we adapt the way we gather to celebrate the life lived of those we have lost.
If our grief is collective, our healing needs to be collective, Cormier says. Social media can be a way of doing it. But we need collective rituals and support.
I wake up every day and ask myself that question: How long? Some days, the self-care activities I started in March like yoga and dressing up in nice outfits with nowhere to go still work, and Im full of joy. But those days are fewer and fewer, and surviving the pandemic has started to feel like a Sisyphean feat: hopeless and painful. I miss my friends so much it hurts, and I cry more than I used to.
Im fortunate not to have to worry about basic survival, like feeding or housing myself. Yet I find myself exhausted. Part of it is that the injustice seems never-ending it feels like everyone is fending for themselves, making their own rules and disregarding others. It seems like nothing is working; not our activism, not our self-care, not our hope. My resilience muscle, as Cormier calls it, has gone soft, and I have no idea how to get it back.
Such ambivalence is understandable and common, given the massive uncertainty surrounding vaccine distribution, Cormier says. Uncertainty is troubling to people in general because it makes us feel like we dont have control, which we dont. I believe that control is an illusion; we like to think that we have control.
And that dissipation of the illusion of control, Cormier says, really challenges our resilience, how we think about things and how we engage in self-care, like building routines with good sleep, exercise, and eating well.
Being resilient is work, says Moritsugu. Attempting to survive Covid-19 is a physical and mental stressor on our bodies and our psyches.
Over the last nine months, we have not really seen the light at the end of the tunnel, he adds. But with the vaccine on its way, he urges people to hang in there and have hope. Its already reaching some who need it most: At the homeless shelter where Schroeder works, both residents and workers are eligible to receive the vaccine. She already has an appointment.
And theres more reason for hope. On January 28, the New York Times reported that coronavirus cases have fallen 35 percent over the past three weeks in the US the sharpest decline weve seen.
But upon hearing this news, Jennifer Nuzzo, an epidemiologist at Johns Hopkins University, told the New York Times, I like the trends we are seeing, and I am personally hopeful that things are going to get better. But there are a number of things that could also go wrong.
Its not surprising that amid the new grief, people may have a hard time feeling joy when they hear even hopeful news, Kennedy says. Weve been given so many promises that have been taken back. Weve improved things only for them to get worse. It makes people less likely to trust.
Cormier says there are positive things we can grasp. Grief brings sorrow, but it also brings gifts. We can find out something about our inner sense of strength that we didnt know we had, or gain resources we didnt know we had access to before. As we look at what weve lost, at the same time we can try to identify, Are there things that we have actually gained? Are there ways in which weve actually grown?
And that answer, Cormier points out, is different for everyone. Grief is a spectrum. And so is hope.
Nylah Burton is a writer based in Denver, Colorado. Her work has appeared in New York magazine, Essence, and British Vogue.