During a pandemic, your body is the biggest thing there is.
I live in New York, a city where, under pre-pandemic circumstances, you can feel everything and nothing at once. But since the first coronavirus case was confirmed here, my life, like the lives of many others, has been contained, no longer ping-ponging from one address to the next (a last-minute happy hour, the train station, my boyfriend’s place, my workplace), but stationary.
Each day is stunningly, sometimes achingly similar, its dullness offsetting shifting moods that burn brighter than ever. This is a collective struggle. We are all, in some way, deeply aware of our bodies and the bodies of others—their health, their value, their proximity to harm. The crisis has put a spotlight on our bodies: right now, there is no more important landscape to maneuver, to understand.
This is true not only with regard to physical health, but mental health—though many are either unaware of, or don’t know how to apply, those connections. Speaking personally, assessing my mental health feels disorienting and overwhelming: I feel mostly fine, then feel inexplicable flashes of rage, numbness, or brain fog. The morning brings anxiety, while the afternoon may lead me into a mild, depressive funk. Like many people, I will diminish or brush past the worst of my moods, eager to move on from them. When people inquire how I’m doing, I say I’m taking it “day by day,” which is another way to say that I’m scared—uncertain and anxious about what each day might bring. Sometimes, it brings nothing. Other times, I feel so heavy with despair I can’t get myself out of bed.
I say this knowing I’m one of the lucky ones. I feel impossibly lucky to still be working, even if the stories I cover often leave me feeling depleted and hopeless. I still laugh and share memes. Still find so many little joys: the sizzle of longganisa sausage in a pan, the tall stalks of green onions growing from an old gelato container on the window. I tell myself everything is okay until my body says otherwise: the indigestion that’s lingered for weeks (despite no changes to my diet); the nights where my body just gives out at 6 pm, my body overwhelmed in a way my mind refuses to acknowledge. The quickened breath and shivering that accompanies an anxiety attack. I can lie all day about how fine I feel; my body can’t.
The reality of the pandemic, and the recession that is following it, means that we will collectively cycle through these feelings of anxiety and depression for months to come. Even if there were a vaccine available tomorrow, people would still need time to recover from the massive disruption that the coronavirus has wrought.
With so many people simultaneously working through the same feelings, it’s more important than ever to not only develop a vocabulary for what we’re experiencing, but to apply that language to our bodies; to listen to what our bodies have to say about how we feel, and what we need.
Anxiety and depression are ubiquitous feelings right now because we are in the middle of a major global disruption, the scale of which we still don’t fully comprehend. But that ubiquity can also mean a lack of clarity: Is it anxiety that’s gripping you today? Or burnout? Or depression?
I spoke to a longtime friend, mental wellness advocate and therapist Jor-El Caraballo about the difference between chronic stress, anxiety and depression to gain a little clarity.
“There’s a difference between experiencing anxiety, experiencing depression, and having a clinical condition,” he told me. “We can cycle through tiers of anxiety throughout the day, and depression throughout the day. Whereas when you talk about it from a clinical standpoint, it’s actually a sort of ongoing disruptive experience. It just gets in the way of functioning over a certain period of time.”
He and other therapists typically draw that line at a minimum of two weeks, but the degree of the disruption is also key, he says. Stress, on the other hand, is more neutral in nature and concerns your body’s response to external stimuli.
But the key to understanding anxiety and depression is knowing that they’re not binary options. They are conditions that exist on a continuum: depression, for instance, could manifest as an overwhelming, inescapable sense of sadness, or as numbness (the intensity, in either case, can vary). The latter, by its very nature, can be harder to monitor, which is why recognizing how these conditions show up in your body is key.
The relationship between the mind and body has been well documented across cultures and time periods, but there is particular interest lately in the body’s relationship to chronic stress and trauma. An array of recent pop psychology books have pushed this research to the fore, including Bessel van der Kolk’s book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. The New York Times bestseller draws upon Dr. Van der Kolk’s extensive research into how trauma shapes the body and mind to argue that trauma is a public health issue.
With his clients, Caraballo prioritizes developing a language for what they’re feeling but also calls them to pay attention to where they’re feeling these emotions in order to help them establish a connection between their mental health and physical wellness.
“These things are inextricably linked,” Caraballo said. “Generally, we don’t know our bodies well enough, just period. And being able to connect them, connect sensations or internal physical feelings to emotion is a real special skill that we’re rarely ever taught.”
One exercise he takes them through is body mapping—identifying where certain emotions live in the body. When you feel distressed or anxious, do you start picking at your hands or biting your nails? Do you develop tension headaches? Where would you map shame in your body, or loneliness?
He uses his patient’s answers to help them connect the dots between physical sensations and more cerebral feelings, helping them identify cues for when they’re feeling unhappy, worried, secure, or comfortable.
I know how easy it is to overlook these cues.
Near the start of the pandemic, I had an anxiety attack triggered by a tense exchange at work. I didn’t realize what was happening at first because it was a feeling that had become relatively familiar over the previous six months. I read the same sentence on my laptop over and over for hours, my heart racing, fighting back tears and waves of anger. The frustration spiraled into panic. It wasn’t until I felt myself shivering that I finally understood what was happening. I wasn’t just frustrated or upset: this was an anxiety attack.
In hindsight, my body had been warning me that I was burnt out for a long time. For months, I endured these attacks, as well as waves of fatigue that would hit me at random times during the day; brain fog that made it hard to concentrate for even short periods of time; weight gains; erratic sleep; a once-strong stomach that would be irritable for days on end. I somehow didn’t connect any of this to what I was going through for the bulk of 2019—easily one of the most challenging years I’d ever experienced.
In the spring, I had one final confrontation with a stalker who had been showing up at my apartment for months. Weeks later, I would learn that I had the BRCA gene—a mutation that greatly increases the risk of developing breast, skin, and ovarian cancers. Not only did my body feel like a time bomb, but I would have to start planning interventions—preventative mastectomies, the removal of my ovaries—I never imagined I would have to undergo. Uncertainty and tension at my workplace loomed large, a fact that is unfortunately not unique among digital media companies but has been both intense and prolonged. Then, in the fall, a legal fight with a delinquent roommate over my apartment left me out of my home for several months, accruing debt as my family and I were forced to pay all the rent in a three-bedroom apartment I didn’t feel safe enough to enter.
How could I not notice how wearing all these disruptions were, or the toll they were taking on me? There was so much to manage, so much to solve day-to-day, that I often didn’t recognize the fog as it came and went. Then, as now, I still knew to feel grateful: I was lucky to have friends offering up places to stay, lucky to have a supportive boss, lucky to have a family who could help support me financially for a brief period, even as I simultaneously felt shame for having to ask for it in the first place. I had the resources to fight these battles, and I was desperate to prove I could fight them and still be a reliable, productive writer.
I also felt eerily normal a lot of the time. Some of this is my hardwired response to crises—I don’t lash out or get worked up, but instead think in terms of lists, next steps and assignments: What’s the issue, and how do we fix it? This gave me the deceptive veneer of competence. I could hold my own in meetings, conduct interviews, discuss story angles and talk through problems. And I had been through periods of depression before, bouts that felt intense and undeniable. This was different—more shadowy and erratic. Surges of adrenaline that would give way to oppressive, all-encompassing exhaustion.
More than once during the fall of 2019, I would stand on the subway platform as a train approached and imagine walking into its path. These were deeply abstract fantasies: I knew I didn’t want to die, but I just wanted to have a moment where I could stop worrying. I wanted to, just for a second, feel the relief of feeling nothing at all.
The thought would pass, and I would get on the train, same as normal, the gravity of my to-do list pulling me through the day. During that time, I lived so fully in my own head, my body might as well have disappeared. It took me until very recently to come to terms with how bad things had gotten for me. Those weren’t idle fantasies, those were suicidal fantasies. I was in deep trouble, but through the busy-ness of my days, I didn’t even recognize it.
When I told Caraballo about this, he was gentle and measured in his response.
“Suicidal thoughts and fantasies are far more common than people think,” he said. “The function of the ego is protection. And for a lot of people, they don’t like to think of themselves as someone who would consider suicide or think of it.”
He pointed out that the stakes for this were also higher for marginalized groups, particularly for black people, in a way that discourages them from being honest about their mental health.
“There are very real implications of identifying yourself as a suicidal person or a person who’s thought about suicide, both in terms of career and socially,” he said. “If you want to take that a step further, you think about how black and brown bodies are treated by the medical system. There’s so much mistreatment in our hospital system.”
He adds that people of color can also internalize the message that as long as you’re being perceived as strong as capable—as long as you have a job, for instance, or you’re functioning day-to-day—that you can’t be depressed and therefore, don’t need help.
Having these experiences before the pandemic and coming to terms with them have helped me manage my mental health more effectively through weeks of quarantine. I’ve accepted that I can be an unreliable evaluator when it comes to my emotional wellbeing: I will always want to say that I’m okay, I will always want to deflect worry. But paying attention to my body and its responses have provided valuable signposts, particularly in my breathing and sleeping patterns. When I find myself completely tapped out as soon as the workday ends; when I’m continuously slammed with an overwhelming urge to sleep that lasts 12 or more hours, I know that means my body is demanding I slow down and recuperate. And not in a few weeks—but now.
All of this is important to managing mental health, and again, it’s important to acknowledge we don’t all have equal opportunity or access to do so. But we also have to separate management from healing—particularly in the case of trauma, burnout, or accumulated stress.
Often, Caraballo told me, we can confuse moving past an event with recovery; but healing, he says, is usually the result of having processed your experience—and that cannot happen in isolation. It will require assessing the impact of an event honestly, integrating the experience, and making a conscious decision to move forward.
“This is, I think, a collective depression that we’re all experiencing,” he said, noting that there will “definitely” be more people now at risk of developing clinical depression because of the pandemic.
He’s unsure of what the path forward will actually look like for the U.S.—there is a great urgency to understand mental health issues, as well as a need for greater access to care and workplace policies, like paid time off, that let employees prioritize mental health. But on an individual level, awareness is one of the best tools a person can have in managing their wellbeing day-to-day. Caraballo suggests taking small steps to be more conscious about your body throughout the day, like using bathroom breaks to check in and notice how your body is feeling, as well as what emotions or thoughts are coming up. Tracking those nuances and differences as they arise throughout the day can allow you to give a more honest assessment of your wellness, he says, but you have to be willing to be vulnerable.
“I just go back to this pressure to be seen as this pulled together, strong, unwavering kind of person,” he said. “And I think if we can allow ourselves the freedom to be more than that, then we can really do what we need to to take better care of ourselves.”
Focusing on my body has allowed me to be softer and gentler towards myself, especially when sickness and death dominate the news cycle. It allows me to feel gratitude for its relative health. It allows me to listen, rather than berate myself. It allows me to be flexible: today was a good day, tomorrow may not be. Even with isolation protocols, my freest moments are still available to me: the moments I get to close my eyes, scan myself from the edges of my feet to the curve of my head, and let my anxieties lift for a moment, like a balloon rising off into the sky. The moment I allow myself to just be a body: whole, complex, worthy of my care, worthy of rest.
If you or someone you know is in a crisis, call the National Suicide Prevention Lifeline (Lifeline) at 1-800-273-TALK (8255), or text the Crisis Text Line (text HELLO to 741741). Both services are free and available 24 hours a day, seven days a week. For more information on mental health conditions, visit the National Alliance on Mental Illness.