Coronavirus Stress Response Disorder – And How To Avoid It.

If you listen carefully right now you’ll hear something that’s actually been getting louder in past couple of weeks.  It is certainly easier to hear it with all this social distancing reducing traffic and background noise, but it’s unmistakable and picking up steam.  It’s the drumbeat of a deluge of hot takes telling us that Coronavirus will be not only a physical health disaster, but in fact that worse is to come.  The mental health consequences will in fact be even further reaching and will leave thousands upon thousands in dire need of support and treatment moving forward when we’re eventually allowed to emerge back into the wider world.

Certainly, this pandemic is going to leave a tsunami of distress, despair, trauma, distress arising from having to shelter with abusers and manipulators, unemployment and on and on and on.  The aftermath emotionally is very likely to be for many people, a seemingly unremitting shitshow.  So all these takes about a coming mental health crisis seem on point then right?  Maybe, but only if we actually think about what we mean by mental health in this sense anyway, and how in hell we respond to the altered world we’re going to step back into.  In western culture the mainstream view of mental distress and anguish has always been the language of illness and disorder.  Mental health in fact has become synonymous with disorder to such a degree that when the average Joe talks about ‘mental health’ what they’re often talking about is the negative end of the mental health spectrum and things that are ‘wrong’ or disordered, rather than viewing mental health in a much more broader and honest context.  Mental health is something to be dealt with in quiet voices with prescription, isolation and six sessions of CBT.  In the tired old cliche, it’s just like a physical injury, the broken brain is just like the broken leg(!), and should be viewed through that lens of repair and getting ‘back to normal’.  The fact that we’re seeing people refer to this oncoming mental health storm as an epidemic, shows just how deeply ingrained the medical model of mental distress is.

It’s curious to watch all this happening as someone with a mental health diagnosis.  I myself reject the medicalisation of my experiences and responses to them, I see my depression not as a mental illness or a mental health issue, but as a response based on things that I’ve lived through and experienced.  To me, ‘mental health’, is one of the consequences of life.  And I’m not invoking any kind of just-world theory here, this is not any kind of a moral issue, but it is a fundamental life experience.  I am not saying that mental crisis isn’t dangerous to your health (I know this from bitter experience) and I’m not saying that it’s not to be taken seriously.  I am saying that I see the immediate medicalising response as a cop-out and missed opportunity.

When the lockdowns are easing, I fear a world that will squander precious time and energy that could be acting upon our collective trauma, but instead looks to reinstate the old normal.  A world that doesn’t hear survivors’ stories, and instead designates a certain amount of people who cannot adjust, as having ‘Coronavirus Stress Response Disorder’ (to be neatly shortened to CSRD).  These people will then be implicitly looked down upon as not having the mental fortitude to ‘keep calm and carry on’, and in the UK it’ll be another way to uphold the myth of ‘blitz spirit’ and other jingoistic bullshit.  Charities and voluntary groups will set up CSRD support groups for weekly meetings in quiet corners and details will be given furtively and with a sense of shame.  Certain groups such as ethnic minorities and the disabled will be deemed to be at particular risk (without anyone looking into the why), there’ll doubtless be a national awareness day, and a few years down the line, celebrity tell-alls and ‘coming outs’ about their lived experiences of CSRD.  And in the name of trying to return to an impossible normal an opportunity will be missed.

So what is that missed opportunity?

It’s a chance to engage with someone’s pain, distress and anguish.  To hear someone’s story and experience.  To ask them what tools and support they need and trust to their expertise in themselves, rather than immediately seeing them as disordered.  To look at the wider issues surround mental health.  Not to box it off, but to think of it relating to employment, housing, our political realities, world trauma, grief, death, bereavement and so much else.  We have to look at mental health in the context of our lives, rather than as something which is damaging or dangerous.  We must stop tying distress to illness or wrongness.  We must not make mental distress apolitical.  Yes as the adage says mental illness does not discriminate, but to say that it discriminates equally is nonsense.  Age, race, disability, gender, sexuality, class – all of these things have an impact on us, and any mental health professionals that refuse to acknowledge this are doing a disservice to themselves and their clients.  In short, we must learn to see this not so much as a medical issue, but as a social one.

We must not let the old narrative of disorder to settle back into it’s former comfort, and it will be interesting to see how many people react in the aftermath.  I suspect that many people will experience emotions (symptoms?) and feel things that in the past would have been quietly hushed and fed prozac and mindfulness.  I hope that this horrific global trauma gives us a new way to look at how we think about emotional responses, about what is acceptable and what isn’t.  I hope that many people upon finding their normal responses and feelings labelled, will push back.  I hope people will reflect about how maybe those with lived experience had skills to share, rather than problems to be resolved.  Our current model of mental health was fraying at the edges before COVID-19, this pandemic is going to show that the way we’ve sought to disorder people, is not, and never was fit for purpose.

4 thoughts on “Coronavirus Stress Response Disorder – And How To Avoid It.

  1. Thank you for your thoughts on this. The medical model is so deeply entrenched within the culture and the minds of people it is like the water a fish is swimming in. This disorderland we live in has also been powerfully tied to the mechanisms of survival like benefits, sick notes, reasonable adjustments in the work (slave) place. in other words It is tied to access to culturally sanctioned and coveted crumbs of coping.

    These COC’s seem to help obfuscate the causes of distress in many ways and they place responsibility for change and ‘adjustment’ squarely with the individual who must endure endless paper cut injustices and subtle attacks and erosions of self worth and clear thinking. It reminds me of weevils in the ships biscuit that everyone must keep eating because this is just the way it is.

    If you work in the mental (ill) health system then you are likely helping to uncritically reinforce these echo chambers of disorder and treatment that are always about the individual – Services such as IAPT where staff are expected to be pleased about hitting their weekly access and ‘recovery’ scores that also slowly erode and diminish everyone involved.

    Surely there can’t be anyone left that really believes how someone scores on a tick box questionnaire has any relevance to someones ‘recovery’ – what can this even mean? but maybe they do because recovery is only about these self assessment measures – no matter that your life is falling in around you, if enough people pleasing or straightforward manipulation of the figures can be created then we have a winner you are now ‘recovered’

    Everyone is happy, the therapist sees what are the equivalent of a childrens gold star flash up on IAPTS to tell you this person is now in ‘recovery’ your manager is pleased because they don’t have to go down some all boxes and targets must be ticked oppressive re-education programme with you or how to manipulate more efficiently pep talk – perhaps this entails the joys of observing a colleague who always hits their targets, maybe you are forced to record your sessions to have them scrutinised by managers and supervisors, maybe you have to redo the ‘recovery workshop’ a full day on efficient manipulation advice, like give the forms at the end of the session because people often feel a little albeit temporary relief from having someone hear them, or read to the client the real (arbitrary) meanings behind a score of 3 on the PHQ9 – or maybe you just save all the bother and do what is absolutely standard in services and just put down the scores that help protect you from this nonsense.

    In fact many clients with none of this inside information tell you the scores are meaningless and just tell you to fill them in. the commissioners are happy because they can then pass on all of this meaningless data to the government who can then spin this spew it out into the culture and the whole merry self interested cycle continues – hell i’m getting paid. meanwhile suffering increases year in year out, more suicides, more prescriptions and more and more people educated and manipulated into self identifying with illness and disorder – psychiatry is happy, lots of customers, the illusion of science, drug companies are very happy, the regulators funded, controlled and staffed by ex industry hierarchy are happy. Doctors are happy the production line of misery is so long its a soothing fiction to be able to shoot tablets from the hips and send people back out there to simply get on with it.

    Actually IAPT staff aren’t happy but like everyone else we can be incentivised to just go along with whatever nonsense is in vogue – don’t reduce caseloads to a manageable none burn out better quality care levels, no just have a ‘wellbeing’ section on the supervision form – ‘work smarter not harder’ maybe you could end the 50 minute hour at 45 minutes? thought about mindfulness we can fast track you?, maybe your anxious and depressed thought about medication? and so now the therapists find themselves in a similar position to the people they are not helping – perhaps they will be managed out of the service or perhaps they are disciplined because at the same time the sickness policy has become ever more punitive its all so wonderfully efficient.

    Self interest is out of control.

    Like

  2. Thank you for writing this excellent piece. We need to avoid and resist the medical language of the CV 19 stress response disorder that is being heard on various media platforms. We need to be more human, share our experiences feeling, fears, then place the difficulties we have within a social context. The question we should be asking ourselves is: “Can we develop a different approach of dealing with distress in a way that isn’t dominated any discipline, but that is owned by us all? “

    Liked by 1 person

  3. Thanks for your article. What are your thoughts about seeking help in the familial rather than wider social context. I don’t think we will ever have the power to change how society works. Can’t hought entanglements be sorted within the familial and ancestral rather than any new global system?

    Like

    1. I think the familial context is one avenue that people can explore if safe for them to do so. Familial and ancestral systems can be nurturing and do many wonderful things, but like any and all systems they can also be toxic and invalidating or abusive.

      Yes, the job of changing how society works is one for billions of hands, and an almost unfathomably large task, but to say that we will never have the power to change society, is to say that society is therefore unchanging. Which it isn’t.

      Interesting question and thank you for reading!

      Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s