HomeArticlesThe coronavirus outbreak & mental health: What you need to know

The coronavirus outbreak & mental health: What you need to know

Hope in the time of outbreaks may come from an unlikely source. The good news? It’s closer than you think.


In times of crises, our minds are hardwired to calculate risk. But when that math feels too much to bear, take comfort that you have a choice — and that solace can be found in others… even while social distancing.

In the 1880s, New York entrepreneur William T. Love dreamed of a tidy, pre-planned community on the banks of Lake Ontario. Although an economic slump in 1893 cut Love’s dreams short, the piece of land and unfinished canal intended for shipping he built there, continue to bear his name.

By the 1970s, Love Canal in Niagara Falls looked like an ideal American suburb — white picket fences and station wagons in the driveways, residents told the Los Angeles Times in 1998.

But not everything in Love Canal was picture-perfect, remembers resident Lois Gibbs in her book of memoirs.

Toddlers who walked barefoot in backyards came back with burned feet. Dogs who sniffed in the garden developed sores on their noses.

A state epidemiologist who came to look into reports couldn’t say why, Gibbs explains in her book.

But as the disease expert left, he warned the community:

Don’t eat anything from your gardens.

Invisible, but overwhelming: Why our minds are wired to wonder about potential threats

By the time, Love Canal residents were seeing mysterious burns and birth defects — it had been more than 30 years since the Hooker Chemical Company had begun dumping chemical waste in the area. Love’s dreams had been filled to the brim with 21 000 tons of chemical waste  — waste so caustic it burned through Hooker employees’ work boots.

Residents could smell the chemicals and sometimes see it seep from the ground. To them, the threat felt as if it was seemingly everywhere and nowhere at once; invisible but also overwhelming.

For many of us, the outbreak of the new coronavirus virus that causes the disease known as COVID-19 can also feel both unseen and overpowering. Unseen in that we can’t see the virus itself, which is transmitted through droplets of spit; and overwhelming in what we don’t know about it and its potential scale. We may mull the risks over in our minds over and over again. And many of us will react very differently to the stress this causes but there is hope in how we choose to channel that stress.

Every day, we are confronted by challenges — maybe it’s relationship problems or simply what to prioritise on that to-do-list.

And each time we’re confronted with stressors like these, we do some calculus: We think how does this threaten me? How can I best overcome this?

We’re psychologically wired this way.

Challenges are stressful. But there’s comfort in the fact that in most situations, our stressful feelings subside as we manage our way through that moment. We even have a name for stress that motivates positive action — eustress. 

Take comfort, many people are likely thinking and feeling what you are

A 1994 federal court eventually called the Hooker Chemical Company’s actions negligent and hundreds of families were evacuated from Love’s Canal.

But in the 1980s, the physician, Henry Vyner, plowed through testimonies, legal documents and medical reports about Love Canal as part of his work to understand toxic pollution’s psychological impacts on people.

Unlike, for instance, the smoke signalling a wildfire, chemical contamination in Love Canal was a largely invisible threat. And not being able to see the threat — and its sheer scale — compounded residents’ uncertainty, wrote Vyner in his 1988 book, Invisible trauma: The psychosocial effects of invisible environmental contaminants. That uncertainty became fear and anxiety.

But Vyner also found that even within this unpredictability, there were particular types of uncertainty.

For instance, diagnostic uncertainty where people might ask themselves, “I’m sick but the doctor told me it was only a cold. Did she really pick up what I have?” 

Or people might wonder, “I am living with HIV or diabetes, will I be okay if I get sick?” — what Vyner would call “prognosis uncertainty”.

And lastly, there is what he refers to as “treatment uncertainty” in which people might wonder if health facilities are prepared.

Sound familiar?

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Catastrophic events, such as chemical spills or outbreaks trigger that same kind of stress or threat calculus: We watch the news reports and we ask ourselves, will my family be among the eight out of 10 who contract the virus and develop only mild symptoms?

Or will they be among the rarer 20% or so that develop a possibly life-threatening illness, based on February data by the Chinese Centers for Disease Control and Prevention.

And this uncertainty is even more palatable perhaps for the many of us who have weakened immune systems because of conditions such as age, diabetes and heart disease that the Chinese data showed placed people at much greater risk of death.

For many South Africans, COVID-19 is a threat multiplier. For some people, work may decline, exacerbating financial pressures. COVID-19 may also place more psychological strain on those already living with chronic conditions, such as mental health challenges.

So our minds return again to that threat calculus, asking ourselves, for example:

“How will we manage without an income?” or “What happens if I get sick?”

People may at some point experience fear, anxiety, anger, helplessness, hopeless, loneliness, and a myriad of other distressing states.

This is normal.

Denial, catastrophizing, anxiety: People will react differently

This moment in history comes with a tremendous amount of uncertainty.

We’re expected to see a range of responses as people try their best to cope with the current situation. Some people may be unfazed in adopting, for instance, social distancing.

Others may act like nothing is happening. Denial is sometimes how our minds deal with threats we see as daunting. 

And risk tolerance — how much risk a person can endure before changing a behaviour —  differs for everyone.

Another response may be catastrophizing. Here, people may be so overwhelmed that everything is perceived as being a threat: Fires, they think, need to be put out all over the place and the world needs to be warned about the ever-impending doom.

Apocalyptic Facebook posts by friends or family may suggest underlying anxiety.

Some people are going through a process where business as usual is irreconcilable with the reality of the day. Confronted by these circumstances, people may be overwhelmed with despair.

However, some may not know how to cope, seeing their strategies as inefficient, anticipating collapse. This may lead to avoidance and extreme isolation. Social disconnection leaves people vulnerable to further mental health distress.

Through thick and thin, we find purpose in others

Psychiatrist Victor Frankl’s descriptions of survival in Nazi death camps became the basis of the psychotherapeutic approach, Logotherapy. Logotherapy is underpinned by the theory that human beings seek to find purpose in their lives through giving to others — even in times of crises.

While Frankl was imprisoned at various concentration camps during World War II, he found that small daily acts, such as creating things or assisting others, helped him cope with suffering and gave him a purpose to live. And he saw this in others too.

In short, Frankl noted that how we approach circumstances matters. Social action, can in tough times, become its own coping mechanism.

We cannot avoid suffering and we’re not guaranteed happiness in difficult times, but there are small acts of purpose to be found.

In light of COVID-19, we are called to social action. Small acts, big acts —acts that help others in what can be disconcerting times.

If someone has gone quiet, they may feel isolated and the world is difficult to bear. Reach out. A phone call, a WhatsApp note, sharing a joke or asking how someone feels can go a long way.

If you identify someone who may need support, organisations, such as the South African Depression and Anxiety Group (SADAG) can help. SADAG runs a 24/7 telephonic hotline for counselling as well as a WhatsApp line and call back service. And the organisation has practical coping tips on its homepage.

We are sure to see more of these actions of compassion in the months to follow. The new coronavirus outbreak still may feel like an invisible, overwhelming threat. But there’s some comfort to be had in knowing that we all still have a choice: To act, to protect ourselves and others — and that this social solidarity can bring you and your community comfort in uncertain times.

Garret Barnwell is a clinical psychologist and former humanitarian aid worker. His professional research interests are on the psychological distress associated with environmental degradation. Follow him on Twitter @BarnwellGarret.

Garret Barnwell is a clinical psychologist and PhD candidate at Nelson Mandela University and a Bongani Mayosi Medical Research Council Scholar. He has a special interest in planetary health, focusing on the psychological experiences of environmental degradation and climate change. Follow him on Twitter @BarnwellGarret.