How The Uncertainty Of The Pandemic Could Affect The Future Of Mental Health
While everyone feels uncertainty on occasion, the pandemic is probably the first time we've all felt it, all at once. This lingering, universal uncertainty is unusual, and experts are starting to wonder about its long-term impacts on mental health.
How uncertainty can cause a stress response.
Here's what we do know: Uncertainty leaves much to the imagination. And in all this open space, anxieties can form. "A lot of what we're dealing with is not a specific fear about one aspect of the pandemic but an anxiety that comes from the uncertainty, unpredictability, and uncontrollability of many features of the pandemic," Aoife O'Donovan, Ph.D., an associate professor of psychiatry at the University of California–San Francisco (UCSF), says on a call to mbg.
O'Donovan explains that, as humans, we're biologically primed to want to actively resolve mental unknowns. When we start to dream up worst-case scenarios, our body's stress response naturally springs us into action.
You can imagine, then, that times of uncertainty—in which our minds don't have a lot to latch on to and are left drifting from threatening outcome to threatening outcome (to threatening outcome to threatening outcome...)—can leave us feeling drained.
"We're activating the stress response to deal with a whole host of things that may never happen and that's taking a toll on us physiologically," O'Donovan says.
This kind of chronic stress has been connected to everything from cardiovascular and autoimmune disease to neurodegenerative decline, and O'Donovan's lab at UCSF was interested in how one emotional response can contribute to so many different outcomes in the body. "In our work," she says, "it seems that inflammation is a really important common mechanism."
The stress-inflammation connection.
Stress leads to inflammation in a number of ways. For starters, hormones released during the stress response, like cortisol and norepinephrine, link to our body's immune cells and cause them to stand guard and send out more inflammatory proteins. Stress can also cause us to do activities that promote inflammation, like eat high-sugar, high-fat foods and skip workouts in favor of the couch.
And when enough inflammation builds up in the body over time, O'Donovan's team has found that it can actually cause certain structural changes in the brain. In one study, researchers associated higher levels of inflammation with worse white matter integrity in the brain, which can increase one's risk of cognitive decline over time. It can also affect the day-to-day functioning of the brain, she explains, and make us more sensitive to threats and less sensitive to rewards.
"Those changes underlie so many psychiatric symptoms... It's kind of a self-perpetuating system, in a way," O'Donovan says. In other words, the stress response that so many of us are feeling right now is not only difficult to work through in the moment; it also might predispose us to feel more stressed in the future.
So, what can we do about it?
This isn't to say that the uncertainty of the pandemic has doomed us to lives of never-ending anxiety. But O'Donovan's research is another important reminder that it's essential to prioritize your mental health during this time.
As for how, she's hesitant to give blanket advice given the intricacies and stark inequalities of the pandemic. "We are all in this together, but some people are really being exposed to a lot more psychological stress than others," she says. "And in that context, it's hard to promote individual behaviors."
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However, if you are able to access stress management tools like exercise, a healthy diet, meditation, she says they can be really helpful for reducing the negative impacts of psychological stress, as can maintaining social relationships as best you can. These things all lower inflammation on their own, and research shows that some of them can also make us more resilient and less reactive in the face of future stressors.
While none of us know what the future has in store, we do know what brings us joy in the moment. And in a world of unpredictability, those are the practices that can be more steadying than ever.