If researchers came up with a method to challenge the mental health of every human on the planet, they couldn’t have designed a better test than the isolation and demoralization embedded in COVID-19 pandemic.
“It’s a tough thing to do, what we’ve been asked to do over the past year,” said Steven C. Hayes, Nevada Foundation professor in the Behavior Analysis program at the Department of Psychology at the University of Nevada. “Anxiety, depression, and all the things we usually think of as clear mental health problems are soaring.”
Hayes is an author of 46 books, including the bestsellers, “Get Out of Your Mind, Into Your Life” and “A Liberated Mind.” He has published nearly 600 scientific articles and, more recently, produced scores of podcasts about mental health and ways to deal with the stresses of the pandemic. His career has focused on an analysis of the nature of human language and cognition and their application to the understanding and alleviation of human suffering. He is the developer of Relational Frame Theory, an account of human higher cognition, and its extension to Acceptance and Commitment Therapy (ACT), an evidence-based form of psychotherapy.
In general, psychologists have estimated that “one out of five people” in the population may be diagnosable with some form of mental health condition. Now, Hayes said, five out of five people are feeling the burden of this pandemic. “Everyone always has some mental challenges of all sorts and now we’ve got that in spades.”
“If there’s anybody who doesn’t feel a sense of uncertainty, anxiety concern for the future, sadness, grief or sense of loss I don’t know where they’ve been hiding — under a rock or something? Are they awake?”– Prof. Steven C. Hayes, University of Nevada, Reno.
The universal stress of the crisis is unusual, but it’s not the sort of emergency that requires special tools that apply only to extreme conditions, he said. Instead, the mental strength and resilience required to stay healthy is “a 365-day-a-year issue. You don’t wait until you are physically sick and then think you have to exercise.” It’s the same with mental health, he said.
Precursors to illness
Hayes cited a study in which 10,000 people were monitored during several months of the pandemic. He said the main predictors of personal disasters were financial health and access to people who can be relied on for support. After those, he said, psychological flexibility was the biggest factor in whether a person will weather the pandemic in a healthy way.
“About 30 studies have looked at what people need to get through this,” he said. “That mental flexibility, the ability to bend but not break, was the most important individual factor. If you haven’t developed that, time’s up. You need to work on that resilience to keep out of the more severe categories (of mental struggles).”
That means developing core psychological skills. Those who do well in the crisis face their emotions instead of running from them; they avoid getting entangled in their thoughts; they focus on what’s important instead of dwelling on minor issues; and they know what their values are and organize their lives around those, he said. Failure to do those things puts people at risk for the classic mental problems as well as relationship problems.
Isolation, lack of human touch
“Managing your family and remaining connected with other people are all related to those skills,” Hayes said. The isolation brought on by the pandemic’s lockdowns and the lack of human touch required by distancing makes it essential to develop those individual coping skills.
“Isolation is one of the worse things you can do to people; some countries outlaw solitary confinement as cruel. And touching, hugging is so important, but it’s been a year that some people haven’t experienced that. People have lost things that they loved doing and they don’t know how to replace them”– Prof. Steven C. Hayes, University of Nevada, Reno.
“If someone you love and care about does get sick you may not be able to see them,” Hayes noted. “If they die there’s no funeral… Any of those things are serious challenges and when you add on to that people lost jobs are hit hardest. It’s a train wreck.”
It’s not all doom and gloom. “You also see a tremendous amount of courage,” he said. “(We see) people protecting each other, loving each other, watching out for their neighbors. It’s the best of times; the worst of times.”
Building mental resilience
Hayes said amid the fear and suffering of COVID-19, there’s also a lesson.
“We’re all stretched and we’re all challenged,” he said. “This is the year we’ll remember, but that we’d just as soon forget. We’d better not, because what predicts getting through (the pandemic) is mental resilience, mental strength skills. It’s an old song, but it’s true, Focus on getting to be a better human, a better version of yourself.”
Such work is a life-long job, he said. Inner strength and flexibility are like resources in a person’s personal bank. “When you need them, you can draw on them,” Hayes said. It’s not like going back to school and learning astrophysics. “These things are things we know. We understand we should be more focused on our values and building healthy habits, but that doesn’t mean we’re doing that.”
Working on those life skills may not require the help of a counselor or an expensive program, he said. “It doesn’t necessarily mean going to see a therapist. Buy a self-help book, watch science-based, self-help videos on your screen and see what healthy advice looks like, write about your values and work on your habits.”
Seeking professional help
The need to do those things didn’t begin in March, he said. “Being the better version of your self is a task for a lifetime. Now, maybe you have a little more time to help yourself.”
With everyone feeling the effects of the crisis, how can people determine whether they need professional help?
“If you find that your ability to function is at risk, you need to reach out to someone,” Hayes said. “By that I mean if you are developing a drinking problem, if you are getting entangled with depression, having suicidal thoughts or not being unable to maintain your relationships.”
Not sleeping well, being unable to marshal an ability to accomplish tasks, a change in eating patterns in a way that could affect overall health also are red flags, he said. “None of that is different than before the pandemic,” he said. “Now, it’s just more common.”
Skills have to be developed
Being well-adjusted and able to cope with change is not a birthright, he explained. “Those skills are built over the years. We all need them so we should learn them. Life changes. People get older, they lose function and they lose friends.” Those who work on their mental resilience are more able to cope with life’s changes.
“Everyone needs to be working on those (coping) skills to deal with the curve balls that are certain to happen,” Hayes said. “Good evidence-based, science-based self help, backed up by support groups, works. In our studies, it was found that that has something like two-thirds of the effect of professional help.”
Self-help is real help
Books and online videos can help, he said, and are free or relatively inexpensive. If people can’t afford therapy, have no time for counseling sessions or lost health insurance, there are still things they can do to improve their mental strength. “Don’t be acting like a victim here,” he said. “.. Get in front of your development of mental health skills. Read about them, go on YouTube and see them, learn them. This life is your responsibility. If you want to grow and improve you are going to have to put some effort into it.”
That’s the message that Hayes spreads in his podcasts, lectures and local TedX talks. He also works with sports teams, most recently the Toronto Blue Jays, to improve the athletes’ mental resilience.
Life after COVID
Researchers predict some lasting post-traumatic stress in the wake of the pandemic, but they also float the idea of “COVID-instigated growth,” he said. “Yes, getting through the pandemic is the goal. Yes, doing healthy things is good. But also keep our eye on the opportunity that there’s as much life in a moment of pain and challenge as there is in (times of) success and pleasure.”
Hayes noted that people who are successful at coping with the pressures of the pandemic also will most likely prosper at other things, such as building their businesses or sustaining strong relationships. “Let’s be the ones who come out stronger on the other side with post-COVID growth,” he said.
“You can be one of those people… I’m kind of excited about seeing what’s going to happen to the culture after COVID. At other times (in history) a flowering of the culture often comes in the aftertime of hard times.”