11 May RECORD DEPRESSION & ANXIETY: COVID AND OUR MENTAL HEALTH
On April 16, 1986 reactor number four at the Chernobyl nuclear power plant in the Ukrainian Soviet Socialist Republic suffered a catastrophic explosion that exposed the core and sent clouds of radioactive material over the surrounding area as a fire burned uncontrollably. Within two days of the disaster, high levels of radiation were picked up as far as Sweden, while plants and grasslands in Britain also measured contamination. Today, 35 years later, 57,915 square miles of Belarus, Russia, and Ukraine are still considered contaminated and the 1,544-square mile exclusion zone, more than twice the size of London, is uninhabited.
There is consensus that thirty-one men died from immediate blast trauma and acute radiation syndrome after the disaster and, in the decades since the catastrophe, sixty more died from radiation-induced cancer. But there is a lot of debate as to how many more deaths from long-term health effects can be attributed to the disaster. In 2005, the UN estimated that a further 4,000 might eventually die as a result of radiation exposure. The Ukrainian government calculates things very differently. As of January 2018, 1.8 million people in Ukraine, including 377,589 children, have the status of victims of the disaster.
The radiation from the Chernobyl disaster and its impact can be measured; they are visible and perceptible. For the past fifteen months, we have been experiencing a disaster around the globe. Its physical impact can be measured in the data of casualties, diagnoses, symptoms, and recoveries. But what about the long-term spread of mental health challenges after over a year of locking down, quarantining, distancing, masking, and more? What about those whose mental well-being was upended by a sudden loss of a loved one or an economic crisis? How many victims of this disaster are being projected, adults and children who may never have even been diagnosed with the virus, but who have nevertheless suffered terribly and will suffer from its lasting impact and effect?
A recent national poll conducted by the American Psychiatric Association shows four in ten Americans reporting that they are more anxious than last year. 43% of adults said the pandemic has had a serious impact on their mental health, and it is showing in behavior. Among adults, 17% said they were drinking more alcohol or taking more drugs than normal, up from 14% a year ago. More than half of adults (53%) with children said they are concerned about the mental state of their children and almost half (48%) said the pandemic has caused mental health problems for one or more of their children, including minor problems for 29% and major problems for 19%. Nearly half (49%) of parents say their child received help from a mental health professional since the start of the pandemic.
While radiation from Chernobyl can be identified and avoided, the residual impact of this pandemic on our mental health and well-being is invisible, often neglected, and arguably not considered enough in policy settings.
If someone were suffering with radiation-induced cancer due to a catastrophe, or any other physical illness for that matter, not associated with any particular event, we would never blame them, shame them, ignore them, or neglect them. This is an obvious point but one that bears repeating: we must treat those struggling with mental illness the same way. It is no less an illness, no more the fault of the person suffering from it, and no less deserving of our support and love. The more mental illness is proliferating, the more we must become educated, sensitized, and prepared to be supportive and include it in our policymaking and programming.
Several years ago, a father lamented to me about his child who was struggling to find his way Jewishly and generally. He told me when the child was young, he had some learning and mental health challenges. That child had a classmate with some physical limitations. The father emotionally described that on the one hand it was beautiful how the children ran to help, assist, support and include the child with physical challenges, but on the other it was disturbing how his son felt excluded, neglected, and even bullied. “If only my child’s challenges were on the outside inside of the inside, maybe he would have been treated differently and turned out differently,” he said.
Our sacred Torah and Halacha see mental health illness not only as real, but as no different than physical illness. Rav Eliezer Waldenberg (Tzitz Eliezer 12:18:8) discusses someone with mental illness who recovers and wants to recite Birchas HaGomel. He quotes one of the “rabbonim of Eretz Yisroel” who says:
It seems to me that also mentally ill, even when it doesn’t lead to life-threatening situations they are nonetheless obligated to bless because it is also in the category of the sick person who is healed… and the law is that anyone who is healed need to bless Birchas HaGomel, yet perhaps we should exempt him from blessing Gomel because his healing isn’t clear considering that he might have a relapse and it shows he wasn’t actually healed! But anyone who is clearly healed should bless.
Rav Asher Weiss Shlit”a was asked about someone suffering with OCD and he writes: A student who is devout and God-fearing suffers from Obsessive-Compulsive Disorder (OCD) and for the most part is unable to say a Beracha or Shema according to halacha, and sometimes spends a lot of time trying to say God’s name properly to no avail, and experiences a lot of anguish. According to the doctors who are experts in this condition the treatment is to never go back in prayer, and if he does not feel he said the prayer properly, he should not make another try. In this way, the doctors hope to save him from his distress.
It is the halacha that the first obligation a person has is to do whatever is required to find healing from this illness and for this it is even permitted for him to bypass and not do mitzvos in the Torah.
There are people all around us struggling with anxiety, depression, OCD, bipolar disorder, and other mental health challenges. The patient with cancer cannot simply will his or her cancer away, the individual with Alzheimer’s cannot simply decide to stop forgetting, and the person with depression or anxiety cannot just decide to not feel worried, or worthless, or exhausted. They deserve no less attention, concern, and resources than those with physical ailments. If you are struggling or treating mental health challenges, know it is not your fault, don’t be ashamed or feel guilty, let us know what we can do to be more supportive.
May is Mental Health Awareness Month, a perfect time to educate ourselves. As we resolve to be more sensitive, please consider the following:
Don’t use the term “depressed” or “anxiety” unless it is clinically appropriate. Find another way to say you are sad or disappointed or that you are worried or concerned. Saying you are depressed or have anxiety over a relatively minor issue minimizes the suffering of someone truly struggling.
When someone you know is acting differently or unusual, don’t judge them or jump to assumptions about them. Pirkei Avos (2:4) quotes Hillel who said: “Do not judge another until you have stood in his place.” Since it is impossible to stand in another person’s place, to be them, to have their baggage or to live their struggles, we can never judge another. Instead, we should be kind, sensitive, supportive and understanding of everyone around us.
Never assume you know everything going on in someone’s life or what motivates his or her behavior. Ian Maclaren, the 19th-century Scottish author once said, “Be kind, for everyone you meet is fighting a battle you know nothing about.” Cut others slack; give people the benefit of the doubt.
When you know a friend or family member has depression, bi-polar, anxiety disorder, etc., be as supportive as you would be with someone suffering with a physical illness or disability. Offer help and assistance, check in, and let them know you are just thinking of them. Unlike acute illnesses, most of the time, depression, for example, is chronic. Once diagnosed, it can be controlled, lessened, or perhaps, even go into “remission.” But it is never cured. Support will be needed in some form always.
When reaching out to someone with mental health challenges, never judge, criticize or make comparisons. Don’t offer advice or minimize the person’s struggles. Simply listen, be present, and be a friend.
While the pandemic has accelerated and exploded mental health challenges, they were on the rise long before we ever started using words like shutdown or quarantine. In 2019, there was a record number of suicides, overdoses and record rates of depression and anxiety. There are many factors contributing to this rise including addiction to social media, chemical factors and more.
Use this month to learn, listen, and understand. Reach out when appropriate. And may it be G-d’s will that just like the number of people physically impacted by Covid continues to decline, may the same be true of those suffering from less visible effects.