By Tara Haelle

It was the end of the world as we knew it, and I felt fine. That’s almost exactly what I told my psychiatrist at my March 16 appointment, a few days after our children’s school district extended spring break because of the coronavirus. I said the same at my April 27 appointment, several weeks after our state’s stay-at-home order.

Yes, it was exhausting having a kindergartener and fourth grader doing impromptu distance learning while I was barely keeping up with work. And it was frustrating to be stuck home nonstop, scrambling to get in grocery delivery orders before slots filled up, and tracking down toilet paper. But I was still doing well because I thrive in high-stress emergency situations. It’s exhilarating for my ADHD brain. As just one example, when my husband and I were stranded in Peru during an 8.0-magnitude earthquake that killed thousands, we walked around with a first aid kit helping who we could and tracking down water and food. Then I went out with my camera to document the devastation as a photojournalist and interview Peruvians in my broken Spanish for my hometown paper.

Now we were in a pandemic, and I’m a science journalist who has written about infectious disease and medical research for nearly a decade. I was on fire, cranking out stories, explaining epidemiological concepts in my social networks, trying to help everyone around me make sense of the frightening circumstances of a pandemic and the anxiety surrounding the virus.

I knew it wouldn’t last. It never does. But even knowing I would eventually crash, I didn’t appreciate how hard the crash would be, or how long it would last, or how hard it would be to try to get back up over and over again, or what getting up even looked like.

In those early months, I, along with most of the rest of the country, was using “surge capacity” to operate, as Ann Masten, PhD, a psychologist and professor of child development at the University of Minnesota, calls it. Surge capacity is a collection of adaptive systems — mental and physical — that humans draw on for short-term survival in acutely stressful situations, such as natural disasters. But natural disasters occur over a short period, even if recovery is long. Pandemics are different — the disaster itself stretches out indefinitely.

“The pandemic has demonstrated both what we can do with surge capacity and the limits of surge capacity,” says Masten. When it’s depleted, it has to be renewed. But what happens when you struggle to renew it because the emergency phase has now become chronic?

By my May 26 psychiatrist appointment, I wasn’t doing so hot. I couldn’t get any work done. I’d grown sick of Zoom meetups. It was exhausting and impossible to think with the kids around all day. I felt trapped in a home that felt as much a prison as a haven. I tried to conjure the motivation to check email, outline a story, or review interview notes, but I couldn’t focus. I couldn’t make myself do anything — work, housework, exercise, play with the kids — for that whole week.

Or the next.

Or the next.

Or the next.

I know depression, but this wasn’t quite that. It was, as I’d soon describe in an emotional post in a social media group of professional colleagues, an “anxiety-tainted depression mixed with ennui that I can’t kick,” along with a complete inability to concentrate. I spoke with my therapist, tweaked medication dosages, went outside daily for fresh air and sunlight, tried to force myself to do some physical activity, and even gave myself permission to mope for a few weeks. We were in a pandemic, after all, and I had already accepted in March that life would not be “normal” for at least a year or two. But I still couldn’t work, couldn’t focus, hadn’t adjusted. Shouldn’t I be used to this by now?

“Why do you think you should be used to this by now? We’re all beginners at this,” Masten told me. “This is a once in a lifetime experience. It’s expecting a lot to think we’d be managing this really well.”

It wasn’t until my social media post elicited similar responses from dozens of high-achieving, competent, impressive women I professionally admire that I realized I wasn’t in the minority. My experience was a universal and deeply human one.

An unprecedented disaster

While the phrase “adjusting to the new normal” has been repeated endlessly since March, it’s easier said than done. How do you adjust to an ever-changing situation where the “new normal” is indefinite uncertainty?

“This is an unprecedented disaster for most of us that is profound in its impact on our daily lives,” says Masten. But it’s different from a hurricane or tornado where you can look outside and see the damage. The destruction is, for most people, invisible and ongoing. So many systems aren’t working as they normally do right now, which means radical shifts in work, school, and home life that almost none of us have experience with. Even those who have worked in disaster recovery or served in the military are facing a different kind of uncertainty right now.

“I think we maybe underestimate how severe the adversity is and that people may be experiencing a normal reaction to a pretty severe and ongoing, unfolding, cascading disaster,” Masten says. “It’s important to recognize that it’s normal in a situation of great uncertainty and chronic stress to get exhausted and to feel ups and downs, to feel like you’re depleted or experience periods of burnout.”

Research on disaster and trauma focuses primarily on what’s helpful for people during the recovery period, but we’re not close to recovery yet. People can use their surge capacity for acute periods, but when dire circumstances drag on, Masten says, “you have to adopt a different style of coping.”

Understanding ambiguous loss

It’s not surprising that, as a lifelong overachiever, I’ve felt particularly despondent and adrift as the months have dragged on, says Pauline Boss, PhD, a family therapist and professor emeritus of social sciences at the University of Minnesota who specializes in “ambiguous loss.”

“It’s harder for high achievers,” she says. “The more accustomed you are to solving problems, to getting things done, to having a routine, the harder it will be on you because none of that is possible right now. You get feelings of hopelessness and helplessness, and those aren’t good.”
That’s similar to how Michael Maddaus, MD, a professor of thoracic surgery at the University of Minnesota, felt when he became addicted to prescription narcotics after undergoing several surgeries. Now recovered and a motivational speaker who promotes the idea of a “resilience bank account,” Maddaus had always been a fast-moving high achiever — until he couldn’t be.

“I realized that my personal operating system, though it had led to tremendous success, had failed me on a more personal level,” he says. “I had to figure out a different way of contending with life.”

That mindset is an especially American one, Boss says.

“Our culture is very solution-oriented, which is a good way of thinking for many things,” she says. “It’s partly responsible for getting a man on the moon and a rover on Mars and all the things we’ve done in this country that are wonderful. But it’s a very destructive way of thinking when you’re faced with a problem that has no solution, at least for a while.”
That means reckoning with what’s called ambiguous loss: any loss that’s unclear and lacks a resolution. It can be physical, such as a missing person or the loss of a limb or organ, or psychological, such as a family member with dementia or a serious addiction.

“In this case, it is a loss of a way of life, of the ability to meet up with your friends and extended family,” Boss says. “It is perhaps a loss of trust in our government. It’s the loss of our freedom to move about in our daily life as we used to.” It’s also the loss of high-quality education, or the overall educational experience we’re used to, given school closures, modified openings and virtual schooling. It’s the loss of rituals, such weddings, graduations, and funerals, and even lesser “rituals,” such as going to gym. One of the toughest losses for me to adapt to is no longer doing my research and writing in coffee shops as I’ve done for most of my life, dating back to junior high.

“These were all things we were attached to and fond of, and they’re gone right now, so the loss is ambiguous. It’s not a death, but it’s a major, major loss,” says Boss. “What we used to have has been taken away from us.”

Just as painful are losses that may result from the intersection of the pandemic and the already tense political division in the country. For many people, issues related to Covid-19 have become the last straw in ending relationships, whether it’s a family member refusing to wear a mask, a friend promoting the latest conspiracy theory, or a co-worker insisting Covid-19 deaths are exaggerated.

Ambiguous loss elicits the same experiences of grief as a more tangible loss — denial, anger, bargaining, depression, and acceptance — but managing it often requires a bit of creativity.

A winding, uncharted path to coping in a pandemic

While there isn’t a handbook for functioning during a pandemic, Masten, Boss, and Maddaus offered some wisdom for meandering our way through this.

Accept that life is different right now
Maddaus’ approach involves radical acceptance. “It’s a shitty time, it’s hard,” he says. “You have to accept that in your bones and be okay with this as a tough day, with ‘that’s the way it is,’ and accept that as a baseline.”

But that acceptance doesn’t mean giving up, he says. It means not resisting or fighting reality so that you can apply your energy elsewhere. “It allows you to step into a more spacious mental space that allows you to do things that are constructive instead of being mired in a state of psychological self torment.”

Expect less from yourself

Most of us have heard for most of our lives to expect more from ourselves in some way or another. Now we must give ourselves permission to do the opposite. “We have to expect less of ourselves, and we have to replenish more,” Masten says. “I think we’re in a period of a lot of self discovery: Where do I get my energy? What kind of down time do I need? That’s all shifted right now, and it may take some reflection and self discovery to find out what rhythms of life do I need right now?”

She says people are having to live their lives without the support of so many systems that have partly or fully broken down, whether it’s schools, hospitals, churches, family support, or other systems that we relied on. We need to recognize that we’re grieving multiple losses while managing the ongoing impact of trauma and uncertainty. The malaise so many of us feel, a sort of disinterested boredom, is common in research on burnout, Masten says. But other emotions accompany it: disappointment, anger, grief, sadness, exhaustion, stress, fear, anxiety — and no one can function at full capacity with all that going on.

Recognize the different aspects of grief

The familiar “stages” of grief don’t actually occur in linear stages, Boss says, but denial, anger, bargaining, depression, and acceptance are all major concepts in facing loss. Plenty of people are in denial: denying the virus is real, or that the numbers of cases or deaths are as high as reported, or that masks really help reduce disease transmission.
Anger is evident everywhere: anger at those in denial, anger in the race demonstrations, anger at those not physically distancing or wearing masks, and even anger at those who wear masks or require them. The bargaining, Boss says, is mostly with scientists we hope will develop a vaccine quickly. The depression is obvious, but acceptance… “I haven’t accepted any of this,” Boss says. “I don’t know about you.”

Sometimes acceptance means “saying we’re going to have a good time in spite of this,” Boss says, such as when my family drove an hour outside the city to get far enough from light pollution to look for the comet NEOWISE. But it can also mean accepting that we cannot change the situation right now.

“We can kick and scream and be angry, or we can feel the other side of it, with no motivation, difficulty focusing, lethargy,” Boss says, “or we can take the middle way and just have a couple days where you feel like doing nothing and you embrace the losses and sadness you’re feeling right now, and then the next day, do something that has an element of achievement to it.”

Experiment with “both-and” thinking

This approach may not work for everyone, but Boss says there’s an alternative to binary thinking that many people find helpful in dealing with ambiguous loss. She calls it “both-and” thinking, and sometimes it means embracing a bit of the irrational.

For the families of soldiers missing in action in Vietnam that Boss studied early in her career, or the family members of victims of plane crashes where the bodies aren’t recovered, this type of thinking means thinking: “He is both living and maybe not. She is probably dead but maybe not.”

“If you stay in the rational when nothing else is rational, like right now, then you’ll just stress yourself more,” she says. “What I say with ambiguous loss is the situation is crazy, not the person. The situation is pathological, not the person.”

An analogous approach during the pandemic might be, “This is terrible and many people are dying, and this is also a time for our families to come closer together,” Boss says. On a more personal level, “I’m highly competent, and right now I’m flowing with the tide day-to-day.”

It’s a bit of a Schrödinger’s existence, but when you can’t change the situation, “the only thing you can change is your perception of it,” she says.

Of course, that doesn’t mean denying the existence of the pandemic or the coronavirus. As Maddaus says, “You have to face reality.” But how we frame that reality mentally can help us cope with it.

Look for activities, new and old, that continue to fulfill you

Lots of coping advice has focused on “self-care,” but one of the frustrating ironies of the pandemic is that so many of our self-care activities have also been taken away: pedicures, massages, coffee with friends, a visit to the amusement park, a kickboxing class, swimming in the local pool — these activities remain unsafe in much of the country. So we have to get creative with self-care when we’re least motivated to get creative.

“When we’re forced to rethink our options and broaden out what we think of as self-care, sometimes that constraint opens new ways of living and thinking,” Masten says. “We don’t have a lot of control over the global pandemic but we do over our daily lives. You can focus on plans for the future and what’s meaningful in life.”

For me, since I missed eating in restaurants and was tired of our same old dinners, I began subscribing to a meal-kit service. I hate cooking, but the meal kits were easy, and I was motivated by the chance to eat something that tasted more like what I’d order in a restaurant without having to invest energy in looking through recipes or ordering the right ingredients.

Okay, I’ve also been playing a lot of Animal Crossing, but Maddaus explains why it makes sense that creative activities like cooking, gardening, painting, house projects — or even building your own imaginary island out of pixels — can be fulfilling right now. He references the book The Molecule of More, which explores how dopamine influences our experiences and happiness, in describing the types of activities most likely to bring us joy.

“There are two ways the brain deals with the world: the future and things we need to go after, and the here and now, seeing things and touching things,” Maddaus says. “Rather than being at the mercy of what’s going on, we can use the elements of our natural reward system and construct things to do that are good no matter what.”
Those kinds of activities have a planning element and a here-and-now experience element. For Maddaus, for example, it was simply replacing all the showerheads and lightbulbs in the house.

“It’s a silly thing, but it made me feel good,” he says.

Focus on maintaining and strengthening important relationships

The biggest protective factors for facing adversity and building resilience are social support and remaining connected to people, Masten says. That includes helping others, even when we’re feeling depleted ourselves.

“Helping others is one of those win-win strategies of taking action because we’re all feeling a sense of helplessness and loss of control about what’s going on with this pandemic, but when you take action with other people, you can control what you’re doing,” she says. Helping others could include checking in on family friends or buying groceries for an elderly neighbor.

Begin slowly building your resilience bank account

Maddaus’ idea of a resilience bank account is gradually building into your life regular practices that promote resilience and provide a fallback when life gets tough. Though it would obviously be nice to have a fat account already, he says it’s never too late to start. The areas he specifically advocates focusing on are sleep, nutrition, exercise, meditation, self-compassion, gratitude, connection, and saying no.

“Start really small and work your way up,” he says. “If you do a little bit every day, it starts to add up and you get momentum, and even if you miss a day, then start again. We have to be gentle with ourselves and keep on, begin again.”

After spending an hour on the phone with each of these experts, I felt refreshed and inspired. I can do this! I was excited about writing this article and sharing what I’d learned.
And then it took me two weeks to start the article and another week to finish it — even though I wanted to write it. But now, I could cut myself a little more slack for taking so much longer than I might have a few months ago. I might have intellectually accepted back in March that the next two years (or more?) are going to be nothing like normal, and not even predictable in how they won’t be normal. But cognitively recognizing and accepting that fact and emotionally incorporating that reality into everyday life aren’t the same. Our new normal is always feeling a little off balance, like trying to stand in a dinghy on rough seas, and not knowing when the storm will pass. But humans can get better at anything with practice, so at least I now have some ideas for working on my sea legs.

https://elemental.medium.com/your-surge-capacity-is-depleted-it-s-why-you-feel-awful-de285d542f4c