How We've Changed the Way We Think About Mental Health
The pandemic has put a spotlight on the mental health crisis in a new and immediate way—a way that cannot be ignored. The stress, anxiety, isolation, and uncertainty of this time are not only raising awareness but pushing us as individuals and as a society to have the honest conversations we always needed to have about mental health—especially when it comes to taking action.
As the pandemic accelerates a mental health crisis that already existed, we can take steps to identify our own individual signs and stressors. And as a society, we can emerge into a new normal where we are much more open about the challenges we’re facing and committed to course-correcting in ways we desperately need.
Two key developments make this opportunity possible.
First, the pandemic has exposed the unsustainable ways of working and living that are fueling the current mental health crisis. Many of us are struggling with the boundaryless “permawork” of working from home. Employers are being forced to admit what working parents have always known—that parenting is a round-the-clock job. Meanwhile, first responders and frontline healthcare workers are not only risking their physical health but facing extreme mental health challenges, as recent reports of suicides make tragically clear. Speaking to Business Insider, Dr. Shauna Springer, a psychologist and trauma recovery specialist, compared these workers to “warriors in the war zone, taking risks, seeing their colleagues fall ill and potentially die, losing patients.”
The second key development is that we now have the science to help us identify our signs, stressors, and solutions. Today, we know more than ever before about the brain’s connection to our mental health and how we manage stress.
And this modern science is validating ancient wisdom. A great example is the Roman emperor Marcus Aurelius, one of Stoicism's most famous practitioners. For Aurelius, the quality of our day is up to each one of us. We have little power to choose what happens, but we have complete power over how we respond. It all starts with setting the expectations that make it clear that no matter how much hardship we encounter—how much pain and loss, dishonesty, ingratitude, unfairness, and jealousy—we can still choose peace and imperturbability. And from that place of imperturbability—or ataraxia, as the Greeks called it—we can much more effectively bring about change.
These principles are at the heart of Thriving Mind, the mental health program Thrive Global created in partnership with Stanford Medicine. Thriving Mind helps us understand the different ways we all respond to stress and anxiety and gives us personalized strategies to spot the signals in ourselves, respond to and course-correct from stress and anxiety, and build mental resilience, which is more important now than ever.
Dr. Leanne Williams, Director of Stanford’s Precision Mental Health and Wellness Center, has used high-definition brain imaging technology to characterize eight different kinds of “short circuits” that occur in the brain when we experience persistent negative stress we feel we can’t control, called biotypes. Understanding the thoughts, emotions, and patterns associated with each biotype helps us understand the moments and scenarios when we struggle most and what actions we can take to help manage our stress or anxiety.
Rumination
We all have inner thoughts and moments of reflection. We all worry. But do you ever find yourself stuck in a loop of brooding self-reflection that you can’t get out of? To the point that it negatively affects your life and keeps you from being productive, finding joy, and going about your day? That’s rumination. This is characterized by extreme brooding and dwelling on negative thoughts and worries, which can result in feeling paralyzed and worthless.
Negative Bias
This bias occurs when we find ourselves stuck in a cycle of negative thought patterns. As a result, our capacity to receive positive information gets shut down. Our brain is naturally hardwired to react more quickly to negative than to positive information—this is actually necessary for our survival, not only physically but also in other settings like the workplace. Usually, negative reactions also resolve quickly. But negative bias occurs when negative reactions persist and we end up catastrophizing and getting stuck in a negative reaction loop.
Threat Response
The threat response is a specific form of negative bias where our fight or flight response actually stays on and in alarm mode. Normally, our brain returns back to its usual baseline after a threat-related event. But imagine an extreme form of feeling fight or flight, possibly triggered by some kind of trauma, and you find yourself stuck in alarm mode and unable to recover.
Anxious Avoidance
In anxious avoidance, the salience circuit of the brain becomes extra tuned into internal changes—like physical signs of anxiety or pain—as well as to external changes in the world around us, like new social situations or sounds. We can end up feeling overwhelmed with stimulation and may want to dampen it down by avoiding and getting away from sources of stimulation. Think about someone who is hypersensitive to light or sound, or fearful of social situations, speaking in public. Anxious avoidance is an extreme version of that behavior.
Cognitive Fog
Cognitive fog arises from a disruption in the circuit involved in conscious will—the one used to control our thoughts and actions in response to current goals. If you undergo a period of sustained stress and the source of that stress is not in your control, this circuit will be under pressure and cognitive fog might appear. In this situation, your brain may feel foggy rather than sharp. It’s hard to execute on decisions, to implement tasks at work and home, to plan ahead, and to regulate unwanted reactions.
Inattention
Then there’s inattention. We don’t typically associate inattention with depression or anxiety, but it’s quite common. Think about the times you’re experiencing negative stress or feeling anxious—it’s really hard to concentrate, isn't it? Your capacity to sustain attention over time is disrupted. Basic functions at work and at home may become extremely difficult or impossible. It may feel quite exhausting to pay attention to the task at hand.
Emotional Numbness
This refers to a loss of the ability to feel pleasure from usual activities and goals. It can develop when we are under intense and chronic stress that leaves us feeling emotionally numb. In this situation, you can imagine how the brain’s capacity to respond to anything positive is burned out. We feel empty and not able to get pleasure from social interactions or to feel meaning or purpose in life. With emotional numbness, we might find ourselves overindulging in food or alcohol in an attempt to feel any emotion at all. Right now, the growing fear and anxiety are leading people to find solace in addictive behaviors:
The CDC warns that the outbreak can lead to increased use of alcohol, tobacco, and other drugs. Online alcohol sales went up 243 percent in mid-March [Nielsen]
Everything that we used to get excited about doing may now feel like a drag and an effort. We may feel like we are going through the motions. Even in this situation, many people are still able to function like high performers at work. They may pay the price by collapsing at night and shutting down the rest of their lives.
Context Insensitivity
Context insensitivity is a very particular form of emotional numbness. Normally we have different contexts in our life (though right now, of course, it might seem like they've all been collapsed into one context: our home). We have our work, our family, our friends, our hobbies, and so on. But with context insensitivity, there is no sense of context between the different domains in our life. Normally, there are different things that motivate us to do something—something that might give us a burst or sense of energy that motivates us to keep moving through our day—maybe a project at work, or a forthcoming vacation. But if context insensitivity develops, motivation and context are lost. And this can take us into a deep state of burnout.
Once you understand these biotypes, you can take action using recharge strategies and small daily steps to build the mental resilience to help you navigate this new normal. Some of these micro-steps have even been found to specifically help certain biotypes, but every micro-step will help strengthen your mental resilience. Here are a few:
Set a cut-off time for news and social media. While being informed can help us feel more prepared in a public health crisis, setting healthy limits to our media consumption can help us have restorative rest and put the stressful news into perspective.
Focus on the rising and falling of your breath for ten seconds. Pausing several times a day to simply breathe allows you to feel less tense and more present in your life.
When you’re washing your hands, take the 20 seconds to think of three things you are grateful for. This will help you lower your risk of viral infection while reinforcing a more positive mindset.
When you feel overwhelmed, focus on your breathing instead of reaching for your phone. We often use our phones to distract us from challenging moments, but this often leaves us more stressed and more disconnected from what matters most. Allow yourself a moment to turn inward instead and focus on your breathing.
If you find yourself judging your emotions or responses around the pandemic, remind yourself that they are normal and justified. Studies have found that pathologizing your responses by viewing them as “something wrong with you for reacting so strongly” actually increases your anxiety. Instead, say something to yourself like, “You are going through a crisis, and you are reacting in a normal way to an abnormal situation.”
When you feel overwhelmed by a problem you face at work, identify the smallest possible step you can take to address it. As you face incredibly complex challenges, practice breaking them down into small, manageable steps by asking yourself, “What’s the smallest step forward I can take in this moment?” This increases your sense of control and self-efficacy.