Things are looking up, why do I feel bad?
By now it is not news that many of us have experienced mental health challenges over the past year. For most of us, every life domain has been affected in some way by the pandemic and by social unrest: physical, mental, social, professional, financial, and even existential. Even those who somehow escaped the worst of the harm have been affected. For those still experiencing loss, violence, work and housing instability, illness, or financial crisis, there is a clear reason for ongoing distress and symptoms. But lately I’ve been seeing that even those whose lives are beginning to stabilize are discouraged because they are experiencing a fresh wave of symptoms of depression or anxiety.
Many times when someone comes in with unexplained symptoms of depression or anxiety, I ask what was going on this time of year last year. And very frequently, it turns out to be a leadup to the anniversary of a traumatic or painful event: a “traumaversary.” Experiencing a resurgence of symptoms at the anniversary of an event is also known as “anniversary effect.”
As the saying goes, the subconscious may experience all times as one, but it sure keeps an accurate calendar. This makes sense from a survival standpoint. Part of trauma response is an attempt to save us from further traumatization by avoiding similar situations. The subconscious may tell us, “last time I was in this situation, something harmful or threatening occurred, so be on the lookout for danger!” Whether consciously or not, we remember situational cues such as what time of year it was, the quality of the light, the smell of the air, the temperature, what seasonal events were happening, what landscape we were in, and numerous other aspects.
What we are seeing now is a mass-scale traumaversary. A year ago we were all plunged into a worldwide nightmare that went from bad to worse, and from which we have largely not yet recovered. Contagion, social strife and violence, financial crisis, medical nightmares, and other sources of fear and powerlessness, if not outright terror. And we are still incurring losses.
You may not even realize how much you’ve been through! This mental health status chart can help you to assess how you’ve been affected. Were you feeling worse than you realized? Are you still in red or orange? Are you moving towards green?
The fact is, we have been through mass trauma on an unparalleled scale. In part because internet access has allowed us to share everyone’s moment-to-moment feelings and reactions all day, every day, all over the world. In one sense that can be good, because it validates our experiences to see others having similar reactions. But in another sense, immersion in everyone else’s trauma can increase your own trauma. Also, having to go about everyday routine as though things are “normal” can make things worse.
What can we do about traumaversary?
For any kind of trauma, recognizing when symptoms may activate is very useful. Many times we do not recognize why we are feeling bad until it’s already been going on for a while, or perhaps even in hindsight. If we know in advance that a certain time of year may be especially hard, that can help to reduce the severity. Not knowing what’s happening can make it worse.
Anticipate symptoms and stressors
What kind of symptoms are you experiencing now? When you think back, are they similar or related to what you were experiencing last year? Is there any pattern to when they occur, such as being at home, at work, around certain people, doing certain activities? Here are some common symptoms I’ve been seeing:
Discouragement: pushing so hard, for so long, and although there is hope for improvement, it’s far slower in coming than we may have hoped.
Burnout/malaise: stress is cumulative, and it takes time and energy to heal from it. Many have not had the opportunity to recover from each day before the next day comes, let alone the opportunity to recover from a year’s worth of constant stress. It’s hard to stay engaged and interested without stress recovery.
Exhaustion: many are exhausted from unceasing exertion: physical, cognitive, and emotional. We may be sleeping a lot more, not feeling restored after sleep, and too drained to participate in our usual tasks and activities.
Impaired executive function: forgetfulness, loss of concentration, unusual time perception (speeding up or slowing down), difficulty planning and implementing activities. Not being able to “get things done.”
Dissociation: losing track, losing time, spacing out, not being present, feeling numb, feeling unreal or that the world is unreal.
Hypervigilance: being easily startled, easily woken, heightened anxiety.
Sleep issues: insomnia, exhaustion, hypersomnia. While many have gotten some relief from the insomnia of the past year, hypersomnia is still prevalent. It’s not surprising considering the cumulative stress and burnout we’re experiencing!
Find ways to support and care for yourself
Recognizing how much you’ve been going through may already be enough to mitigate some of your symptoms, because they will feel less inexplicable. This may also make it easier to allow your reactions instead of telling yourself you “should” be able to function. Acknowledge to yourself how hard this has been and continues to be! We can’t truly heal from a trauma that is ongoing, though we can find ways to cope.
Remember the basics of caring for your body: sleep, nutrition, exercise, and social interaction. It’s unreasonable to expect yourself to feel okay emotionally if your basic needs aren’t being met. Go through each one and see what can be improved, even in a small way.
Also, allow yourself to experience enjoyment! Sometimes when everything has been terrible for a long time, we feel wrong or guilty enjoying anything. But joy helps us to stay mentally healthy and balanced. It doesn’t mean you aren’t serious or you don’t care about others.
Back to “normal”?
There is hope and solid progress towards restoring a robust and healthy society. But life has changed forever in some ways. Sociopolitical rifts have become stark. Lives have been lost, homes have been lost, jobs have been derailed. And most of all, safety has been lost. In truth, we are all vulnerable to illness, we are all vulnerable to violence, we are all vulnerable to want and instability, but the past year has made this truth concrete to many who felt safe before. We can’t put this back in the box. These are real losses, and if grief comes up, it’s okay to allow it.
One sure-fire approach to help restore your own sense of agency and safety in the world is to contribute to making it safer for everyone, whether that means protecting others simply by following pandemic guidelines, supporting causes that help the community, or speaking out in helpful ways. You’re still part of a living, hopeful world that many people are working on improving. ❤