Dr. Doug Walker has spent years helping communities heal after manmade and natural disasters, but he has never witnessed a situation quite like the global pandemic caused by COVID-19.
“The pandemic is universal and brings us to a place we’ve never been in our generation,” said Walker, PhD, chief programs director and clinical psychologist at Mercy Family Center in New Orleans, an outreach ministry of Mercy. “In other natural disasters, the areas impacted are surrounded by areas that are intact — physically, biologically and economically. There is extra stress and anxiety associated with COVID-19 because there’s no way to escape from it and no cavalry coming to provide relief.”
Every disaster has its own signature that can impact some people more than others and is often hard to predict, said Walker, a national trauma expert.
As this pandemic brings more uncertainties, Walker believes recovery from a mental health perspective involves understanding how mental health has been impacted, finding ways to manage stress and anxiety and having empathy for the unique experiences of others.
Understanding the stress-to-trauma continuum
After Hurricane Katrina in 2005, Walker decided to pivot professionally and devote some of his time to helping people who have suffered trauma. He has traveled around the United States and to 25 countries to help design and implement large-scale mental health programs after disasters, including the EF-5 tornado that devastated Joplin, Missouri, in 2011, and the Deepwater Horizon oil spill along the Gulf Coast in 2010.
In 2016, he traveled to Japan as a Fulbright Scholar, where he glimpsed mass trauma in the communities still recovering from the earthquake, tsunami and the nuclear meltdown and explosion at the Fukushima Daiichi Nuclear Power Plant. While there, he saw how people could not return back to their homes and how they lived in fear that their food may be contaminated by a type of radiation that will remain in their soil for hundreds of years.
This eye-opening experience in Japan made him see the COVID-19 pandemic through a different lens.
“What makes COVID-19 unique is that you cannot identify or see the danger,” said Walker.
What is universal about all disaster situations, however, is that everyone experiences stress and anxiety differently — what he describes as a stress-to-trauma continuum. Some people feel a normal amount of stress and anxiety during threatening situations, while others may be in crisis mode where it is difficult for them to function.
In most cases, Walker believes the COVID-19 pandemic is causing stress and anxiety within normal ranges for most people that will fade over time when things become more certain.
When someone has a direct experience with COVID-19, they may experience trauma — the feeling that their life or health is threatened. Although Walker said there is no evidence yet to support the idea of COVID-19 leading to post-traumatic stress disorder, he believes it is possible. PTSD is a more extreme reaction, where a person who experienced something traumatic replays that experience in their mind and begins to shut down. This can impact their ability to function in their daily lives.
What Walker is most concerned about is a type of trauma called “traumatic grief,” which he predicts will be on the rise over the next six to 12 months. Traumatic grief occurs when someone experiences an untimely death and is unable to process it. With COVID-19, there is an added layer — a lack of closure.
“We don’t have control over saying our goodbyes either as a personal wish or through a spiritual or religious tradition,” he said, noting that many people have been unable to be at the bedside of their loved ones. In cases where their loved one dies due to complications from the disease, they may be unable to have a traditional funeral service or practice certain religious traditions, like burying their loved one within 24 hours, which is the custom of certain religions.
“Because of our inability to have control over the situation and the fact that death may come suddenly, traumatic grief will be fairly common and difficult to address without that sense of closure,” said Walker.
Practical steps on path to recovery
In order to recover after a disaster or traumatic event, research shows that people need to feel safe, calm, connected to others, have hope and/or believe that they can rebuild or have the ability to become even better.
While there is no playbook on how to handle stress, anxiety, grief or trauma related to COVID-19, Walker recommends adopting these resiliency skills:
- Focus on problem solving: When people are stressed or traumatized, the brain tends to focus on survival and often cannot work through problems. With COVID-19, there are a lot of things that are out of our control, but it’s important to find creative ways to solve problems. For example, finding ways to successfully work from home, developing strategies to step in as your child’s teacher or creating your own face mask.
- Manage your reactions: Trying to find calm in a stressful situation is tough. Learn what triggers your emotions and find strategies to calm yourself down, like breathing exercises, meditation or mindfulness activities.
- Invest in healthy social connections: Although this is hard to do right now with social distancing, there are virtual ways to connect with each other. This is also a great opportunity to spend meaningful time with the family members or friends in your household.
- Participate in positive activities: Although our leisure time activities may be more limited, find activities that make you feel better, like getting outside, exercising, reading a book or watching a good movie.
- Practice helpful thinking: This is probably the most complex skill because it requires changing the way you think or feel about a situation. Living along Lake Pontchartrain in a suburb north of New Orleans, Walker witnessed people flocking to his neighborhood over the last few weeks to enjoy the walking paths around the water. Although initially annoyed by the increased traffic and noise, he changed his thinking by reflecting on how happy everyone seemed as they were engaged in healthy activities.
Glimmers of hope and gratefulness
As everyone determines their new normal in the coming weeks, months and years, Walker likes to think that there is light through the storm. He reflects on a poem by Kahlil Gibran from the early 1900s that says, “The deeper that sorrow carves into your being, the more joy you can contain.”
“Through this experience, we are mourning the things we love most and are really grateful for,” he said. “We talk about our economies readjusting, but I think our humanness is being readjusted. I hope it sticks and that the way we treat each other and understand the world brings us closer rather than separating us.”
Mercy, named one of the top five large U.S. health systems for four consecutive years (2016 to 2019) by IBM Watson Health, serves millions annually. Mercy includes more than 40 acute care, managed and specialty (heart, children's, orthopedic and rehab) hospitals, 900 physician practices and outpatient facilities, 45,000 co-workers and 2,400 Mercy Clinic physicians in Arkansas, Kansas, Missouri and Oklahoma. Mercy also has clinics, outpatient services and outreach ministries in Arkansas, Louisiana, Mississippi and Texas. In addition, Mercy's IT division, Mercy Technology Services, and Mercy Virtual commercially serve providers and patients from coast to coast.