The Great Exhaustion: Long-Lasting Pandemic Effects

Source: Amy Z/Pixabay

If you are feeling exhausted, and you are not quite sure why, you are not alone. At least once a week, I hear from patients and colleagues alike that “I am just so bone-tired, and I don’t know why.”

While I am not aware of the numbers and official statistics nationwide, I personally know many individuals who have at this point needed to take time off from work under the Family and Medical Leave Act due to COVID-19-related mental health difficulties. In March of 2022, The New York Times published an article titled "The New Phase of the Pandemic Is COVID Exhaustion." However, 10 months later, it seems to be that an all-encompassing and much more generalized exhaustion has become very hard to shake off.

It is hard to pinpoint where this sort of existential weariness is coming from when the world seems to be opening back up, social activities and travel have resumed, and, in a lot of ways, people are behaving as if a pandemic never happened—stores are now full of unmasked people, flights are sold out, and concert venues are working at full capacity. (I admit, I also have purchased tickets to three events in the last month.) By all accounts, the world—at least our corner of it—is mostly back to normal. So why are we feeling so decidedly “not back to normal”?

There are a number of reasons why a prolonged collective trauma, like the one we have all endured, also causes long-lasting consequences. Some may seem more obvious, while others may be unconscious and have more to do with the deeper layers of processing of our experiences, including how much time is needed to metabolize trauma. All speak to the very justified need to slow down at a time the world seems to be telling us to pick up more speed.

No Longer Taking Things for Granted

In my family, we have a tradition: If you attend Thanksgiving dinner, you must write anonymously on a sheet of paper at least one thing you are grateful for this year. All notes are then put in a basket and read aloud, with guests trying to guess who wrote each statement.

This year was unusual in that we had the first friends-and-family Thanksgiving in three years, so people were asked to write their gratitudes for the last three years. And here is where the even more unusual part comes in: More than half of the people present wrote statements like, “I am grateful my spouse and I survived”; “I am glad to be able to be with everybody again”; and “I am thankful we did not get sick.” These are not typical statements made during a typical holiday. They are the kinds of statements that we make when we have just survived something that tremendously shook up our world.

Being able to take some things for granted makes our lives easier. Deriving from years of research into the normative unconscious (cf. Weinberger & Stoycheva, 2019), we now know that, in order to function properly, our minds have to be able to rely on at least some consistencies in our environment. This is imperative, because we filter so much information in any given moment, that if we were doubting and questioning every single stimulus, we would become very quickly overstimulated.

However, as my family's statements illustrate, we are no longer feeling safe in such fundamental experiences as "I will see my family tomorrow" or "I, or my spouse, will be here, alive, for the holidays." Since we are no longer taking certain things for granted, such as safety, the ability to see our loved ones on a regular basis, and even the systems that “hold” our world together (including political, health care, and others, which have been significantly shaken up in the last few years), our ability to trust in predictability has been greatly impacted. It is natural that this will result in a kind of existential weariness.

The Adrenaline Dump

When we are under a lot of pressure or experience heightened levels of stress, our bodies react by releasing stress hormones, such as adrenaline, to help us deal with the situation. If you have found yourself functioning in a kind of prolonged fight-or-flight mode through the last three years, you are not the only one. The rapidly changing COVID-19 guidelines, the increased stress related to loss and grief, and the changes in social support we all experienced constitute one lengthy situation of heightened stress—a situation that none of us have ever experienced in our lifetime. The pandemic, for many, has felt like constantly struggling to poke our heads above the water, just to be hit with another wave again.

The long-term impact of this is the inability to effectively recover from stress, which means that our bodies were persistently bathed in stress hormones. It is understandable that once the storm passes, we may need longer to return to “normal” functioning. Fatigue is one of the hallmarks of the adrenaline dump—or the period after our bodies stop pumping stress hormones into our system to keep us able to cope.

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Burnout

Similarly, if we look at how we process emotions—and especially the research of Emily and Amelia Nagoski (2020)—we find out that burnout is mostly the aftermath of an inability to move effectively through the cycle of negative emotions. For a prolonged period of time, many of us could not complete healthy emotional cycles exactly because we were consistently facing new challenges. From more than a million deaths to date in the U.S. alone, to civil unrest, to mass shootings, to the politicization of a worldwide healthcare issue, we have not been able to catch a break and metabolize our negative emotions in a healthy way.

In May 2022, Dr. Vivek Murthy, the U.S. Surgeon General, issued an advisory, declaring healthcare workers’ burnout a national emergency. And while certain professions have indeed experienced a much higher load as a result of a health-related global threat, nobody has been spared. In January 2022, the American Psychological Association published an article indicating that the stressors brought on by a prolonged pandemic have become “persistent and indefinite.” They traced a steady increase in across-the-board burnout since the beginning of COVID-19, including in the following areas: cognitive weariness, emotional exhaustion, and physical fatigue.

In Conclusion

It is challenging if, while the world is buzzing with action again, you feel like you are just not up to all the activities, socialization, tasks and chores, or emotional processing that is required of us on a daily basis. You may be asking yourself, "The pandemic is over, so why am I still so tired?" It may be even more difficult if there is a persistent voice in your mind telling you to make up for lost time because it has been so long since you did [fill in the blank]. However, these feelings are not abnormal or even unusual.

A good rule of thumb is to listen to your body, rather than the pesky voice in your head, and to take care of yourself in a way that will facilitate healing. What this means is this: If you are tired, rest; if you are overwhelmed, reduce the stimulation; if you are burned out, allow yourself time to feel your feelings and to introduce more joy in your life. We are all in our own recovery process and, despite what it might seem on the outside, it will take some time for the emotional aftermath of the pandemic to be fully metabolized.