Preserving Health in the time of Covid19

Illness Anxiety disorder (IAD) is a real diagnostic category listed in the DSM5. IAD or health anxiety, is diagnosed when someone worries excessively that they are seriously ill or when they perceive normal body sensations as signs of a severe illness. If this sounds familiar it should. IAD used to be called hypochondriasis. Covid19 has prompted a slew of such cases so severe that some people wear masks in their own homes, even to sleep and are afraid to go to their own backyards. Some afflicted with this disorder cry incessantly.

The fear of getting this illness is causing a wave of hypochondriasis that is understandable and immobilizing for many. But IAD is not the only incapacitating mental health diagnosis linked to the Novel Corona virus. The rates of general anxiety disorders, depressions, suicide attempts, increasing substance use and physical and sexual abuse, not to mention the overwhelming number of people grieving, have all risen in the last weeks. Even more disturbing, given how little is still known about the disease, is the number of cases of Post-Traumatic Stress triggered in essential workers especially health care workers and in some cases the disease attacks the brain causing dementia like symptoms. Many of these disorders are linked to the biological course of the disease. Others are linked to the social and emotional consequences of the isolation and loneliness that physical distancing and sheltering at home cause.

In my entire professional life, through 9/11, Superstorm Sandy and any other number of other large-scale tragedies I have never been so inundated with requests for help with mental illness. In addition to my private practice I field easily more than 10 additional calls daily. All of them are crises.
With time the work of scientific investigation will proceed and more will be learned about Covid19, how to treat and how to inoculate against it. What we can do now is recognize that we live in a time that allows us to be socially engaged despite physical distancing. There are many options available to staying in contact with relatives and friends. Using those resources may inoculate against some of the mental health consequences. What we should never do, however, is give in to the primal desire to believe that any one of us has the knowledge and insight to determine that the risks are minimal and that life at this point can revert to the old normal.

There is a small but vocal movement to revert to life before Covid19 even before we gain control. Some of the proponents appear to be suffering their own form of IAD. They are so adamant and so reactionary to the idea that they must go back to their old life before we have a way to control the disease other than isolating that their obsessions and correlated anxiety seem to rise to a diagnosable level. It seems that they are suffering some form of OCD. Yes, financially we must get back to work. But that must be done in a manner that limits exposure to illness and death that is supportive and protective of everyone.

Yesterday was a confluence of events- there was the loss of several people I know, hearing from a relative who is a funeral director about the ungodly number of people he has buried in the last month and a local “secret minyan“ that continues to function despite the fact that several members are now very ill. The kicker though was hearing a pastor being interviewed on a news station insisting that he would hold regular services with close to a hundred in attendance and then reading a statement out of Lakewood that said virtually the same thing. Essentially, they both said that doing the work of god as defined by these religious leaders will protect from the virus. Perhaps because I am not a cleric, I misunderstood them, but they sound like they are suffering from a compulsion that does not allow them to evaluate the current reality. My belief is that the work of god is defined as caring for the needs of all. Willfully putting people in harm’s way is not something that the Judeo-Christian belief subscribes to.

You may be lucky and not yet know anyone who has gotten ill physically and or psychologically from Covid 19. You may be lucky and not have had any contact with severely ill people or been to a hospital straining to treat the overwhelming number of sufferers. And I truly hope you never have to. But for those of us who have let me say clearly – If you have no degree or experience in health care, public health or have never taken a course in statistics than please stop! Stop pontificating. Stop putting yourself and others in danger and stop believing you know all of god’s ways!