Note: This article contains content regarding suicide.
“We need this bed desperately,” the nurse said. She was referring to the hospital bed that 22-year-old DJ Meisner laid in, implying that Meisner had to leave the hospital despite suffering from a months-long bout of intense nausea and vomiting as a side effect of long COVID. It was December 2020, and there were people in need of beds with much more severe conditions – people who currently had the virus.
Aside from contracting COVID-19 in early 2020 and in turn losing their health to the long-term symptoms, Meisner also lost their job, a research grant, and relationships both romantic and familial. Enduring loss after loss naturally resulted in a deep state of grief and depression for them that took over a year to even slightly improve, the reasoning for which they largely attribute to the pandemic.
Not only did dealing with such intense symptoms of long COVID make it difficult for Meisner to prioritize healing from their other losses, but it also created new problems. They had seen multiple medical specialists, all of whom had inconclusive results, and visited the hospital a total of six times that year only to be admitted once due to limited space. And yet, they still managed to rack up tens of thousands of dollars in medical debt which in turn caused tension within their family. That December night would be the last time they visited the hospital for their symptoms.
Loss and grief are universal experiences, but the pandemic has affected the process of healing in novel ways by presenting people with unique and complicated obstacles they wouldn’t normally face, resulting in a reported increase in mental health issues such as depression, anxiety, suicidal ideation, and prolonged grief disorder. Social isolation, limited resources, and an altered relationship with time can hinder the process of healing and even cause new issues on top of the grief itself.
According to a study led by researchers from the Boston University School of Public Health, symptoms of depression were three times higher during the pandemic than before. The study included 1,441 respondents from March 31 to April 13, 2020. The responses were compared to those of 5,065 participants from a 2017-2018 National Health and Nutrition Examination Survey.
[pullquote speaker=”” photo=”” align=”left” background=”on” border=”all” shadow=”off”]I thought I was going to die[/pullquote]
Meisner suffered from symptoms of long COVID for about eight months starting from March 2020, the worst of which being chronic nausea and vomiting, which only worsened with time. By October the suffering was unbearable and culminated in enough pain for Meisner to attempt suicide. “I thought I was going to die and this was a harm reduction method of not having to be in complete agony,” they say.
They could keep down just the smallest amounts of food, and by the end of the year, they had lost 30 pounds. Along with the deterioration of their health was the deterioration of their personal relationships. Their sickness did not allow Meisner to be the friend, partner or child that they could normally be, and this rift between them and their loved ones added to the grief.
For 24-year-old Cayla Clarkson, this social isolation was a major aspect of the pandemic that greatly affected her healing process. Initially, it gave her the necessary space and time to grieve the loss of her best friend, Alex Amaro, who was a victim of a fatal hit-and-run in Toronto, Ontario in December 2020.
According to Dr. Robert Neimeyer, director of the Portland Institute for Loss and Transition, social support is an important aspect of healing from grief. Clarkson and her friends disregarded Toronto’s stay-at-home order because they needed this social support from one another. For the eight consecutive days between the day of the accident and the day of the funeral, Clarkson hosted a continuous sleepover with friends, terrified at the thought of being alone.
During the week-long gathering, she recalls refusing to be in the bathroom alone during shower time, afraid to be still with her thoughts. Clarkson would routinely ask a friend to sit on the toilet to keep her company while she showered.
“After everybody left and my boyfriend went back to work, that’s sort of when I went to go lay in bed for six months,” she says. Laying in bed for months at a time, says Neimeyer, is a “perfect training ground for depression and for the ruminative preoccupation with loss that is at the heart of prolonged grief.”
Neimeyer says that the percentage of people who have experienced symptoms of prolonged grief disorder before the pandemic was around 10%. “We don’t really have strong evidence on point right now,” he says. “But I wouldn’t be surprised if that (percentage) doubled or tripled.”
Due to Toronto’s lockdown, Clarkson also lost her job and was out of work for seven months beginning just two weeks before the accident, which exacerbated her social isolation. Although grateful in some ways, she soon realized how much structure having an excuse to leave the house provided her with.
“If I just wanted to lay in bed all day, then I could do that,” she says. But soon, her days began morphing together and memories became muddled. On several occasions, Clarkson told her boyfriend a story about her day only to be told that it had actually happened days before. “I really took seven months to not do anything,” Clarkson says. “It definitely hindered me in a way.” When she eventually went back to work, she found herself beginning to prioritize things like errands and chores again.
Another effect the pandemic had on her grief surrounded the funeral services. Because large gatherings were restricted, people could only attend Amaro’s funeral in pods of ten and for just 15 minutes at a time. There were no eulogies given and there was no official service. Clarkson remembers being unsure if the 15-minute limit was going to feel like too much time or not enough.
[pullquote speaker=”” photo=”” align=”left” background=”on” border=”all” shadow=”off”]It’s almost been a year and we still haven’t had a real funeral[/pullquote]
A large component of this, Clarkson points out, is that among the hundreds of thousands of funerals to happen during the pandemic, many other large events like weddings or birthday parties were also postponed. “Now, it’s really hard to find a venue,” she says. “It’s almost been a year and we still haven’t had a real funeral.”
According to an article by Dr. Alan D. Wolfelt for the Center for Loss and Life Transition, funerals are crucial for the healing processes of the bereaved. Not only are they a designated space for collective remembrance and support, but they also help people acknowledge and learn to handle grief, Wolfelt writes.
Whether or not the pandemic is directly related to a loss, the fact alone that the loss occurred during the pandemic will affect the healing process, says San Diego-based licensed professional clinical counselor Justeen Jennings. “If somebody lost their dog in June of 2020, even though the pandemic didn’t cause their dog to die, they were so vulnerable in many other circumstances that their reaction to losing their dog was directly affected by the pandemic.”
As is in Clarkson’s case, although the pandemic did not directly cause the death of her friend, Clarkson’s healing process was immediately affected. “It’s all intertwined,” Jennings says.
A unique aspect of the pandemic Clarkson dealt with during her healing was reacting to businesses opening back up after the lockdown.
“Because things were closed, (Alex’s death) didn’t even feel real at first,” Clarkson says. She experienced what she describes as delayed grief. About six months after Amaro died, bars began opening back up in Toronto. Clarkson went to a regular spot for Amaro and half expected to see her there. “That was sort of a milestone,” she says.
Jennings explains the way that most people are experiencing grief and loss during the pandemic “whether they know it or not.” There are the more obvious cases of loss like the death of a loved one, but there is also “grief and loss in the fact that we aren’t able or weren’t able to celebrate our successes in the same way we were used to,” Jennings says.
[pullquote speaker=”” photo=”” align=”right” background=”on” border=”all” shadow=”off”]It was waking up and immediately crying and being so dreadfully captivated by terror at the thought of having to live another hour[/pullquote]
Meisner did not suffer from bereavement, but they still endured grief due to non-death-related losses directly related to the pandemic. They describe the lowest part of their last two years as “an incredibly awful and bleak time,” experiencing negative emotions to a degree with which they were previously unfamiliar.
“It was waking up and immediately crying and being so dreadfully captivated by terror at the thought of having to live another hour,” they say.
Neimeyer explains that death-related and non-death-related losses are both comparable and incomparable.“One of the ways in which they are comparable is that all losses have a profound attachment,” he says. “Whether it’s a matter of our losing an aspect of ourselves, perhaps through injury, illness (or betrayal), we cease living in the body that we once did.”
Is therapy for you?
Licensed professional clinical counselor Justeen Jennings says that the increase of people seeking therapy from before the pandemic to now is overwhelming, though unsurprising. Before, there were three therapists in her San Diego-baed private practice, herself included. Today, there are 19, all of whom are completely booked.
Are more people depressed and anxious because of the pandemic? Or did it just exacerbate their existing issues and push them to seek therapy?
“I think it’s both,” Jennings says. “The pandemic either increased their symptoms, gave them symptoms, or it became more socially acceptable to go to therapy because of the pandemic.”
Director of the Portland Institute for Loss and Transition Dr. Robert Neimeyer also sees this increase in people seeking therapy. “I think the need for someone to talk to about matters of the heart – that’s growing more intense for people,” he says. “It becomes more important to have that lifeline.”
However, Neimeyer emphasizes that although therapy is helpful, it isn’t necessary for absolutely everyone. “If we are in a dangerous place, turning to alcohol and drugs to abuse, the pain or we’re contemplating suicide, obviously, professional consultation may be called for,” he says. “But more generally, what’s called for is compassionate self-care and the invitation of other care. And then if after some months, we find ourselves still in a very difficult place, or maybe it’s getting worse rather than better, that’s a time to reach out for professional support.”
A major difference between these two types of losses is that one receives some level of ritualistic support and social recognition, while the other one receives significantly less if any at all, Neimeyer says.
He points out the way that burying a dead child is often met with more social support or recognition than losing a relationship with a child due to addiction or estrangement. “It’s striking that non-death losses are often made invisible except to the person who has experienced them,” he says.
Whatever the type of loss, Neimeyer says fully healing is possible. But what does that look like? “Healing is possible for all losses,” he says. “However, it is also probably the case, paradoxically, that all losses continue to have a bearing on our life.” According to Neimeyer, depending on the depth of the connection and the circumstances of the disconnection or loss, they can still be haunting.
[pullquote speaker=”” photo=”” align=”left” background=”on” border=”all” shadow=”off”]Non-death losses are often made invisible except to the person who has experienced them[/pullquote]
He explains that healing from grief or loss does not necessarily mean that it won’t hurt anymore. “Those are not losses that typically become greatly less painful across time. But the grief doesn’t grow smaller, we tend to grow larger,” he says.
By December, just one day before their 23rd birthday, Meisner made another plan to commit suicide. They wrote a note, had a rope ready, and selected which tree at Point Reyes they would spend their last seconds, going so far as to calculate the exact height necessary to make death instantaneous. However, once they arrived, they were greeted by groups of tourists and families enjoying their Sunday afternoon at the cape. Meisner, desperate and defeated, turned around and drove to their mother’s home in Marin County. Strangely enough, that was the first day since Meisner could remember that they had not vomited.
Meisner has managed to slowly heal from their grief-filled year, attributing much of this process to eye movement desensitization and reprocessing therapy (EMDR). Despite this, they still struggle with their preexisting depression and anxiety.
According to Neimeyer, grief stays with someone in more ways than one. “It can certainly constrain us,” he says. “We may find ourselves depart through the way in which we defend against pain. We may begin to limit experience.” Another way grief may affect people in long term is by promoting avoidant behavior. Neimeyer describes this as “unmetabolized or unintegrated trauma.” There are aspects of the grief or loss that can be traumatizing, such as a vehicular crash or the death of a loved one. “The way in which we tend to hold traumatic memories is something that can be intrusive,” he says.
Folks can also experience post-traumatic stress when the losses experienced are profound. However, Neimeyer adds, “people can experience post-traumatic growth in a way that we become more profound, wiser, more grounded and not as easily shaken by future adversity.”
Meisner echoes this, “It’s kind of impossible to experience pain without learning from it or growing from it,” they say. “If you do not die from the thing, you in theory now have the knowledge of dealing with that thing, even if you barely survived.” Pain can inform and transform, Neimeyer says, emphasizing that there are positive lessons in loss. “That’s another way it can be with us, but in a way that enhances us rather than diminishes our loss.”
[pullquote speaker=”” photo=”” align=”right” background=”on” border=”all” shadow=”off”]It’s kind of impossible to experience pain without learning from it or growing from it[/pullquote]
When healing from a loss of any kind, Neimeyer recommends therapy, but stresses that it isn’t necessarily for everyone, so long as there is someone to talk to. “Find someone with whom you can speak your heart that helps you make meaning of the loss through the quality of their compassionate connection and curiosity.”
Another component of healing according to Neimeyer includes self-compassion. “Instead of critiquing ourselves for being depressed or withdrawn following such a loss, give ourselves the latitude and the level of understanding that we are grieving,” he says. “That is natural and noble. It’s simply that we don’t want the grief to ultimately keep us from living.”
Jennings stresses the importance of normalizing any reaction to the pandemic. “Any reaction is a normal reaction,” she says. “It’s how you react to and deal with these feelings.” This can be done by asking if your behavior is helpful or hurtful to the overall goal. “And letting that guide your behavior is going to be key to reaching where you want to be in your functioning.”
