I promised myself I wouldn’t write about Covid anymore, but anyway…
A group of British researchers, led by PhD candidate Emma Sorenson, asked 17,000 school students about their subjective wellbeing during the first UK lockdown in early 2020. The researchers found that about 1/3 of the 8-18-year-olds reported that their mental wellbeing had improved during lockdown. Ms Sorensen said “The common narrative that the pandemic has had overwhelmingly negative effects on the lives of children and young people might not tell the full story. In fact, it seems as though a sizeable number of children and young people may have experienced what they felt was improved wellbeing during the first national lockdown of 2020”.
Much of what we call poor mental health relates to an inability to function in our current reality. In order to diagnose a psychological disorder, the mental health professional must establish the presence of clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Our reality as humans is, and always has been, that we must be able to relate, in-person, to other humans. In my clinical practice, I diagnose new clients with disorders such as depression often based, in some part, on their current engagement with others (or lack thereof). Certain disorders, like agoraphobia or social anxiety disorder, even more explicitly relate to functional impairment in our ability to be outside and amongst others.
But is reality now changing? What if the New Normal is to not engage in-person, to not be physically present in the outside world?
Crises often hasten change which was already occurring. Pre-2020 we were already moving much of our lives online. Shopping and banking were moving away from bricks and mortar. Universities were offering online content, and students were often preferring to engage with that content. Connecting with friends was increasingly mediated via apps.
All of these changes have only accelerated over the Covid era.
All of these changes are especially true for the young.
Now, it is perfectly possible to conduct your entire life functions from home. Save for a medical crisis, one need not ever leave the house.
Young people, with their more adaptable minds and their ignorance of prior ways of living, are choosing physical isolation in droves.
I have previously written about the Experience Machine thought experiment. My articles toy with the idea that the population may step-by-step enter into a Matrix-style reality, not out of force but via their own free will. Covid and the associated lockdowns have brought us closer to this nightmare (or dream, depending on your perspective).
Take Psychological services as just one example.
In Australia in 2019, you had to live in a rural/remote area to qualify for a government-subsidised telehealth session with a psychologist. There were actually more hurdles than just this – it was a serious pain to utilise the Medicare telehealth program.
Then, when the pandemic hit, the government opened telehealth up to all comers. This wisely allowed for existing mental health patients to continue to receive services while eliminating a potential contagion point.
However, over the two years of the telehealth program, its popularity with clients and psychologists alike soared. And at the tail end of the lockdown era the government went much further and guaranteed the program in perpetuity. Now all psychological services can be held from home, all of the time, no questions asked!
And this is just one example of many of the stampede toward a disembodied future over the last 2 years.
I do worry what this change means for human thriving, solidarity and civic mindedness. But my main point in this article is – what does this change mean for diagnosis?
Agoraphobia is the fear of open spaces. Can agoraphobia be thought to be maladaptive once the bulk of the population is happily interfacing with the world via a device on their couch?
When the majority don’t leave their houses, how do we make sense of someone with depression who doesn’t leave their room?
Psychological diagnosis rests on a foundational understanding of Normal. And without a doubt Normal is changing.
Perhaps in some near or distant future, the sick will be those who insist on physical touch and public engagement. And, when that day arrives, we psychologist will be right there helping them to adjust to the New Normal.