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It started as February crept toward March. Posts on social media began to appear asking if anyone else was in a “weird funk” for “no reason,” as one friend on my timeline put it. A tweet from February 26th claiming not to know a single person who wasn’t having an inexplicably “garbage” couple of weeks (the “worst ones of the whole pandemic,” even) was liked more than 20,000 times. Since then, texts from friends have confirmed the heightened stress they’re somehow, after a year of extreme stress, able to feel, and I’ve been reaching for my go-to soothers — baths and Golden Girls episodes — with a restless regularity.
Most of the messages I saw and sent spoke to a two-part theme: a mounting, mutual sense of dread coupled with confusion over that dread. And the confusion makes sense. After all, we’ve had months, a whole 12 of them for most of us in the U.S., to process and adapt as best we can to life under COVID-19’s siege. Now, after a year of unending anguish — from the more than 530,000 lives lost to the virus in the U.S. alone, to historic joblessness, ongoing police brutality against Black bodies, climate disasters, and a violent attempt to overthrow our nation’s democracy — there’s finally a bright spot on the horizon.
New COVID-19 cases are a fraction of what they were at the January peak, and good news about vaccine efficacy (if not always its accessibility) continues to rise. We’re beginning to consider what stitched-back-together versions of our lives can look like by year’s end — a line of thinking that brings up plenty of anxieties in its own right, but also unmistakably carries with it the promise of relief. This collective hope, arguably our first meaningful dose of it since the pandemic started, is something many of us are, on a rational level, reveling in. And yet, underneath that optimism, unease festers. Why the uptick in anxiety now?
The answer could lie, at least partially, in something trauma experts refer to as the “anniversary reaction.” According to New York state's Office of Mental Health, as a trauma-representing date approaches, survivors of that trauma "report a return of restlessness and fear. Psychological literature calls it the anniversary reaction and defines it as an individual’s response to unresolved grief resulting from significant losses.” The reaction, this description continues, can “involve several days or even weeks of anxiety, anger, nightmares, flashbacks, depression or fear.”
The pandemic is a trauma we’ve all collectively sustained. And with the one-year COVID anniversary of the pandemic upending life in the U.S. here — it was on March 11, 2020, that the World Health Organization declared COVID-19 a pandemic, and stay-at-home orders successively went into effect soon after — it isn’t a stretch to think we’ll react accordingly. That’s a view supported by many of the experts I heard from, including Beth Tyson, MA, a psychotherapist who specializes in grief and trauma.
“The onset of COVID-19 in early March 2020 was a collective, or mass, trauma that impacted the entire world for the first time in our living history,” Tyson said. “Anniversaries of traumatic events typically stir up intense emotional reactions, and the one year mark of COVID-19 will do the same.”
That’s a reality that many therapists and mental health professionals already report seeing in patients.
“The anticipation of the anniversary also causes an increase in symptoms, and we are already seeing it,” Joanna Filidor, LMFT, who specializes in the treatment of trauma, said. “People are feeling burned out, powerless, and helpless… others are feeling trapped. Typical coping skills aren't as effective anymore, which leads to more anxiety and depression. A lot of people are reaching out for support.”
Meira Ellias, LCSW-C, LICSW, TCTSY-F, a psychotherapist who’s worked in the fields of trauma, grief, and loss for over a decade, says that some people “may not even realize they’re feeling more anxious because they are passing traumatic milestones.” Even still, our bodies have a way of remembering, even if our conscious minds don’t.
As Tyson explains it, this manifestation of trauma serves a purpose. It’s there to help steer us in the direction of safety and is often triggered by certain factors in our environment, including changes of season as well as specific dates on the calendar. Our brains react to a “perceived” threat as if it is a real threat, and it triggers a need to reach safety.
What complicates this need is that many of us can’t yet because the pandemic is still very much ongoing. Because of that, some experts use other language to describe what's happening.
Roxane Cohen Silver, PhD, a professor of psychological science, medicine, and public health at University of California Irvine, has led multiple studies examining the mental health impact of national disasters, and in September testified to Congress on the “cascading collective trauma” effect of COVID, climate crises, and social injustice. Calling the past year “unlike anything I’ve ever studied,” she believes that, rather than an anniversary reaction, what many are now grappling with is the cumulative mental health impact of an extreme and continuing “chronic stressor.”
“I use the metaphor of a war which is where there's a chronic stressor, we don't know when it's going to end and we don't know how bad it's going to get,” she said.
But, as Cohen Silver is quick to clarify, for many individuals the past year’s collective trauma is also compounded by personal traumas that do have dates attached, such as the loss of a loved one, or even the loss of a milestone or life event like a graduation or wedding. “We have lost both the lives of hundreds of thousands of people, and we’ve also lost hopes and opportunities and life experiences,” she said.
Taken together, that combination of individual and collective loss is incredibly heavy, and it could be resulting in something that David Bond, LCSW, director of behavioral health at Blue Shield of California, calls “complicated trauma,” made all the worse by our chronic exposure to it. He compared it to holding a two-pound weight:
“If you held it there for a few minutes — fine, not a big deal…. But if you held it there for an hour, your arm would get very stressed. Muscles would be fatigued, and other people might say, ‘But you’re only holding two pounds,’" he said. "The difference is that you’ve been holding it for such a long time that your body just can’t anymore.”
This, he says, is where the real danger comes in: when a pain that you would have been able to process and more easily recover from as an acute event stretches into something sustained. And for those who already struggled with mental health prior to the pandemic especially, that strain could translate to health impacts because of an inability to get away from trauma.
This “inability to get away” has not been evenly felt because the impacts of the pandemic have not been evenly applied. It’s those from marginalized and under-resourced communities — whose mental health was already more likely to be vulnerable before the pandemic — who have borne the greatest impact of the virus’ health and economic consequences.
“Speaking from the perspective of both a Black person and mental health professional, the one-year anniversary of COVID-19 in the United States brings up feelings of unease, discomfort and uncertainty,” Atlanta-based psychotherapist Amira Johnson, MSW, said. “Black people suffer the most in the United States mentally, physically and emotionally, yet don’t receive the care that we need for three main reasons: stigma, mistrust and fear, and resources.”
Black people in the U.S., as is true for those from Latinx, Indigenous, and Asian-American communities, are significantly more likely than white people to know someone who died from COVID-19 or to have experienced a COVID-19 hospitalization themselves. That’s a fresh layer of grief and pain to work through on top of other racism-rooted traumas, making Black communities in “desperate need of mental health services,” Johnson said. Historically, however, there have “not been many advocates for this group of people that have the ability to link them with service providers,” specifically ones they can relate to and afford, she added.
The presence of community-based trauma impacts what healing from individual grief, losses and traumas looks like, and vice versa. As Bond put it, we need to see healing happen on the community level in order to feel its effects personally.
“When you experience community trauma, the recovery also is going to require the community around us to get better,” he said. “It’s not just an individual thing. If you were in a car accident, this is about your personal psychological trauma. But this is community trauma, on a national and global level, so we’re looking not just for our own healing, but the healing of all the people in the communities we live in.”
Community can be seen not just as something needing to be healed, but also the space where that healing happens. And that’s true whether your uptick in anxiety is due to COVID’s impending anniversary, the fact that you’re beginning to process the impact of chronic, complicated trauma or some combination of the two, according to Sanjay Nath, a psychologist and professor of graduate clinical psychology at Widener University.
“In terms of coping, it’s important to harness systems and communities that might help, whether that be the mental health community, our government assistance systems, employer assistance systems, or our school and non-profit systems,” Nath said. “While often coping is framed at an individual level — ’What can I do?’ — sometimes the focus on self-care for the body, mind and spirit puts the burden back on individuals to figure it out and take on the task of coping. Ideally, there’s a balance of self-care and self-coping and other-care and other-coping that is situated and grounded in relationships.”
On the intimate community level, trauma-informed therapist Charna Cassell, MFT, recommends “preemptively acknowledging” the fact a difficult anniversary is on the horizon this month and preparing for its potential emotional toll accordingly.
“Set up a call with friends or family members who are skillful listeners or arrange for someone in your pod to come hang out with you,” Cassell said. “Spend time in nature to gain perspective and feel more grounded. And, of course, meet basic needs such as nutrition and sleep, which will help you feel more regulated in general.”
In addition to creating structure and looking just enough ahead to ensure you feel supported, Johnson also stressed the importance of staying attuned to the present, especially if you’re already struggling with heightened anxiety.
“Although it’s important to have a life plan and understanding of one’s next steps, it’s also important to stay in the present moment and be grounded within it,” she said, adding that mindfulness-based activities like journaling, meditating or going for a walk can help. “As cliché as it sounds, collectively we need to take life one day at a time right now, which in a way will help us appreciate life even more because we’re actually experiencing it and living rather than just striving and surviving.”
