Pandemics, Poverty, and Mental Health

The dull stress of the late pandemic is a kind of window into what a lot of people live with all the time.

Illinois WPA Art Project / Library of Congress

As the pandemic drags into its second year, the tone of the coverage about day to day life has shifted. The most fortunate among us have been the most likely to do nothing: not go into a workplace, not go into a hospital or nursing home, not go to a grocery store, not travel, with all the attendant risks.

What this looks a lot like is depression. The New York Times ran a popular story about “languishing”: “a sense of stagnation and emptiness. It feels as if you’re muddling through your days, looking at your life through a foggy windshield. And it might be the dominant emotion of 2021.”

This was on the heels of another piece about boredom: “perceiving one’s ‘activities as meaningless,’” “limited in your control over the situation.” And one about “hitting the wall”:

“When people are under a long period of chronic, unpredictable stress, they develop behavioral anhedonia,” Dr. Wehrenberg said, meaning the loss of the ability to take pleasure in their activities. “And so they get lethargic, and they show a lack of interest — and obviously that plays a huge role in productivity.”

Here’s NPR on brain fog, from April 17: “Even if people do not rise to meet the threshold of having depression, it results in this general unhappiness, this general disaffection, this general sense of I’m just tired of it all.”

I am… fortunate, in the sense, of having experienced actual clinical depression as basically all of the above: anhedonia, disaffection, mental exhaustion, stagnation. So I practically knew it was coming, and when it did, I wasn’t surprised. I knew what was wrong, and having gone through that without knowing what’s wrong, it’s much, much less scary. It still sucks, but you can hold it at a distance, examine it, pin it to the wall.

There are probably people who are not experiencing this, just because of how they’re wired. But a lot of people who have been comparatively lucky — no illness, no deaths, minimal exposure to risk, which tends to correlate with other forms of luck and status — have basically been forced into the symptoms of major depression, even if they’re not actually depressed in a clinical sense.

As these articles on the mental stresses of the pandemic in its second year roll out, the symptoms described started to remind me of another underlying cause: poverty. In the past decade or so, the cognitive effects of poverty have been a rich vein of research. And as with clinical depression, there are some considerable parallels to the stresses of poverty.

Here’s an informal literature review from a 2018 piece by Olga Khazan:

Past studies have also suggested that being low in socioeconomic status can affect the way we think. A paper in Science in 2013 found that “a person’s cognitive function is diminished by the constant and all-consuming effort of coping with the immediate effects of having little money, such as scrounging to pay bills and cut costs.” The cognitive cost of poverty, that study found, was practically like losing an entire night of sleep. Another study from last year found that people who had lived in poverty performed worse than those who had never been poor on tests of verbal memory, processing speed, and executive functioning.

That 2013 paper distinguished that mechanism from immediate stress, which, as they point out, can actually increase function. It’s the chronic nature of poverty that’s the problem. A fairly recent Yale study actually found that poverty, but not war trauma, was the issue for Syrian children with diminished working memory and inhibitory control. Here’s another study from 2019 in PNAS which gives a bit of hope: reducing debt reverses the effect, which will hopefully help people who have been able to rebuild their balance sheets during the pandemic.

A couple more, on the compounding stress of poverty and racial disparities in sleeping, by… oh, hey, by me, will you look at that.

Living through the pandemic is not like being poor. But it seems to be producing some outcomes, just as it has sort of simulated clinical depression in people who are not depressed, for people who are not poor. Perhaps it’s even focused on the better-off, who are theoretically more likely to have avoided the real tragedies of the pandemic but are reporting at least some of the toll of constant, grinding, chronic, pervasive… well, just shit.

They’re more isolated. They’re not leaving their neighborhoods. They’re not able to spend money on cool stuff. They’re not able to access daycare or afterschool care, or they can just sporadically. Maybe — like me! — they got laid off and had to juggle gig work and health care and unemployment bureaucracy and freelance paperwork around parenting. Public places are shut off to them, more tightly policed, or the social prohibitions on behavior (see: the outdoor masking discourse) are heightened, and maybe that pissed them off and they took some risks because of it, or just out of total boredom. Even if they’re not sick or out of work, there’s a lot more of that among their friends and family than before, and they’re doing more emotional and financial support of the people around them than ever.

And all that is a comparatively good outcome. That’s if you’re lucky.

This is not exactly like being poor. There’s an exit coming. Things are going to get better soon, and that will fix a lot of this for a lot of people, and it’s probably made the mental load of all this lighter than it would have been if the vaccines had been slower to develop or less effective in clinical trials, or if the government response had been worse.

It’s not even really close to chronic poverty — but that should make it more resonant, because the best we’ve got right now is pretty bad, and you can start to see what the worst is like from here. If broadly recent history is a guide, we forget a lot about pandemics, maybe because our brains just wear out. We shouldn’t forget this.

Freelance writer/editor in Chicago. Words in Marker, The Atlantic, COVID Tracking Project, elsewhere. Author of ‘Chicago: From Vision to Metropolis.’

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