Within weeks, the familiar symptoms of mental illness have become universal reality. A new poll from the Kaiser Family Foundation found nearly half of respondents said their mental health was being harmed by the pandemic. Nearly everyone I know has been thrust in varying degrees into grief, panic, hopelessness and paralyzing fear.

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But that response can cause us to lose sight of the dangerous secondary crisis unfolding alongside the more obvious one: an escalation in both short-term and long-term clinical mental illness that may endure for decades after the pandemic recedes.

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A silent rush hour envelopes the streets leading out of downtown and birds perch like royalty on buildings, inside the quiet. The homeless shelter is full and the streets are empty. Inside the shelter, coughs and hacks fill the air like always, but each one is weighty, and heard by everyone. The Bible Group did not allow bibles in laps tonight. The cots and TV rooms are full of viral villains, invisible but seen by many resident’s imaginations: A furry critter alighting on the throat. A bug walking on every alveoli. A red hot cartoon devil poking between the shoulder blades. A c-clamp around the forehead. A road runner running up and down the ribs. No escape from the voices, the visions, the virus. In the morning the corporate regulars are not out on the sidewalk, in suits, ready with spare change. The critters return inside their minds.

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The unequal treatment of the two kinds of health — physical over mental — is consonant with our society’s ongoing disregard for psychological stability. Insurance does not offer real parity of coverage, and treatment for mood disorders is generally deemed a luxury. But we are in a dual crisis of physical and mental health, and those facing psychiatric challenges deserve both acknowledgment and treatment.

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The Chinese government moved psychologists and psychiatrists to Wuhan during the first stage of self-quarantine. No comparable measures have been initiated by our government.

Video calls to therapists are what we are ordering, like cocktails at a bar, hoping for a lift and shift in pandemic trappedness. Feeling trapped is what 56% of therapy clients are reporting. Pandemic call-ins are what are saving us – from what feels like mini deaths, aka mental illness. Nightmares of crawling the walls of our tiny or spacious homes are what are haunting us. Cigarettes and alcohol are what we are numbing with. Chips and Cheetos are what we are salting ourselves with, damning the flood of tears.

 

There are roughly four responses to the coronavirus crisis and the contingent social isolation. Some people take it all in stride and rely on a foundation of unshakable psychic stability. Others constitute the worried well, who need only a bit of psychological first aid. A third group who have not previously experienced these disorders are being catapulted into them. Last, many who were already suffering from major depressive disorder have had their condition exacerbated, developing what clinicians call “double depression.”

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A worried woman in the kiosk stands at the Pensacola beach selling sunscreen, at the edge of the sand, since county law says she can’t go further; no commerce on the beach sand.  Too many rules make her anxious. Too few make her anxiouser.

She counts her dollars repetitively, eyes darting for people empty handed, which means they aren’t walking to their car, but to snacks or the bathroom. She smiles at each of them, skilled at holding out the squeeze tubes in their sightline, but not too close. The sandy children are her tonic, in the long hot hours of work. She captures their gaze and jokes with them about “Mr. Sunshine” turning their skin his favorite color. Pink.

The kiosk is her only income, and her anxiety spikes when she hears of other beaches shutting down. She has cut her cable, sold her last few cigarettes, stopped morning coffee in the Mr. Coffee (also thrift store), sold her daughter’s cell phone for $79, stood stoic which she yelled “MOM! You are ruining my life!” and taken no showers. She tells her landlord she can’t save herself rich. Every day more anxiety.

 

We should recognize that for a large proportion of people, medication is not an indulgence and touch is not a luxury. And that for many of us, the protocol of Clorox wipes and inadequate masks is nothing compared with the daily task of disinfecting one’s own mind.

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The personal is political, but the physical is also mental, and our pandemic bodies are drinking in a wine cask full of cortisol, settling into muscles, and leaving our nervous systems drunk with anxiety.