LAUREN GILGER: Pandemic fatigue. Most of us are probably hearing that right now and think, "I have that." But according to our next guest, it's more than just being tired of social distancing and wishing our lives could go back to normal. It's about long-term stress, anxiety and depression that's wreaking havoc on people across the country right now. David Sbarra is a professor of psychology at the University of Arizona, and he told me that the next big challenge will be to flatten the mental health curve.

DAVID SBARRA: I think we're increasingly seeing that people are more depressed and anxious that they've been — than they've been in quite a while. They're stressed, chronically stressed, maybe burnt out. We're also feeling a large degree of grief for our life that we miss and the way we used to do things. So when we talk about pandemic fatigue, we're talking about a whole constellation of factors that are really burdening people right now as they navigate COVID-19 and the coronavirus.

GILGER: Yeah. Do we have statistics on this? Like, do we know how bad it is and how it's manifesting itself?

SBARRA: We do have some statistics and I think a number of people in this area who are experts in mental health have become increasingly alarmed by the national statistics in this area. So if you look at percentage of people who are reporting increases in depression and anxiety symptoms, there is a considerable increase in longitudinal studies where this same data had been collected before. And so the double-digit increase in the percentage of people who are starting to report that they're being put upon and that they feel their moods are, are disturbed, they're having anxiety symptoms including worry and panic and traumatic responses. So there's quite a lot of new data being collected in this area that is quite concerned.

GILGER: Yeah. So what's leading to this? I mean, some of this is obvious, right? Like the pandemic, the length of it. It's gone on longer than most of us imagined. But I imagine there are more layers to this. Like, for example, like how do long periods of stress, like prolonged stress, affect your brain, affect your mental health?

SBARRA: Well, we know quite a lot about stress physiology and the effects of chronic stress on the body, and I can talk about that in a second. But if we just sort of back it up to what's going on in the mind, we can think about the circumstances out there in the world, right? So, for example, you know, high levels of unemployment, people facing financial and food insecurity, a lot of concern for people who are able to keep their job, how they're going to, especially people with children, how they're going to manage working from home, working remotely and then doing their kids' school and helping with school or even just managing young children. So all of these objective realities contribute to the stress. But a big part of the psychology of stress is about uncertainty and uncontrollability. And I think that that's really what we're seeing here, is that none of us have the ability to control the pandemic beyond taking a certain set of behavioral mitigation strategies. But we can't control the rates necessarily that we're seeing throughout the state or in the country. We can't speed up the development of the vaccine. We can't know how the vaccination is going to be rolled out, so to speak. And all of these things just contribute to a sense that the future is quite uncertain and the future is quite uncontrollable. And this then leads to a degree of, of physiological stress reactivity that puts people in a vigilant state and puts us in a sort of activated state of alarm that is ultimately bad for us down the road.

GILGER: Yeah, and it's not equal for everyone, right? Like health inequities play into this.

SBARRA: Oh, absolutely. And I think that one of the things that the pandemic is revealing is just sort of the deep fissures in our society between who are essential workers and who are people who can financially support themselves, and what are the situations upon which some people are uniquely impacted by the stress associated with COVID-19 and coronavirus.

GILGER: And among that, one that really comes to mind for me is, is right, like older people or people who are, are at risk? Like, there's already a big worry about isolation for people over a certain age and now you have to be isolated, right? How is that playing out? I mean, how do you overcome something like that there?

SBARRA: There is a tremendous risk for loneliness, for isolation and loneliness, among people who are, who are older. People who are 75 plus. And there's a lot of concern about that. But a lot of the data that is available that the loneliest people are young people between 16 and 24 years of age. And so that's sort of may come as a surprise to your listeners. And so, so we typically think it's people in nursing homes that are the most isolated. But in general, it's, across the population, it's probably younger people. And there's all kinds of reasons why that might be. So no one's exactly certain.

GILGER: That's so interesting. OK, so let's talk about some of the implications then. Like, what are you seeing this lead to? I mean, we're already seeing numbers, again, of opioid overdoses and usage go up. We're seeing lots of domestic violence, suicide calls going up. What are some of the impacts we are likely to see?

SBARRA: Well, I think that's probably why the idea of flattening the mental health curve is ultimately going to become as important as flattening the coronavirus curve itself. One of the things we need is systematic policies that can address some of the sort of national discontent that we're experiencing. First and foremost, we need to get the virus under control. Until we mitigate the spread of the virus, and until we ultimately work toward a vaccination rollout, you really can't do economic and social reform. But after that, we need to rebuild this country better. We need to think more seriously about the social services and the social safety nets that are available for people who are disenfranchised, that are available for people when they lose that job, that are available for people when they become hopeless. You know, one of the increasingly common topics in social sciences about suicide is something you and your listeners may become familiar with, the idea of deaths of despair, is that from non-Hispanic white adults, we're seeing increased rates of alcohol and suicide-related deaths in a way we haven't seen before. And this is largely about social safety and the social determinants of health. It's not that we're all feeling more depressive at individual level. It is a societal force that is being put upon people.

GILGER: All right. That is David Sbarra, professor of psychology at the University of Arizona, joining us. David, thank you so much for the time.

SBARRA: Thank you.

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