What the London 'Blitz' reveals about how much pain and tragedy people can handle in 2020
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It's hard to imagine how 2020 could possibly get worse. "What if we lose Betty White," a friend said on a drive to the Supreme Court to lay flowers.

So many Americans have lost friends or family members to COVID-19. Thousands of Americans survived the virus only to desperately need organ transplants and forever will struggle to breathe. Others are still suffering without smell or taste even three months after having the virus. Millions of Americans are out of work. Debt is stacking up for those trying to survive in the COVID economy. A lack of health insurance can mean hospitalizations from the virus are putting people into bankruptcy.

"The Blitz Spirit" became a common phrase during World War II when London citizens would continue to walk to work and live life as usual even after hours of bombings the night before. People spent their evenings rushing to basements and shelters for their lives, not knowing where the next bomb would hit and if family or friends would survive. The inspiration behind the poster "Keep Calm and Carry On," which never officially made it to public release, echoes the sentiment of the era.

"It suggests resilience in the face of unexpected adversity, sustaining a common bond between citizens facing a shared threat and remaining calm or cheerful despite calamity," wrote history Professor Richard Overy. "All of these were sentiments the authorities hoped would define the popular British reaction to enemy bombings during the second world war, just as they will no doubt be cited again as British society wrestles with the challenges of the virus."

But the idea that people "carried on" out of bravery or some sense of patriotism isn't the whole truth. The idea that they didn't suffer a lifetime of psychological after-effects is even more absurd. As the world copes with COVID-19, the hopeless cling to normalcy and the desperate strive to survive physically and financially.  It can't be alleviated by national encouragement, as President Donald Trump doesn't do that, or from Zoom concerts or happy hours. It's going to be a slog that the country will face.

At the start of the virus, there were efforts to help sew masks as Americans waited for President Donald Trump to implement the Defense Production Act. People rushed to donate to food pantries and soup kitchens. Celebrity Chef José Andrés and his World Central Kitchen stepped up to give meals to as many as possible. Today, it seems like random acts of kindness have slowed, and the sense of American community and helping your fellow citizen has given way to loss and hopelessness.

Americans are facing the greatest amount of depression in 2020, the Commonwealth Fund reported. Perhaps it is attributed to more COVID-19 deaths and people suffering from the virus.

"Past research shows that even prior to the pandemic, Americans were already among the most likely to experience emotional distress," the report read. "It seems that in several countries the pandemic has contributed to higher rates of emotional distress compared to before the outbreak."

Then there's the matter of the ongoing need to beg Americans to agree that Black lives matter. Protesters continue to take to the streets to ask not that Black lives are better, that they be given special treatment or something extra, merely that they matter. Racism continues to take its toll on Americans. Because of healthcare disparities and access to care, people of color are dying of COVID-19 far greater, per capita, than their White counterparts. Black Americans are not responsible for the hate against them, yet they continue to be unfairly burdened with the emotional, psychological and financial toll.

The stress, fear, anxiety, worry and sadness that 2020 has left Americans with could account for the decision by many to ignore the quarantine and social distance at the beach, flock to the bars and risk their health just to eat brunch. Some simply can't take it anymore, even if it means they and everyone around them could die.

One psychologist recalled survivors of the Holocaust, the Great Depression or the Dust Bowl, who would continue to hoard food well after things got better. The trauma was so imprinted on their brains that it simply never ended. That could be a whole generation of people, washing grocery bags, spraying down the mail with disinfectant, and carrying hand sanitizer.

"When we get out of a habit, it's hard to get back in," neuroscientist and psychologist Julianne Holt-Lunstad said. "So, just like we're worried about an economic recession, we should worry about a social recession—a continued pattern of distancing socially, beyond the immediate pandemic, that will have broader societal effects, particularly for the vulnerable."

A Pew Research Survey of Americans in March showed that twice as many were experiencing psychological distress due to their financial woes than during the recession of 2007-2008. By May, that number reached 33 percent.

President Donald Trump claims that there is a very real danger that not opening all businesses because people are killing themselves out of depression and anxiety, either about the virus, the loneliness or from financial despondency. While more people will likely die from COVID-19 or the long-term impact of the coronavirus on their bodies than from suicide, the mental toll of the 2020 tragedies is a problem that is not only being nationally ignored, it's one that will last long after 2020 is over.

"Keep in mind, this is looking at chronic effects over time," Professor Holt-Lunstad said. She noted cases where public drinking water became unsafe. Even after the problem was solved, people still refused to trust it and were afraid to drink from the faucet. As an example, generations of Flint, Michigan residents will likely never trust drinking water again, regardless of the cities they live in.

Yale University doctors explained that it isn't unusual to experience trauma with the litany of horrible things the world has navigated this year. Disaster psychiatry isn't merely meant for survivors of 9/11, Dr. Kimberly Yonkers, MD explained that this year certainly fits. Unlike 9/11, however, the COVID-19 crisis impacts everyone. Piling on the California wildfires, the hurricanes, floods and the deaths of so many beloved musicians, actors and Justice Ruth Bader Ginsburg only compound the trauma. To make matters worse, there's no end in sight, despite what the president promises about a miracle cure that will come just before his election.

"I think all of this is really having a profound mental health effect on the population," Dr. Yonkers noted.

"One common problem we're hearing about has been the loss of the normal routines of daily life," said Dr. Steven Marans, MSW, Ph.D. "Major disruptions like this can undermine our normal capacities to regulate stress."

Not having that personal contact with friends or family can be another fear, he explained. "Social connectedness is especially important because it can serve as a major protective factor when people are feeling most vulnerable."

The doctors explained that in cases like this, the prefrontal cortex (for higher cognitive functions) and the amygdala (for emotional processing) can be disrupted. It creates a greater secretion of stress hormones, which can make you gain weight. It can also increase your heart rate, change your breathing and cause your muscles to tense. It can also cause problems with sleep, an inability to concentrate, feelings of helplessness, irritability and more.

Dentists in New York City report an outbreak of "cracked teeth," because people are clenching their jaws, grinding their teeth in their sleep and regular routines like brushing and flossing are down.

The Yale doctors suggest staying away from the news as much as possible, a difficult task when social media is among your only social interactions. They also suggest going for walks, keeping a journal, finding ways to stay social like setting up one actual voice call or video chat with a friend or friends daily, find a new hobby, or something that makes you happy to refocus your attention on.

Trump isn't likely to become a "therapist in chief" anytime soon, making the country feel like everything is going to be OK. However, it is the message that former Vice President Joe Biden seems to be trying to convey with a reassuring tone and grandfatherly pat on the American shoulder.

Bombs don't have to be falling for life to be difficult, and the so-called "Blitz Spirit" wasn't the grand expression of love and togetherness history tries to make it out to be. It was just as psychologically damaging then as the coronavirus is now. Arguably, things are far worse now because there's no escaping the virus without a full quarantine.

Sadly, cases of community or commitment to each other may feel like they're dwindling. But it continues to be the one easy thing everyone can do to get through the remainder of the hellish year. There is still a dark and cold winter to go, so preparing mentally now will help.

There is a list of numbers to call if you're in a mental or physical crisis here.