Resilience in the Time of Pandemic

In the recent editorial titled “Mental Health of Communities During COVID-19 Pandemic,” Vigo et al. ¹ summarize a timely analysis of the psychological impact the current pandemic might have on the general population and vulnerable groups. The authors start by outlining the continuum of foreseeable health-related anxieties with deleterious consequences on both ends of that spectrum. They astutely predict the range of traumatic experiences and trauma-related disorders, the negative complications of social isolation, and the specific risks that communities can face: stigma, discrimination, substance use disorders, violence, mass poverty, and medical complications. While the authors present well-informed opinions and sensible solutions, they only touch in passing on the role of resilience in the face of adversity. This oversight is important since most people facing hardship and loss adapt fast and well. ² Adversity does not only create illness but also breeds strength. Neurobiological evidence demonstrates that not all stress is harmful, and depending on the amount and the individual, can have valuable benefits, by stimulating creativity and adaptation. ³ In the face of major loss, humans often find the power to reconnect with loved ones and each other, reevaluate their survival skills, and consolidate their capacity for health and well-being. Individual worldview was found to be the best predictor of resilience after September 11, 2001 terrorist attack. ⁴ As clinicians, we have been surprised to discover that amid this pandemic, many patients are more altruistic, less anxious about small things, more appreciative of their loved ones, and more connected to their values and faith. National surveys show that majority of Canadians adhere to systems of faith, which are likely to be activated in times like these. While psychiatry in Canada is largely provided in a secular fashion, psychiatrists often witness the ubiquitous human reliance on religious and spiritual beliefs in times of adversity. Becoming more sensitive to these aspects and acknowledging the role of religious and spiritual beliefs in healing and resilience might open new opportunities for support and intervention. Modern conceptualization of resilience is moving away from the narrow definition of “symptom free” to an evolutionary and developmentally sensitive perspective in which aspects related to affiliation, resourcefulness, and meaning play major roles. ⁵ In these challenging times, our patients are transforming and so should we. This is Psychiatry’s opportunity to shift focus from overidentifying what does not work, to seeing what does. If we are to navigate the current situation smoothly, our clinical and research focus cannot ignore the resilience occurring under our eyes. We cannot continue to only predict and search for illness, we also must be perceptive of fortitude. Qualitative studies examining the full experience of the pandemic (negative and positive aspects) and the coping mechanisms employed by different vulnerable populations might shed light on their inner ability to problem-solve and mobilize vigorous responses. Encouraging these responses might be as important as rescuing treatments, if not more. Mankind has faced larger disasters than this and has recovered and thrived every single time. This contagion is no different. In Freud’s memorable words, health can still be defined as the capacity “to love and to work.” And no pandemic can stop that if we do not let it.