As we embark on 2021 to say that the COVID-19 pandemic has wreaked havoc on our communities, families, and psyches is an understatement. The rising numbers of cases and deaths have been unfathomable, and triggered many negative emotions, such as grief, denial, and anger—all of which have precipitated a rise in mental health challenges. Whether we fought through restlessness to get back to our regular lives or grudgingly figured out new ways of living within the restrictions, 2020 felt like one of the longest years of our lives. In addition to stressors related to finances, environment, vulnerability, politics, social connection, etc., we were bombarded by media scenes of police brutality, egregious racism, political violence, economic crises, natural disasters and, if we had the ability and perspective to look more closely, scenes of love, hope, and community.

Reflecting on these moments, I am reminded of the four existential concerns coined by the philosopher-psychiatrist Irwin Yalom. He described them as freedom, meaninglessness, isolation, and death—and would discuss how at any given time one of these concerns or fears is prominent in our conscious mind. In talking with clients, friends, family members, and the community at large, it is evident to me that now more than ever, these existential fears are dominant in our collective psyche and contributing to widespread depression, anxiety, and general malaise.

“Freedom in this sense has terrifying implications; it means that beneath us there is no ground – nothing, a void, and an abyss. A key existential dynamic then, is the clash between our confrontation with groundlessness and our wish for ground and structure.” (Yalom, 1980, p. 9)

Yalom talks of people being “afraid” of freedom. What about freedom scares us? We fear the responsibility that comes with our freedoms and we are often torn between craving liberty and resisting responsibility. This tension between freedom and responsibility has played out at a societal level with mask mandates, social distancing, and curfews. When we are offered a greater future freedom in exchange for present responsibility such as wearing masks and following social restrictions to combat the disease—there is a reactive anxiety due to the perceived burden that accompanies those responsibilities. Many of us struggle with this burden. One is tasked with not only ensuring one’s own safety in the environment but also the safety of others. The resulting emotions are anger and exasperation, which are present in those who are willing to accept this responsibility and in those who struggle to adhere to this notion.

There is this feeling of having to sacrifice some freedoms for the “greater good.” It also highlights the concept of “rugged individualism” versus “collectivism,” and what the idea of freedom signifies in these contexts. Unfortunately, given the very physical nature of this pandemic, we are not afforded the luxury of time to understand each other’s views and therefore naturally the issues have become polarized and politicized.

“The human being seems to require meaning. To live without meaning, goals, values, or ideals, seems to provoke considerable distress. In severe form it may lead to the decision to end one’s life.” (Yalom, 1980, p. 422)

Meaning, or fear of losing one’s sense of purpose, is a significant concern for many people during this time of crisis. Those who are unemployed or are actively looking for jobs have shared their feelings of lowered self-worth, value, and motivation. Some unemployed folks who have depression find that this time has led them to experience moments of hopelessness about the future, lethargy, sleep disturbances, appetite changes, and feeling a sense of foreboding or dread. Some who are employed and working from home have been feeling stressed as they navigate their boundaries between family and work life. They often complain of being stretched too thin. They perceive that they are unable to adequately fulfill their roles in either area, which has been demoralizing. Some older adults use the excuse of running errands or going to the grocery store on a daily basis in order to feel a sense of purpose.

Some of my teen and college-aged clients report that it has been hard to stay on top of schoolwork or attend all of their college online classes, describing that it feels pointless. There is also a sense of malaise and lowered motivation among some youth who struggle to enjoy their online club activities. Additionally, the pandemic has been rather taxing on adults and kids with ADHD who are struggling with having to focus on screens for several hours in a day.

Suicide in this past year has been on the rise. In a study done by the CDC in August 2020, they found that 1 in 4 young adults expressed suicidal ideations, with 75% of those aged 18-24 dealing with a mental health issue. Many individuals have been suffering from passive or active suicidal thoughts. Passive thoughts include, “I wish I weren’t here” or “I wish I could just disappear” whereas active thoughts, sometimes with a plan, include “I feel like killing myself” or “What would happen if I took a bunch of my medication?” Often times the issues have been due to lack of sense of purpose. As one of my clients had put it, “What is the actual point of life? I’m living in a mundane situation and I just do the same thing over and over.” Overall, the hopelessness factor has been rising in this country given how quarantine can feel stifling to vulnerable individuals.

On a positive note, there are those who have found new meaning for their life, whether it is increased family connection, an artistic expression, culinary endeavors, gardening, connecting with nature or family, or overall self-care through yoga, meditation, and spiritual practices. Exploring the concept of meaningfulness is a salient part of the human condition and when this comes into question, it can spiral into deeper negative emotions or it can help lead to your inspirations.

“No matter how close each of us becomes to another there remains a final unbridgeable gap; each of us enters existence alone and must depart from it alone. The existential conflict is thus, the tension between our awareness of our absolute isolation and our wish to be part of a larger whole.” (Yalom, 1980, p. 9)

As social creatures, isolating ourselves from friends and society has been very difficult for many of us. Given the very lonely feel of this pandemic, so many people have felt restless about not being able to socialize so seamlessly as usual. There are increased feelings of depression and dysphoric feelings. As one person put it, “Zoom is not the same, and the masked meetups are okay, but there’s a tense feeling around this because we know we can’t relax.”

For teens, the online world and social media has been their main source of connection and entertainment. Teens stay up late into the night playing video game while simultaneously chatting with other gamers. Usually, the excuse given is that this is the only time that all their friends are available and that there is no reason for an earlier bedtime when a whole night life of activity awaits them. Some teens have gone to great lengths to hold onto their tech devices as they view this as the lifeline to their social relationships.

The feeling of loneliness was especially hard during the holiday season. Clients and friends shared that their older parents were refusing to stay put and were feeling “cabin fever,” wanting to continue meeting with friends and family members during the holidays. Many clients shared feelings of frustration and panic when trying to reason with their parents to stay socially distanced. Extroverts struggle even more with social distancing as they feel the isolation more deeply.

Some people admitted to travelling between states without quarantining, going to clubs or restaurants where masks are not mandated, and engaging in regular social activities. Social media has made the notion of FOMO or “fear of missing out” even more stark, as young adults complain of why they must stay put while they see their friends out and about, travelling and socializing with no apparent concerns. This has created more isolating feelings for those who have restricted themselves. Ultimately, as Yalom discusses, it is this fear of loneliness, lack of social connection, and the need for belonging and community that propels folks to pursue social connection. The politics around social distancing has also contributed to the chaos of the issue, with a spectrum of responses. There has been judgement passed on all sides about the appropriate amount of social isolation and what is considered acceptable.

On the brighter side, folks have found ways to isolate in company with “pods” friends, family, and neighbors who have been part of their respective “quaranteams” ensuring that all members are only socializing with the same group of people and generally keep to themselves in a given time frame. This has truly helped lift spirits for those who crave social connection and who thrive in the company of others.

It is important to note here that domestic violence, specifically intimate partner violence (IPV), rose globally this past year and the US was no exception. However, the calls to hotlines such as the National Domestic Violence Hotline (NDVH) were significantly decreased into the hundreds in March 2020, compared to the thousands that it normally receives. Apparently, COVID-19 has been used as a weapon of control and abuse by domestic violence perpetrators to restrict access to services, shelters, counselling, etc. per reports from the NDVH. Unfortunately, victims of domestic violence are often emotionally and physically isolated from others, but given the additional layer of a pandemic, the feelings of isolation for a victim and their actual ability to escape their situation can be insurmountable and devastating. The National Domestic Violence Hotline and website are good resources for those who are aware of a friend or family member who needs help.

“The primitive dread of death that resides in the unconscious – a dread that is part of the fabric of being, that is formed early in life at a time before the development of precise conceptual formulation, a dread that is chilling, uncanny and inchoate, a dread that exists prior to and outside of language and image.” (Yalom, 1980, p. 45)

Underlying all our anxieties about life is a subconscious fear of death. The tragic loss of over 500,000+ Americans (as of February 2021) and millions across the world has brought this existential concern fully to the forefront. There are those who have had to face the untimely and gut-wrenching loss of their family members due to the disease, without the ability to hold their hand, comfort them, and get needed closure. As humans, we have developed many defense mechanisms over millennia to counter toxic emotions that we do not want to face. A common defense is our brain’s ability to adjust to and normalize a persistent danger, which has resulted in blind spots and caution fatigue as well as a notion of personal invulnerability despite being aware of the danger and seeing it affect everyone around us. This need to assert oneself makes one feel more alive and in control. As family members or close friends are afflicted, the feeling of vulnerability returns, and the fear of death rises temporarily, only to recede again. I have seen families who have dealt with losing a family member, yet over time have grown lax with their own restrictions, justifying those choices as an attempt to feel normal again.

This historic crisis of the pandemic has challenged all of us in so many ways to introspect, sacrifice, find new ways of being, regain a sense of ourselves, develop new skills, navigate family roles and disruptions, cope with financial struggles, face grief and loss, etc. The list goes on and is varied for each person. In our struggles, we have come face to face with the four existential fears, though we may not have consciously realized it. They have manifested in our emotions, our thoughts, and our actions. As Yalom says, it is of vital importance for psychological development that we try to confront these existential fears and come to terms with them. I believe that in the process of accepting the inevitability of our feelings, we will be able to cultivate greater compassion for ourselves and others. This can in turn help us to lead a less stressful existence. As one client who has a daughter with long-term COVID-19 symptoms aptly put it, “We are always in such a rat race with life, always busy, and when we are faced with something like this, we don’t know how to handle it. I believe COVID-19 is giving me this chance to face my toughest emotions and to use this time to prepare myself mentally and emotionally for anything in the future.”