Depression and Resilience After COVID

Many people experienced some form of depression during COVID. Pandemic restrictions made it difficult to enjoy the present or feel hopeful about the future. Along with depression, many people also experienced a weakening of their sense of resilience--the feeling that they could count on themselves to bounce back from difficulties.

While the pandemic isn’t over, things are very different from the way they were before vaccines became widely available. Restaurants and sports stadiums are full. Theaters are open. Concerts are back. However, while some people’s depression has lifted as they’ve returned to something like their pre-pandemic lives, other people are still finding it difficult to feel engaged and hopeful.

Dr. Jane Rubin sees a number of patients who were depressed before COVID began. All of them felt worse during the worst of COVID. However, as life opened back up, some of them have experienced a marked lessening of their depression, while others haven’t. This has led her to recognize that her patients’ depression takes two different forms, one of which allows them to feel more resilient, and one of which weakens their resilience.

What are the two types of depression you’re noticing, and how do they affect your patients’ sense of resilience?

A number of patients I see who struggle with depression experienced significant setbacks during COVID. People whose work requires them to be on-site--scientists who work in labs, classroom teachers, personal trainers-- found that their work was stalled, or that they couldn’t do some of their work at all. But the people I’m thinking of continued to put one foot in front of the other. The scientists figured out how to work on other projects that didn’t require being in the lab. The teachers and trainers figured out ways to work online. It wasn’t easy and, sometimes, they became quite disheartened, but their sense of resilience kept them going.

This was also true for people who were looking for relationships. The inability to meet people in person made dating feel impossible for some people. But others took up the challenge and dated on  Zoom. In fact, I know a couple who met on Zoom at the beginning of COVID who just got married.

I think these people have been able to be resilient because they have very clear goals for themselves. And I think those goals are an important part of their identities. They feel that they wouldn’t be able to be fully themselves if they weren’t able to be a scientist, a teacher, or a trainer. So they’re willing to work really hard to make sure they don’t lose those possibilities.

It’s very similar for the people who didn’t stop dating during the pandemic. These are people who know they want to be in a committed relationship. They know that they won’t feel fulfilled without a partner or a family. They aren’t at all ambivalent about it. So they just kept going, even when the going was rough.

How does the second group differ?

For the second group of people,  life seemed to grind to a halt during COVID. They still went to work and did the other things they needed to do, but they had a very hard time believing their lives could get better. They stopped applying for new jobs, or dating, or doing the things we could do during COVID-- like getting together with people outside-- that made life better during a difficult time.

For these people, resilience was in short supply. They didn’t really believe their lives could be better, so they didn’t believe they had the ability to make them better. And, even as our lives have opened up again, they’ve been slow to re-engage with life.

Why is resilience so difficult for these individuals?

Depression makes it really hard for them to formulate clear goals for themselves. Whether they don’t believe they deserve to have the life they want, whether they’re self-sabotaging--whatever the reason, depression is like a thick fog that keeps them from seeing their lives and their possibilities clearly. So, they can’t move forward, because they don’t know where they want to go. And, because they’re not using their energies to move forward, it’s hard for them to feel that they have any inner reserves.

So it seems that resilience is not so much “bouncing back” but bouncing forward. How can therapy be helpful to both kinds of clients? 

I think it’s helpful to the first group to have a therapist who both understands how difficult their situation is and supports them in their efforts to keep moving forward. It can be a difficult balance sometimes. We don’t want to be Pollyannas, cheerleaders who don’t take our patients’ difficulties seriously. On the other hand, we want to help them find the emotional resources to keep going. That requires holding on to our sense of possibility for them and being able to convey that sense of possibility in a way that makes sense to them.

For the second group, even though it’s very important to empathize with the suffering that COVID has caused them, it’s also important to recognize that their depression and their lack of resilience pre-dated COVID. So, despite the myriad difficulties COVID has caused them, we have to find a way back to talking about the issues that brought them into therapy in the first place. What makes it so hard for them to believe in themselves? What do they feel they actually deserve, or don’t deserve, in life? Why do they feel powerless to make changes in their lives?

In some ways, COVID has made these struggles more difficult for people because it’s confirmed their fears that things can only get worse, not better. So we need to identify sources of hope and possibility even as we acknowledge how hard times have made things worse for them.

Are you struggling with depression and moving forward after COVID? Please click to learn more about depression therapy and treatment with Jane Rubin, Ph.D.Jane Rubin, Ph.D., is a clinical psychologist in Berkeley, California. She works with individuals in Berkeley, Oakland, the East Bay, and the greater San Francisco Bay Area who are struggling with depression and anxiety. She also specializes in working with people who are trying to find meaning and direction in their lives.