COVID-19: Mental Health and Hysteria during the Pandemic

I just had a therapy session with my wife regarding why we both find ourselves angered by the hysteria exhibited by the people around us (both physically and virtually).

I hope that this post will resonate with people that suffer from anxiety/depression because the current climate perpetuated by the media and its loyal sycophants is nurturing behavior and thought patterns that I learned to fight during rehab/mental health counseling.

If you’re curious about these psychological mechanics and tactics, I recommend “The Feeling Good Handbook”, which offers an evidence-based strategy for combating depression and anxiety without the use of unnecessary (and costly) medications.

'The Cure for My Chronic Anxiety and Depression':

For years, I struggled with mental illness. I took many different medications and sat through thousands of hours of psychiatric talk therapy. I had multiple psychiatrists and their M.O. was always to prescribe a long list of medications. Between 2009 and 2018, I was never on less than 6 medications at a time.

However, it wasn’t until I was exposed to CBT (Cognitive Behavioral Therapy) in 2018 that I was able to find relief from chronic depression/anxiety. Through CBT (which is the treatment methodology of “The Feeling Good Handbook”), I was able to stop taking ALL of my psychiatric medications and began focusing on the root causes of my anxiety/depression instead of merely masking the symptoms.

CBT is based on a simple conceptual framework: Feelings follow thoughts and feelings lead to behaviors. For example, I used to engage in counterproductive behaviors because I felt anxious because a particular thought materialized in my consciousness. If we are able to effectively manage our thoughts, we can minimize destructive behaviours that result from them. CBT trains practitioners to evaluate thoughts through the lens of logic and evidence. Irrational thoughts that provoke mental distress are referred to as “cognitive distortions.”

One of the most common cognitive distortions is catastrophization, which means a person assumes the worst possible outcome will happen by default. From a probability/statistics perspective, catastrophization is almost always not supported by available evidence since the worst possible outcome and the best possible outcome generally have low likelihoods of occurring (think of the tails of a bell-curve). An outcome in between these two polarities is the more likely event. For example, assuming I study an average amount of time, it’s more likely that I’ll score closer to the average score on an exam than it is that I’ll have the highest score or the lowest score on that exam.

The Pandemic of Profit-Driven Catastrophization

Catastrophization is a form of sensationalism. The media, due to their profit-driven business model, is biased towards catastrophization since catastrophic headlines are more likely to attract eyeballs (and please advertisers) than mundane or nuanced headlines.

In the 1960s, there were only 3 main news networks: ABC, NBC and CBS. Overtime, due to the increased activist nature of journalism (largely catalyzed by the Watergate Scandal), the advent of the 24-hour news cycle, and the stronger profit-incentive of a competitive market (as more networks entered the market, the competition for ratings increased), the tone of the news became more negative and more catastrophic.

The featured graph (taken from Steven Pinker’s Enlightenment Now) to the right shows the results from a study that analyzed digital transcripts of news reports across several decades to measure the change in the tone of news reports. A rating of “0” on the y-axis represents neutral coverage. A positive rating represents positive coverage (words like “great,” “superb,” etc.) and a negative rating represents negative coverage (words like “horrible,” “racist,” “irresponsible,” etc.).

As you can see, coverage became far more negative in the latter part of the 20th century and has only worsened during the twenty-first century. In other words, the media has developed a fetish for catastrophization.

How Well-Intentioned Virtue-Signaling Creates a Climate for Catastrophization

The current hysteria with the COVID-19 pandemic has several close parallels with the controversy behind climate change. I’ve always stated that climate change is real and must be taken seriously and must be dealt with. However, I also believe that we must base our climate change policy (to mitigate the harmful effects) on multivariate evidence instead of apocalyptic catastrophization. One of the best commentaries that I’ve read about the economic trade-offs of climate change policy is “The Climate Casino” by Nobel Prize-winning Yale economist William Nordhaus. Nordhaus talks about a “tipping point.” The tipping point is when steps taken to combat climate change become so destructive to the human race that the resulting harm exceeds the harm that would materialize if no actions were taken. For example, besides the U.S., China and India, some of the greatest polluters are developing countries that are currently undergoing massive economic growth. Economic growth is obviously inversely related to poverty. If steps to mitigate climate change involve slowing the rate of global poverty alleviation, then people are dying from starvation and economic depressions instead of from heightening sea levels, scorching droughts and more intense tropical storms.

However, a nuanced approach to climate policy is insufficient for some activists who would prefer to advocate catastrophic policy positions that are more reminiscent of Evangelical Christian eschatology (“Armageddon is here…”) than evidence-based policy prescriptions. There is a secret language among these activists that creates an exponential escalation of prophetic virtue-signaling. A competition ensues where activists seek to show that they take the climate change issue the MOST seriously. People, such as Nordhaus, who adopt a nuanced view based on economic trade-offs are seen as greedy, wishy-washy, or both and are smeared with insults such as “he doesn’t trust the experts – the scientists” or “all he cares about is economic development – aka money.” Obviously, it’s entirely possible to recognize the existential threat of climate change without advocating economic suicide.

We currently see the EXACT same dynamic occuring with the COVID-19 pandemic. Many people want to show that they TAKE THIS CRISIS SERIOUSLY. Inevitably, this emotional virtue-signalling leads to a competition where the individual with the most catastrophic vision of the future wins. We are constantly bombarded with the same mantra – “Trust the experts.” I’ll remind everyone that “the experts” have been wrong about this issue just as much as they’ve been right (if not more) but that’s a different topic. As with climate change, it is entirely possible to take the existential threat of COVID-19 seriously AND also to be concerned about simplistic solutions that are based on bad data and univariate or bivariate epidemiological models.

Locked in their houses and bored out of their minds, many Americans have fallen into the catastrophization trap. The ability to share a news article (published by an organization with a profit-motive, which makes them want to publish the most catastrophic headline possible) that a Facebook friend shared does not make an individual a profound or useful commentator on the global state of affairs – it makes them a parrot who has nothing original or noteworthy to add to the global conversation.

Take this scenario: An individual posted an article yesterday that touted how American COVID-19 deaths have now surpassed Italy’s COVID-19 deaths. The headline is obviously intended to shock and provoke with its death toll proclamation. However, as a millisecond’s worth of contemplation by a reasonable person will uncover, there is nothing meaningful that can be deduced from that piece of information. Italy’s population is about 60 million. The U.S.A.’s population is about 330 million. In what world would this finding be surprising? Assuming the raw mortality rate is roughly uniform across countries, one would logically conclude that American COVID-19 deaths would dwarf Italian COVID-19 deaths even when policy differences are controlled for. Unfortunately, when it comes to the catastrophization Olympics, logic and evidence take a backseat to emotion and hyperbole.

While we’re on the subject of raw mortality rates, let me make an observation that anyone with a 5th grade education could deduce. A raw mortality rate consists of two numbers – a numerator and a denominator. The numerator is the number of people who have died from COVID-19 and the denominator is the number of people who have contracted COVID-19. Contrary to what Sanjay Gupta or Rachel Maddow would have you believe, NO ONE has any idea what the true COVID-19 raw mortality rate is. Why? Because we don’t know the true values of the numerator or the denominator. Currently, anyone who has contracted COVID-19 and dies from COVID-19 is counted as a COVID-19 death. It doesn’t matter if an individual has a collapsed lung, cystic fibrosis, smoked for half a century and already had the flu when he contracted COVID-19, if he dies, his death is counted as a COVID-19 death. Therefore, the numerator is heavily biased towards overcounting the number of people that die from COVID-19 because there are no controls for comorbidities. With respect to the denominator, we have NO IDEA how many people have contracted COVID-19 and survived. Due to the lack of testing and the fact that the vast majority of people who contract COVID-19 are either asymptomatic or only experience mild symptoms, the denominator is heavily biased towards undercounting the number of people that have contracted the virus. So, we have an inflated numerator and a virtually infinitely deflated denominator. So, what can we deduce about the mortality rate of COVID-19? Virtually nothing. However, that sort of quantitative skepticism will never be tolerated by the zealous competitors in the catastrophization Olympics. Certainty is always preferred to ambiguity.

X=Numerator & Y=Denominator

Catastrophization is something that mental health professionals say we should avoid. Let’s follow their advice in this pandemic

The competitors in the catastrophization Olympics are well-intentioned. It’s good that they want to take this crisis seriously. Perhaps their unfailing faith in the public health ‘experts’ (who appear to suffer from a profound deficit in mathematical/statistical literacy) is a symptom of the human condition: we don’t like to admit that there are unknowns – we prefer to believe that we have all of the information, even if that entails always believing the worst possible scenario.

We are living in a time when, if an individual has a M.D. or D.O. next to their name, she is treated as an oracle. Several years ago, when I was preparing for an interview for a 3-year administrative residency in hospital administration (which is a hospital leader training program), I interviewed several physicians to glean knowledge about the American healthcare system. One physician’s reply to my question was quite profound:

“Eric, I’m a doctor. I don’t know anything about healthcare. I’m an expert in medicine, not hospitals.”

I feel that if I approached that same physician during this crisis, he would be much more comfortable telling me exactly what the state of American healthcare is and how we should fix this situation. While catastrophization is not helpful, its certainty allows people to believe that they have ALL of the relevant information at their fingertips. It’s only a Facebook post away…

Deception is bad public policy. The Surgeon General reversed his recommendation in April.

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