Psychopathological conditions such as depression and anxiety surged as a significant public health issue in the 21st century. With the advent of COVID-19, this generation has experienced an unprecedented vulnerability in mental health, exacerbating the already pressing dilemma. As mental health professionals and researchers attempt to remediate this difficult situation, the topic of acute stress and its link to mental health conditions is more important than ever to understand. In their 2020 article, “Risk and resilience in an Acute Stress Paradigm: Evidence From Salivary Cortisol and Time-Frequency Analysis of Reward Positivity,” Ethridge and colleagues discussed the “associations between the hypothalamic-pituitary-adrenal-axis stress response and event-related potentials sensitive to the receipt of reward-related feedback”(1). They reported that “it is possible that those who experience increased stress have subsequently altered reward processing, but it is also possible that those with altered reward processing experience increased stress” (2). This state of altered reward processing is called anhedonia, defined as “an inability to derive pleasure from formerly satisfying activities” (1).
Anhedonia is a condition that is highly linked to increased risks in mental illness, and “has a functional impact on engagement in social connection, as social anhedonia has been associated with decreased social support and impaired functioning in social domains” (Hagerty 2-3). In the recent paper, “The impact of COVID-19 on mental health: The interactive roles of brain biotypes and human connection,” Hagerty and colleagues state, “Cruelly, COVID-19 sets the perfect stage for the propagation of social anhedonia cycle. Due to social distancing ordinances, exposure to usual sources of rewarding stimulation, including sources of human connection, are markedly reduced in our current reality” (3). This further signals that “individuals who are already primed for blunted anticipatory reward [anhedonic brain style]... could experience an even greater degree of amotivation to connect with others” (3). These findings are consistent with the reported increase in depression, dissociation, anxiety, and substance abuse that has followed the onset of the global pandemic. In an article published in The Guardian, Eilene Zimmerman writes, “The isolation, uncertainty and lack of control are a perfect setup for depression, anxiety, drug use and excessive drinking.” In the same article, Zimmerman discusses the lack of repercussions that might contribute to the increasing prevalence of mental health conditions; for example, professionals now “only have to look good from the neck up for 8am Zoom meetings, so it’s easier to hide intoxication or a hangover” (Zimmerman online). Casey Schwartz, in her article in The New York Times, discussed the findings of the Computational Story Lab of the University of Vermont. The Hedonometer, an instrument that measures the “happiness of populations in real time,” analyzes and measures word choices across millions of tweets all around the world, every day, to give its reading of well-being. According to the Hedonometer, the saddest day of 2020 was Sunday, May 31; it was also the saddest day recorded in the last 13 years (Schwartz online). Dr. Danforth, co-founder and inventor of the Hedonometer, stated “there was a full month of days [in 2020] that the Hedonometer was reading sadder than the Boston Marathon day,” (Schwartz online).
Considering the onset of COVID-19 and the projection of its long-term trajectory, research on the mechanisms of stress and its effects on reward processing is essential and necessary. Ethridge and colleagues found that “neural responses to gains and losses were blunted” (11) after being exposed to acute stress. This signals that repeated stressors induce a state of dissociation from life events, which results in the reduction in neural responses to both positive and negative stressors. Given this knowledge, it will be imperative to implement mental health interventions by increasing awareness, access, and availability of mental wellness resources as we brace for the ensuing second wave of the pandemic.
References
Ethridge, P., Ali, N., Racine, S. E., Pruessner, J. C., & Weinberg, A. (2020). Risk and Resilience in an Acute Stress Paradigm: Evidence From Salivary Cortisol and Time-Frequency Analysis of the Reward Positivity. Clinical Psychological Science, 8(5), 872–889. https://doi.org/10.1177/2167702620917463
Hagerty, S. L., & Williams, L. M. (2020). The impact of COVID-19 on mental health: The interactive roles of brain biotypes and human connection. Brain, Behavior, & Immunity - Health, 5, 100078. https://doi.org/10.1016/j.bbih.2020.100078
Schwartz, C. (2020, October 12). Is Everybody Doing ... OK? Let's Ask Social Media. The New York Times. https://www.nytimes.com/2020/10/12/style/self-care/social-media-.html.
Zimmerman, E. (2020, October 13). Why professionals, depressed and anxious, are developing addictions during Covid. The Guardian. https://www.theguardian.com/lifeandstyle/2020/oct/13/white-collar-professionals-substance-use-disorders-pandemic.
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