Normative Narratives

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Entering the First Post-COVID Mental Health Awareness Month, a Timely Reminder: It’s (Still) OK Not to Be OK

“It’s OK not to be OK

…was a common refrain at the beginning of the pandemic, with many people experiencing mental health issues for the first time. As the world ground to a halt, with more isolation and fewer distractions, people were forced to reconcile with negative feelings they may have otherwise been able to ignore. There was a sense of “we’re all in this together”, and I do believe a more understanding society with respect to mental health will be an enduring legacy of the pandemic.

But naturally, as vaccines have taken us out of the most dangerous phases of the pandemic for both physical and mental health, that sentiment has receded from the headlines a bit. Life has largely returned to normal for all but the highest-risk people, as COVID shifts from “pandemic” to “endemic”. Unfortunately, part of that normal has historically been a negative stigma surrounding mental health issues; the pandemic helped reduce the stigma, it did not erase it. For some people, that might have been a temporary reduction tied to the pandemic itself.

Unlike the relatively strong economic recovery, the mental health effects of the pandemic may prove more persistent. People who lost loved ones are still learning to live with those losses. People who have experienced depression once are much more likely to experience recurrences. Younger people, our future, experienced anxiety and depression at particularly high rates.

I am not trying to be pessimistic or alarmist, but a clear-eyed assessment of the situation (as well as self-reported survey results) suggests that our mental health crisis isn’t going away; if anything, it seems to have plateaued at an elevated level. So, as we enter May 2022, the first “post-COVID” Mental Health Awareness Month, a reminder—it’s still OK not to be OK; it always was, and it always will be.

There was no shortage of sources of distress before the pandemic, the pandemic introduced others, and there will be new ones in the future—that’s life even during “normal times”. Just reintegrating into society while dealing with the “social rust” of the pandemic could be a new source of self-criticism for people who tend to be too hard on themselves (as I have been, and can only assume is a common characteristic among those with a history of mental health issues.)

Shared Sources of Distress

In considering how larger shared experiences can impact our collective psyche, let’s first look inside America’s borders. The “blue wave” of 2020 appears to have been a mirage, as Biden’s agenda, which encompassed many long-sought progressive goals, has largely stalled. Structural inequalities in our electoral system, combined with a lack of progress on voting rights legislation (if anything, we’ve regressed on that front), make it seem unlikely this opportunity will present itself again anytime soon. Inflation is too high, and while as an economist I still don’t think it presents a long-term threat to the economy or American’s standard of living, it’s certainly a source of material hardship, uncertainty, and anxiety right now. Needless to say, the leadup to the midterm elections will not be a harmonious experience.

Looking abroad, while the bravery and commitment to democratic values exhibited by the Ukrainian people has been heartening, that is a small silver lining to what is an extremely traumatic manufactured crisis. Taking a broader view, universal values such as freedom, accountability, transparency and self-determination will continue to be attacked, as authoritarians wage their existential wars against them. The institutions tasked with preserving the “liberal world order” established after WWII simply don’t seem to be up to the challenge.

So, if you have a more liberal worldview, it has been a frustrating couple of years. Early in 2021, with vaccines on the way and the “blue wave” rolling into Washington, it felt like the tumultuous Trump era was about to come to an end with a New Deal-type inflection point in American history. That has failed to materialize, and instead the Democratic platform and democracy in general seem to be on the ropes.

If, on the other hand, you have a more conservative worldview, you’ve probably been either directly or indirectly exposed to the far right “rage machine”, where everyone who is different from you represents a threat to your way of life. This reality, fueled by anger, division, and an intentional blurring of fact and fiction, is also a very poor environment for one’s mental health.

Regardless of your worldview it has been a tough couple of years. But we should not despair, despair is self-fulfilling. Things may not look good now, but change often comes from unexpected places. Demographic trends and youth sentiments still point toward future interrelated victories in social, racial, environmental and economic justice. Remember, “the arc of history is long, but it bends toward justice.”

Nor should we be ignorant in the name of self-care. It is up to each person to find their own balance, one that allows them to be informed without being overwhelmed by the deluge of negative or false information out there. You can’t help others if you don’t first take care of yourself.

“Toxic Masculinity” and Mental Health

Men don’t experience anxiety and depression at lower rates than women, despite what the survey results above may suggest. Rather, men are generally less willing or able to communicate their needs and get help. The proof is in the most extreme manifestation of unaddressed distress— “deaths of despair”. Whether looking at suicides specifically, or the broader category including overdose deaths, men are about 3.5 to 4 times more likely to die this way than women are. You don’t just jump from being “OK” to a death of despair; in this case where there is fire (death), there is a lot of smoke (unaddressed mental health issues.)

Men being less likely to seek help is one of the negative manifestations of a very politically charged term, “toxic masculinity”. Before going any further I think it is important to define a term like this, which is so open to interpretation. In my opinion someone can be as stereotypically “manly” as you can imagine, and that isn’t necessarily “toxic” if they are living their truth and aren’t hurting anyone else. That toxic masculinity exists doesn’t mean masculinity is inherently toxic, or that men are inherently bad. Masculinity only becomes toxic either when someone either rejects parts of themselves to live up to gender norms, or dehumanizes others for not living up to them.

Toxic masculinity, almost by definition, precludes mental health treatment; it essentially acts as an additional, internal stigma against mental health issues. This is a shame because, in addition to all the personal benefits, talk therapy can also lead to greater tolerance towards others. The alternative, ignoring problems and letting them fester, typically results in people turning their anger towards themselves and/or other people.

For example, violent and sexual crimes are disproportionately carried out by men. I am not trying to excuse anything by pointing out one of the root causes, perpetrators of serious crimes should be held accountable. LGBTQ people deserve to live a life free of discrimination and full of dignity just like anyone else. To that end, the likes and proclivities of heterosexual people shouldn’t be defined by their genders either!

I chose to focus on the intersection of toxic masculinity and mental health because I have lived it. Even without many common impediments to care (I was lucky to have financial resources, supportive family and friends, and an employer I could be honest with), I still made things much harder on myself than they had to be. Not everyone is as lucky to have the, let’s call it “margin for error”, that I did when it came to mental health issues. Even so, it is still easy for me to imagine a world where I never made it to the point of acceptance so that I could start healing, or even one where I just didn’t make it at all.

So, as a man on his own mental health journey, a yogi and a “sports bro”, I feel compelled to state what should be obvious: even for men, it’s still OK not to be OK. There is room for toughness and vulnerability in everyone, people contain multitudes. Open yourself up to that, and to getting the care you need, and you will find the confidence to face your fears and stand up for what you believe in even when it’s unpopular—real courage. Not only will you be better for it in the long run, but you also won’t need to hide behind the shield of toxic masculinity that harms both its adherents and their victims alike.