Many experts are warning that this pandemic will leave a legacy of mental health issues. But these warnings sometimes seem vague. If you want to know exactly what this might mean, your own family history could be the place to start.
Mine is probably typical in showing how the psychological legacy of an epidemic can last for many generations. But my history also suggests that living with quarantine and lockdown has been much more a part of social experience than we perhaps realise.
Like many under lockdown, I’ve been doing a bit of idle digging and delving into family ancestry. Mainly, I was looking to clear up one or two little mysteries. As a child, I had been the repository of my grandmother’s memories and had always wanted to see if I could put names and dates to her stories. There was, for example, the question of her youngest brother, Sidney, news of whose death in 1915 in the First World War was as vivid for her in her 90s as when she first heard it as a young woman. But had he really volunteered at 15 and his body never been found?
Another question was about my grandmother’s daughter, Constance, my father’s baby sister. My grandmother had told me sadly how she’d died of the Spanish flu, but I didn’t know at what age. All I knew was what my father told me. He’d been playing with his toys outside her room when the doctor had emerged to tell them she’d died. He said he’d felt terrible guilt that he’d been lost in his game and hadn’t thought of her. I’d always wondered whether this had been a factor in his own melancholy, his persistent guilt about things he hadn’t done and his generalised anxiety. The ancestry research confirmed she died aged three, when my father was eight, a loss that would have been traumatic for a young boy. And it was certainly a loss that shaped the family dynamic. The next year, my grandmother gave birth to another daughter, my aunt, over whom she hovered, fussed and imbued with timidity until her dying day.
Had this background anxiety of pandemic been a factor when the polio epidemic struck in the 1950s? Was it the reason my father injected so much terror into the disease even though the epidemic was largely under control by the time I came along? I can remember as a small child, walking with my parents in areas that, to this day, I still think of involuntarily as “this is where you catch polio”. Maybe we were passing these places when I was questioning my parents about the children with callipers at my primary school. Maybe he gave me details of what the disease did (infecting the spine and muscle wasting). I remember he said it was in the soil, but that was probably his euphemism for faeces. What he did give me was a pretty deep-rooted fear of contagion and a lifelong commitment to frequent hand-washing.
Contagious diseases were pretty much the stuff of my childhood. Most of the big illnesses – German measles (now considered mild), measles and mumps – all required quarantine. Children were often away from school for long periods, kept at home for over a fortnight, so there was no risk of spreading to other children. Written at an earlier period, in the 1930s, Arthur Ransome’s Winter Holiday immortalised the issue of quarantine. The children are quarantined and unable to return to boarding school when their friend Nancy, “captain of the Amazons”, develops mumps and is confined to her bedroom. For the most part, anxiety was pretty palpable. I remember my mother considering it lucky that I’d got away with a few spots for chicken pox while my siblings had been covered. “None of the marks and all of the immunity,” she said triumphantly.
Some might be inclined to interpret my experience as indicating how these epidemics are part of the natural cycle that we’ve always lived with. Those people assume most children find ways to deal robustly with the pervasive anxiety. And it’s true that many children, given reassurance, can emerge without psychological damage. Patrick Cockburn’s remarkable account (in the London Review of Books) of catching polio during the epidemic in Cork is a powerful evocation of the fears and uncertainties of that epidemic but also an account of a child overcoming anxiety. But my memories suggest that epidemics that leave vague but powerful anxieties can cast a long shadow. My father’s experience of his sister’s death left him chronically anxious, fearful of where the next disaster would strike, and this was particularly acute around his children. I wish I could say I shrugged it off. But the truth is I picked up a lot of his anxiety, as any child does with an anxious parent. This is why mental health charities and psychiatrists are saying there is an urgent need to monitor the “profound” effect on people’s mental health – now and in the future.
There’s something particularly difficult about losing someone in an epidemic. It’s often sudden and frightening, and it’s depersonalising. Your individual tragedy is just one of many and there’s little comfort in being a statistic. In this current epidemic, with the restrictions around grieving and funerals, it means that you are also deprived of personal agency, unable to sort out rituals for your own comfort or to shape the narrative around saying goodbye.
Recently, a friend’s father died of coronavirus. She was unable to be with him and has been suffering from depression since. How many people are there like this, haunted by the lonely deaths of relatives and friends in care homes and hospitals? Or families of care workers and doctors distressed by what they’ve seen? How many children are imagining the disease and what it did to their loved ones? It’s hard to imagine that, without help, they won’t carry this anxiety forward.
If I still feel the legacy of the Spanish flu epidemic in how it shaped my family dynamic, it seems likely that unless the mental health issues are given proper prominence now, as we attempt to recover, this epidemic too will be carried far into the future.
• Ros Coward is an author and journalist whose books include Female Desire and Speaking Personally: the Rise of Confessional Journalism