When I take on a new client, somewhere in the first session or two I ask a question that almost always gets the same reaction. How did COVID affect you? There's a pause. Then, more often than not: nobody has ever asked me that.

And then they tell me. Every single one of them. The job that ended. The parent they couldn't visit in the hospital. The wedding that shrank to six people. The year of school that happened on a laptop in a bedroom. The drinking that started as a way to get through March 2020 and never really stopped. The panic attacks that showed up that spring and still visit. Nobody has trouble answering the question. They've just never been asked.

That's the part I can't get past. We lived through a shared trauma, the biggest one in most of our lifetimes, and much of the mental health field has quietly filed it under things that happened rather than things that happened to you. This article is about why that's a mistake, what the pandemic actually did to us, why so few people are asking, and what it looks like to finally take it seriously.

Here's the short version. Trauma isn't defined by how many people it happens to. It's defined by what it does to your sense that the world is safe, predictable, and survivable. COVID hit all three of those at once, for everyone, for more than a year. The fact that it happened to everybody doesn't make it less of a trauma. It just means it has fewer witnesses, because everyone was busy surviving their own.

What Makes Something a Shared Trauma

Psychologists use a few overlapping terms here. Collective trauma is a catastrophe that hits a whole group at once and changes how that group understands itself. Kai Erikson, who studied the survivors of the Buffalo Creek flood in the 1970s, described it as a blow to the tissue of community that damages the bonds between people, not just the people. Gilad Hirschberger, writing more recently, has argued that collective trauma reshapes a group's memory and identity for generations. Shared trauma is the term clinicians use for the specific situation where the therapist has been through the same event as the client. Carol Tosone and her colleagues developed that idea after September 11th and after hurricanes and wars, and it turns out to describe the pandemic almost perfectly.

What all of these have in common is that trauma is not really about the event. It's about what the event does to the nervous system and to the assumptions we live by: that tomorrow will look roughly like today, that the people we love will be there, that the ground is solid. A pandemic doesn't have to put you in the ICU to break those assumptions. A 2021 study led by Victoria Bridgland found that people were reporting PTSD-like symptoms tied to COVID even when they'd never been sick and never lost anyone. The threat was in the future and in the air, not in a single moment, and the mind treated it as a threat anyway.

That's the piece traditional trauma screening misses. The standard checklists ask about discrete events: an assault, a crash, a death you witnessed. They're not built for a slow, diffuse, two-year event that came in through the television and stayed. So it doesn't show up on the form, and if it doesn't show up on the form, a lot of clinicians never ask.

What the Pandemic Did to Us

The scale is hard to hold in your head, so I'll keep the numbers few. In the first year of the pandemic, the global prevalence of depression and anxiety rose by about a quarter, according to a study in The Lancet that the World Health Organization later endorsed. In the United States, more than a million people died. Every one of those deaths, by one careful estimate, left about nine close relatives bereaved. That's roughly ten million Americans grieving a COVID death, most of them without a proper funeral.

But the numbers aren't what my clients talk about. They talk about the specific ways their lives bent and didn't bend back.

It changed how we function

For a year or more, most of the structures that hold a life in shape disappeared. Commutes, offices, gyms, schools, churches, dinners with friends, the boundary between work and home. People lost their routines and their sense of time. A lot of them describe a fog that settled in around that period, a loss of concentration and follow-through that never fully lifted. Sleep got worse. Drinking went up. Screens filled the gap. Some of that recovered when the world reopened. A surprising amount didn't, and people carry it now as a private sense that they used to be more capable than they are.

It reset childhood

This is the one that keeps me up at night. Adults lost a year or two. Children lost a stretch of development they can't get back, at whatever age they happened to be. A seven-year-old learned to read through a screen. A thirteen-year-old spent the year that's supposed to be about friends alone in a bedroom. A high school senior graduated in a parking lot. Whatever a child was supposed to be learning about the world during those years, they learned it in a world where strangers were dangerous, school was optional, adults were frightened, and the future was on hold.

The research backs up what parents saw. A meta-analysis in JAMA Pediatrics found that during the pandemic about one in four children and teens had clinically significant depressive symptoms and one in five had clinically significant anxiety, roughly double the rates before. Emergency room visits for suspected suicide attempts among teenage girls were up by half in early 2021 compared with 2019. The 2022 national test scores showed the largest drop in math ever recorded. Chronic absenteeism nearly doubled and has stayed high. The Surgeon General issued a formal advisory on youth mental health in late 2021 and called it a crisis. None of that has fully reversed.

I'd add something the data can't show. A lot of kids came out of the pandemic with a different relationship to reality. They'd spent formative years where the real world was something you visited briefly and carefully, and the screen was where life actually happened. Many of them are still living there.

We lost people, and we couldn't grieve them

The deaths were bad enough. The way they happened made them worse. People said goodbye to parents over a nurse's phone. Funerals were postponed, streamed, or skipped. Families who would normally have gathered were told to stay apart. Grief needs ritual and company, and the pandemic took both away at exactly the moment they were needed most. In 2022 the diagnostic manual added prolonged grief disorder as a formal diagnosis, and I don't think the timing was a coincidence.

More than 140,000 American children lost a parent or a grandparent who was caring for them in just the first fifteen months, and the number kept climbing after that. Many of those children are now teenagers who have never been asked about it either.

And there were the other losses, the ones nobody sends a card for. Businesses that closed. Careers that stalled. Friendships that didn't survive the distance, or the argument about masks. The version of yourself you were planning to become in 2020. Those losses are real, and most people have never been given permission to call them losses.

We were told, every day, that we might die

I want to say this plainly, because it gets skipped. For more than a year, we all turned on the news and listened to people telling us that we were going to die, or that our parents were, or that the person coughing in the grocery store might be the reason. Death counts scrolled across the bottom of the screen. Sirens ran through the night in the cities. The rules changed weekly and the experts disagreed. Whether or not you believed the worst of it, your nervous system heard it.

A body that's told it's in danger every day for a year adapts by staying on. That's not weakness. That's what the alarm system is for. The problem is that the alarm doesn't have an off switch, and for a lot of people it never got the message that the emergency was over. They're still bracing.

We were alone with it

The isolation was the mechanism that turned all of the above into trauma rather than just hardship. Hard things are survivable when you go through them together. The pandemic asked us to go through the hardest thing in decades alone, or with the same three people, indefinitely. In 2023 the Surgeon General declared loneliness a public health epidemic, and while it predated COVID, the pandemic poured fuel on it. If you've never quite gotten your social life back, you're not alone in that, which is a strange thing to say about loneliness.

Why Nobody Asks

If the pandemic did all of that, why does almost every new client tell me they've never been asked about it? I have a few theories, and I think all of them are partly right.

It happened to the therapist too. This is the shared trauma problem. Therapists were locked down, scared, and grieving alongside their clients, and we moved our entire practices onto video in a week. When you've been through the same thing as the person across from you, it's easy to assume you already know what it was like for them, and easy to avoid a topic that's still raw for you. Tosone's research on clinicians after 9/11 found exactly this pattern. Being personally affected changes what you're willing to bring up.

It doesn't fit the form. Intake questionnaires and trauma screens are built around single events with a date. The pandemic was a slow, diffuse, ongoing condition. It doesn't fit the box, so it doesn't get checked, and a lot of clinicians follow the form.

We all agreed to be done with it. Somewhere in 2022 the culture decided the pandemic was over, and talking about it started to feel like reopening something everyone wanted closed. That's understandable. It's also how avoidance works, and avoidance is the engine that keeps trauma running.

When it's everywhere, it looks like nowhere. Trauma is usually something that sets you apart. When everyone has it, it stops registering as an event and becomes the weather. People assume their struggles are personal failings rather than a shared injury, and clinicians assume the same.

What It Looks Like Now

More than six years on, here's what I see in my office that traces back, in whole or in part, to 2020 and 2021.

Anxiety that started that spring and never left. A social battery that never recovered its old capacity. Health anxiety that flares with every cough. Kids and teenagers who can't tolerate a classroom or a crowd, or who go quiet and disappear into their phones. Grief that never got a funeral. Families split over masks or vaccines who still aren't speaking. Boundaries between work and home that dissolved and never re-formed. A quiet conviction that institutions can't be trusted and the floor can drop out at any time. Drinking that was supposed to be temporary.

Not everything is COVID. But a surprising number of the problems people bring me have a 2020 chapter, and they're often surprised to find it when we go looking.

How to Ask Yourself the Question

If nobody has asked you, you can ask yourself. Here's roughly how I'd walk a client through it.

1. Draw the line. Think honestly about your life in February 2020 and your life now. Sleep, drinking, work, friendships, energy, focus, how your body feels in a crowd. Where are the differences?
2. Name what you lost. People, yes. But also plans, rituals, a job, a place, a year, a relationship, a version of yourself you were on your way to becoming. Say each one. Most people have never listed them.
3. Notice what never came back. The friends you stopped seeing. The office you never returned to. The church, the gym, the team, the habit. Some of that was a choice. Some of it was just never picked back up.
4. Notice what your body learned. How you feel when someone coughs nearby. Whether you still flinch at handshakes or hugs. Whether news alerts spike your pulse. That's the nervous system's memory, and it's separate from what you think about the pandemic.
5. Ask the kids. If you have children, ask what they remember and how it felt. Ask what they think they missed. You'll learn things you didn't know, and they'll learn that it's allowed to be talked about.
6. Tell someone. Trauma gets worse in silence and better in company. Say what you found out loud, to a therapist, a partner, or a friend who was there too.

When to Bring It to Therapy

If you're already in therapy and your therapist hasn't asked about the pandemic, bring it up yourself. It isn't off-topic and you don't need permission. A good clinician will follow you there.

If you're not in therapy, a few things are worth treating directly. Anxiety or panic that started during the pandemic and hasn't let up responds well to treatment for depression and anxiety. Grief that's stuck, especially for someone you couldn't say goodbye to, is its own kind of work and it helps. And if the pandemic left you with the classic marks of trauma, the bracing, the avoidance, the intrusive memories, the sense that the world is no longer safe, trauma-focused therapy is built for that, including approaches like EMDR that work on how the memory is stored rather than just how you think about it.

For kids and teens, the signs to watch are school refusal, withdrawal, a social world that's shrunk to a screen, and anxiety that's out of proportion to what's in front of them. Those are treatable, and earlier is better.

The Bottom Line

COVID was a shared trauma. It disrupted safety, predictability, and connection for everyone at once, it took more than a million American lives and the ability to mourn them properly, and it reset childhood for a generation. The fact that everyone went through it doesn't make it smaller. It makes it easier to miss, because there's nobody standing outside it to point and say, that was a lot.

So I'll be the one to say it. That was a lot. If nobody has ever asked how it affected you, consider this the question. I suspect you have an answer.

If you'd like help working through yours, I see clients in person in Santa Ana and online across the states where I'm licensed, and the pandemic is welcome in the room. Reach out here if you want to talk.

Frequently Asked Questions

This article is for education, not treatment. If the pandemic left you with symptoms that are disrupting your life, please talk with a mental health professional.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).

Bridgland, V. M. E., Moeck, E. K., Green, D. M., Swain, T. L., Nash, K., Fahlman, L. A., & Takarangi, M. K. T. (2021). Why the COVID-19 pandemic is a traumatic stressor. PLOS ONE, 16(1), e0240146.

COVID-19 Mental Disorders Collaborators. (2021). Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. The Lancet, 398(10312), 1700–1712.

Dee, T. S. (2024). Higher chronic absenteeism threatens academic recovery from the COVID-19 pandemic. Proceedings of the National Academy of Sciences, 121(3), e2312249121.

Erikson, K. T. (1976). Everything in its path: Destruction of community in the Buffalo Creek flood. Simon & Schuster.

Hillis, S. D., Blenkinsop, A., Villaveces, A., Annor, F. B., Liburd, L., Massetti, G. M., Demissie, Z., Mercy, J. A., Nelson, C. A., Cluver, L., Flaxman, S., Sherr, L., Donnelly, C. A., Ratmann, O., & Unwin, H. J. T. (2021). COVID-19–associated orphanhood and caregiver death in the United States. Pediatrics, 148(6), e2021053760.

Hirschberger, G. (2018). Collective trauma and the social construction of meaning. Frontiers in Psychology, 9, 1441.

National Center for Education Statistics. (2022). The Nation's Report Card: 2022 mathematics and reading assessments. U.S. Department of Education.

Office of the U.S. Surgeon General. (2021). Protecting youth mental health: The U.S. Surgeon General's advisory. U.S. Department of Health and Human Services.

Office of the U.S. Surgeon General. (2023). Our epidemic of loneliness and isolation: The U.S. Surgeon General's advisory on the healing effects of social connection and community. U.S. Department of Health and Human Services.

Racine, N., McArthur, B. A., Cooke, J. E., Eirich, R., Zhu, J., & Madigan, S. (2021). Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: A meta-analysis. JAMA Pediatrics, 175(11), 1142–1150.

Tosone, C., Nuttman-Shwartz, O., & Stephens, T. (2012). Shared trauma: When the professional is personally affected by the traumatic event. Clinical Social Work Journal, 40(2), 231–239.

Verdery, A. M., Smith-Greenaway, E., Margolis, R., & Daw, J. (2020). Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States. Proceedings of the National Academy of Sciences, 117(30), 17695–17701.

World Health Organization. (2022). Mental health and COVID-19: Early evidence of the pandemic's impact (Scientific brief).

Yard, E., Radhakrishnan, L., Ballesteros, M. F., Sheppard, M., Gates, A., Stein, Z., Hartnett, K., Kite-Powell, A., Rodgers, L., Adjemian, J., Ehlman, D. C., Holland, K., Idaikkadar, N., Ivey-Stephenson, A., Martinez, P., Law, R., & Stone, D. M. (2021). Emergency department visits for suspected suicide attempts among persons aged 12–25 years before and during the COVID-19 pandemic — United States, January 2019–May 2021. MMWR Morbidity and Mortality Weekly Report, 70(24), 888–894.

Keep Reading

Related articles

The Realization of Harm

Claiming religious objection to providing life-saving services is an admission of personal apostasy. You are no longer serving God. I realized that in the years I was actively waving the banner of my faith, I was harming people I'd never met. I caused harm. I caused hurt. And I did it believing I was helping those who were suffering. I realized I was part of the problem after serving the communities I feared the most.

Read More »

Skiing, Lanes & False Memories

Skiing never came easy to me. My older brother was a phenomenal skier. It came naturally to him, or at least he made it appear so. Either way, it made my lack of talent even more evident and painful. And I do mean painful. My parents were relentless in their insistence I learn to ski, despite coming home from full-day classes with more bruises and fat lips than I can count.

Read More »