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Virtually our entire existence became medicalized in the spring of 2020. How we worked, shopped, washed, loved had suddenly been transformed into actions with a profound impact on our own health as well as the health of our nations, essentially into matters of life and death. Medicalization is obviously not a new phenomenon; many of the activities just mentioned have been subject to medical expertise and language. Yet the intensity and scope of the medicalization we are experiencing now is novel – at least in terms of recent history. Most of us had not experienced what it is like to have our public and private lives framed in terms of medicine. In some ways, now we share what was already the reality of many chronically ill people. This medicalized reality unavoidably has profound ramifications for our politics. This essay sketches out the political consequences of the medicalization that the coronavirus has unleashed, drawing on examples from the UK and the US. I do so by focusing on four themes: political discourse, political change, political emotions, and democratic citizenship.

The COVID-19 crisis has served, not just to instill fear in the populace, but to highlight the importance of fear as a motivating dynamic in politics. The gradual emergence of political philosophical approaches calling for concern for ‘positive’ emotions may have made sense under non-pandemic conditions. Now, however, describing fear in the face of a deadly pandemic as ‘irrational’ or born of ‘ignorance’ seems ‘irrational’ and ‘ignorant’. In this article, we draw upon the work of John Gray and behavioural science to present a defence of fear. We show how the pandemic has highlighted deficits in the work of four thinkers highly critical of fear: Martha Nussbaum, Zygmunt Bauman, Hannah Arendt and Sarah Ahmed. We argue that, if such approaches are to be of value in anything other than optimal conditions, then they have to acknowledge the fundamental role of fear in helping human beings to pursue fundamental interests.

This thesis explores how the medicalization of negative emotions impacts political agency. Mental suffering apparently abounds in the modern world. Diagnoses of and medical prescriptions for mental disorder have for decades been surging among liberal democracies, including the UK. Critics argue that this is partly because negative emotions are increasingly being understood and treated as symptoms of mental disorder; that is, they are being medicalized. This has wide-ranging political implications. Negative emotions, such as anger, sadness, and fear, alert us to and drive us to address perceived wrongs. If we are able to relate our emotions to issues that we share with others, they can engender political action. But labelling an emotion as a mental disorder frames it as a medical problem, potentially foreclosing the possibility of comprehending the emotion as an understandable reaction to something that could and should be addressed politically. The medicalization of negative emotions, thus, appears to threaten our political agency as liberal-democratic citizens. To explore whether, and, if so, to what extent this is the case, I draw on the political thought of Hannah Arendt to construct a theoretical framework explicating the relationship between political agency, its sources, and negative emotions. Within this framework, political agency is defined as the individual’s capacity to act in concert with other people to shape or respond to public issues. I then apply this framework to a series of historical and contemporary case studies of political action by people whose emotional and mental fitness for public life has been called into question. I argue that the medicalization of negative emotions has generated factors that can be and have been used to undermine people’s political agency. However, I also contend that the disempowering effects of medicalization are more uneven and less severe than many critics have suggested.