Minding your mental health – whilst living through a pandemic
This piece was written by one of our contributors; Ireland-trained medical doctor – Ciara Kelly.
2020. It has been a curveball year so far, hasn’t it? If I asked you to describe 2020 in three words, what you would say? I bet there would be a lot of overlap in your responses. Full of uncertainty? Challenging? Worrying? Chaotic? Scary? Difficult? Or maybe… all of the above.
Although we will all have our own unique stories to tell from 2020, there is a collective nature to what we’re living through and with as the COVID-19 pandemic continues. I’m a doctor specialising in public health, and while preventing and managing infectious disease outbreaks is part and parcel of our work, the extent, severity and duration of the current global outbreak of the Sars-CoV-2 virus is far beyond anything we in public health and other medical experts around the world have ever experienced before. And for the general population, the worry, stress and anxiety stemming from life as we currently know it (the ‘new normal’) can understandably feel overwhelming at times.
Looking after our mental health has always been important, and mental health struggles were not a rarity pre-pandemic. 20% of the global burden of disease was attributable to mental health disorders before COVID-19 arrived (1). The mental health charity MIND (2) reports that 1 in 4 people will experience a mental health issue of some kind every year in England, while 1 in 6 report experiencing a common mental health problem (e.g. depression, or anxiety) in any given week.
The COVID-19 pandemic has brought with it many different potential sources of stress to our mental health, which the vast majority of people will have been affected by to a lesser or greater extent – from health concerns to job security worries, to stress arising from reductions in or loss of income to social isolation. Life as we knew it and the structures and routines we had built as part of it were, for the most part, turned upside down and inside out. On top of that, for much of this year, we have been living without the freedom to make plans for the short and long-term, whether for simple pleasures such as a trip out for a meal, to the cinema or even to get a hair-cut, or to celebrate a significant life event, such as getting married or graduating.
A recent study (3) published in the medical journal The Lancet which sought to examine changes in adult mental health in the UK population before and during ‘lockdown’ found that the population prevalence of clinically significant levels of mental distress among adults in the UK rose from measurements taken in 2018-2019 to when measured in April 2020, which was one month into ‘lockdown.’ The pandemic has also disrupted the traditional delivery of mental health services in both developed and developing countries (4), with many services providing online and phone support instead. A recent commentary article, also published in The Lancet, identified three main challenges facing public mental health globally1, which were; to prevent an increase in mental disorders and reductions in mental well-being across population, to protect people with diagnosed mental illness from COVID-19, and to provide appropriate public mental health interventions to health professionals and carers.
And as with most things pertaining to COVID-19, all of these challenges can feel insurmountable when you consider them all as one big mountain to climb. Overcoming them will be no mean feat, and will take time, multi-disciplinary input, and government commitment. But what can each of us do in the short-term to look after our mental health at the individual level? As it turns out, plenty, and we can start today. Let’s discuss.
Stay connected
Loneliness and a lack of social ties have been consistently associated with adverse effects on our physical and mental well-being (5) – and looking after our health in all its forms has never been more important. During ‘lockdown’, many of us could not see family or friends for weeks on end, confined to our homes either by ourselves or with those we lived with. Use of social media and other phone and video call apps sky-rocketed, with online versions of offline occasions flourishing – hen parties, family calls, book clubs, group quizzes, and even dates! Although there are of course potential downsides to excessive use of our phones and screens in general, technology kept us connected during a time when in-person connection was not possible outside of our homes, and it made all the difference.
This summer, with the recent easing of some of the restrictions in the UK and Ireland, greater numbers of people have been able to visit each other again, which has been a welcome change for many. As we continue to live with the risk of COVID-19 ever present in our lives, make sure you stay connected to family and friends, on and offline. Online means of staying connected will continue to be important as we live through the ‘new normal’, particularly for those with family and friends abroad while international travel remains an issue under government review. And of course, if you are meeting up with friends and family in person, be sure to follow current government and public health advice to keep you and your loved ones safe.
Regular routines and looking after your health
The routine of daily life was turned on its head once restrictions were introduced to curb the spread of COVID-19 in the UK and Ireland. Working from home was encouraged, and many found themselves scrabbling to figure out some sort of home office set-up for the foreseeable future. For those working from home, the daily commute was no longer part of a typical day. Gyms and other fitness facilities closed, removing our visits there from our mornings and evenings too. The vast majority of places where we might previously have socialised – restaurants, bars, cinemas, etc. – were all closed too. Suddenly, we found ourselves with a lot more time at home, unable to book, plan, or schedule much of anything really. That diary planner purchased at the start of the year began to look pretty empty – and maybe it still does.
In a time when it can feel like we’ve lost all control over many aspects of life, comfort can be found in establishing and maintaining little routines to add structure to our day. That will look different for everyone. Maybe it’s a few positive morning or bedtime habits strung together, or maybe it’s a lunchtime walk, or a daily call to a family member or friend. However that little bit of structure looks to you, consider making time for it. These routines can also be useful to help us build consistent positive health behaviours into our day. These behaviours, such as for example taking regular exercise, getting good quality and quantity sleep, eating a healthy dietary pattern, not smoking and keeping alcohol intake to within low-risk guidelines are really important to help us look after our physical and mental health as best we can.
Stay informed but not overwhelmed
While technology has been fantastic this year as a means to keep us connected while far apart, there is definitely the potential for too much of a good thing. It can also feel very tempting to constantly check for new updates on the COVID-19 pandemic, refreshing your newsfeed for the latest information on case numbers, progress on a vaccine, or testing. Staying informed on current government and public health advice is of course very important – but being on constant alert for the latest news, much of which often isn’t positive, can leave us feeling stressed and anxious, adversely affecting our mental health. Instead of a regular refresh, try setting yourself a consistent and limited time to check for updates – maybe in the morning, maybe in the evening, whichever works for you. The news outlets aren’t going anywhere!
Don’t forget as well that you can find the most up to date public health advice in relation to COVID-19 at www.gov.uk/coronavirus for those in the UK, and at www.hse.ie for those in Ireland.
Set and respect your boundaries
If it doesn’t feel safe, it isn’t safe for you.
Although you might expect the opposite, for many people, navigating the new normal way of life might feel more mentally challenging than lockdown was. Now, in the UK and Ireland, some of the restrictions that were in place are being gradually eased, such that we can now gather again in small social groups, and to an extent, visit others and receive visitors. After spending so much time at home, with little to no social interaction outside of our own households, this is bound to feel more than a bit strange, particularly for those who are medically vulnerable and at greater risk of more severe illness should they develop COVID-19.
It’s very understandable to feel uneasy about jumping straight back out into the world, and everyone will have their own pace at which they feel comfortable socialising again, and to what extent. We need to support and respect the pace and boundaries of our family and friends in this context. As Dr. Michael Ryan, Executive Director of the WHO Emergencies Programme said recently – ‘If it doesn’t feel safe, it isn’t safe for you.’
Say no to stigma and seek help if needed
Sadly, despite the progress that has been made in recent years regarding stigma surrounding mental health struggles in our society, the shadow of stigma remains for many people. There is absolutely no shame in struggling with your mental health – in fact, being strong enough to put our hands up and ask for help is one of the bravest, most courageous things we can do.
We can each play our part to break down this stigma by opening up the conversation around mental health with our family and friends, in and outside of the context of a global pandemic. A simple ‘How are you doing okay?’, or ‘How are you finding the new normal?’, could transform someone’s day – a gesture of kindness which might just be the key to unlock thoughts, emotions and feelings that were hidden away, but building up inside. Remember that support is still here for those in need – further links regarding resources can be found below specific to mental health for those in the UK and Ireland, and always remember that your GP is a fantastic first port of call if you are seeking help from a healthcare professional with your mental health.
If you’re not okay, please don’t suffer in silence.
Let’s recap
Mental health matters, and we need to say no to the stigma that surrounds it. The COVID-19 pandemic has been a challenging time for us all – physically, mentally and emotionally. We’ve got to mind our mental health as we navigate a new normal way of life. Take the time to look after your mental health – and support your family and friends in their efforts to do the same.
Links to further resources
Information for those in the UK on looking after your mental health during the COVID-19 pandemic:
https://www.nhs.uk/oneyou/every-mind-matters/coronavirus-covid-19-staying-at-home-tips/
Information for those in Ireland on looking after your mental health during the COVID-19 pandemic:
https://www2.hse.ie/wellbeing/mental-health/covid-19/minding-your-mental-health-during-the-coronavirus-outbreak.html
NHS Recommended Mental Health Charities, Organisations, Support Groups:
https://www.nhs.uk/conditions/stress-anxiety-depression/mental-health-helplines/
Samaritans
Free call 116 123 (for those in the UK and Ireland)
References
(1) WHO. Global health estimates 2016: disease burden by cause, age, sex, country and region, 2000-2016. 2018. https://www.who.int/healthinfo/ global_burden_disease/estimates/en/index1.html (accessed April 28, 2020).
(2) MIND. Mental heath facts and statistics. 2020. Available at: https://www.mind.org.uk/information-support/types-of-mental-health-problems/statistics-and-facts-about-mental-health/how-common-are-mental-health-problems/#:~:text=mental%20health%20problems%3F-,How%20common%20are%20mental%20health%20problems%3F,week%20in%20England%20%5B2%5D.
(3) Pierce M et al. Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. Lancet Psychiatry. 2020. Available at: https://www.thelancet.com/action/showPdf?pii=S2215-0366%2820%2930308-4
(4) Campion J et al. Addressing the public mental health challenge of COVID-19. The Lancet. 2020. Available at: https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(20)30240-6.pdf
(5) Ward M, Layte R and Kenny RA. Loneliness, social isolation and their discordance among older adults. The Irish Longitudinal Study on Ageing. 2019. Available at: https://tilda.tcd.ie/publications/reports/pdf/Report_Loneliness.pdf
