Mental Wellbeing During COVID-19

It has been one of the most unusual years in most people’s living memory.

Living through a pandemic takes an incredible amount of strength and perseverance to work through the upheaval and uncertainty which comes with a new highly infectious virus. Especially when it can be difficult to see an end in sight.

This drastic change in our way of life in having our freedoms altered, changing the way we work, losing jobs, losing loved ones, educating children from home, perhaps overcoming the virus ourselves and notably not being able to see friends and family, all takes an incredible toll on our mental wellbeing.

Some people are currently having a very hard time. Everyone’s lives have been touched by this.

Normal face-to-face interactions, which are so important for mental wellbeing, have been taken from us.

For many, the sudden change in lifestyle will bring on feelings of grief for a life we are no longer able to freely live. This is even harder when the friends and family to whom you would normally be able to turn are possibly struggling with their own challenges.

For some the pandemic may exaggerate a current episode of depression or anxiety or bring back feelings which have been well controlled for years. For others, it may be the first time they have felt this way.

In practice most people managed through the first lockdown even though it was hard. This time around, with a lockdown through the winter months and having experienced intermittent lockdowns for a year, it has been much harder for many.

Whatever your experience, it is important to know that you are not alone, and these feelings are common.

Talking to a friend or family member about how you are feeling can be a helpful way to relieve some of the symptoms you may be experiencing. But that is not always the case and in some more extreme cases, or for those with long-term issues, it is important to speak to a professional who can identify if additional support may be suitable.

If you are feeling low, then speaking to someone who is an expert can be helpful.

Specialists can help to give you tools to work though these feelings. At other times medication for a few months can really make a big difference to help get on top of these feelings.

These emotions can often come out of nowhere and can be very intense. At the beginning there is nothing visible and this can lead to less sympathy and awareness from those around you. It can be a very lonely place to find yourself.

Signs of depression:

• Continual low mood or feelings of sadness

• Lack of motivation

• Feeling irritable or intolerant of others

• Difficulty making decisions

• Feeling hopelessness

• Experiencing low self esteem

• Feeling tearful

• Felling guilt-ridden

• Not getting enjoyment out of life

• Feeling anxious or worried.

• Disrupted sleep – difficulty falling asleep or waking up early in the morning.

• Lack of energy

• Changes in appetite

• Low interest in sex

• Feeling suicidal or having thoughts of self-harm

At one of the last face-to-face doctors’ meetings before lockdown a psychiatrist presented his research into depression and anxiety in university students across the UK. Both these conditions were present in around 20% of students pre-lockdown. Anxiety was slightly higher than depression. It is likely these conditions have increased in prevalence over the last year. There are a lot of people struggling with their feelings.

Although depression effects all aspects of society, it can be particularly hard for men to disclose how they are feeling. It is young men who are most at risk from self-harm. Young adults who typically lead successful independent lives may have been thrown into profound and unexpected changes. Brain maturation is a slow process that continues into our late 20s to early 30s as a result, many young adults may not yet have all the tools necessary to deal with pressures they are currently under.

Children are at home all day again, missing their friends, their teachers and all the activities they love doing which help bolster their self-esteem and sense of identity. Not seeing older family members who can be so important in providing a sense of continuity and perspective for many months is upsetting and unsettling.  Rules keep changing for them. It is very hard and they are sacrificing so much.  Children and teenagers can also suffer from depression and anxiety.

General tips for mental well-being:

1.      You can only control yourself.

When depression and anxiety start to set in, negative thoughts start to overtake all other thoughts. You can start to feel upset with those around you as well as feeling bad about yourself.

Always bring everything back you and your actions. That is all you can control. You cannot control other people.

It begins with you starting to work on yourself.

Once you start this is a lifelong journey.

2.    Maslow’s Hierarchy of Needs

This is the starting point for anyone trying to keep themselves in a good mental space.

Source: Maslow’s Hierarchy of Needs, https://www.en.wikipedia.org/wiki/Maslow's_hierarchy_of_needs

Start at the bottom of Maslow’s Hierarchy and make sure you have your basic needs met - food, water, sleep, exercise. Run though a check, are you exercising? Are you sleeping properly? Are you drinking enough water?  It doesn’t matter where you live and how good things appear to be, if you are only getting 3 hours sleep a night you are not in a good space.

This is where to start. These are the first things to work on.

Secondly to have a secure safe home that you enjoy being in. Making sure you make an effort at home. Little things like setting the table, make nice food, lighting candles, tidy away papers so work isn’t everywhere and making your home a nice space to relax in can make a big difference to your mental wellbeing.

Third is the sense of love and belonging. Reaching out to family and friends. Taking time to send birthday cards, zoom or call people who are in your life. Make time for other people and practicing feeling grateful for the small things in life which give pleasure.

Finally, the level of self-actualization is the amazing feeling in life that we can all touch on from time to time when everything feels as if it is going well.

3.      Ask for help.

If it gets too much, talk to professionals. Early intervention can often stop issues quickly which otherwise could go on for years.

Cognitive Behavioural Therapy (CBT) is a time limited talking therapy that is effective for anxiety and low mood.

Prescription of appropriate medications can make a significant difference for people in certain situations. 

Although you can be depressed or anxious without developing substance misuse or problematic behaviours there is an overlap.

You may have things more under control in normal life but at the moment with the added pressures, this may exacerbate or rekindle vulnerabilities which are then used as a coping strategy, with time these strategies start to have negative consequences.

Loss of mental wellbeing is linked to problematic behaviours. This includes using alcohol or drugs, gaming and gambling and many others. These behaviours have increased during lockdown. There is help available if needed. This will be covered in an upcoming blog.

This really is a time in our lives to learn how to focus on living one day at a time. It is a time to recognise if you are needing help and to ask for it.

It is also a time to look around us to see who may be struggling. It is often hard to see, even for experts, unless someone comes forward for help.  

If you would like to speak with a highly experience GP to discuss how you are feeling, then please get in touch by booking an appointment online here or calling the practice manager on 020 7730 8835.  Remote consultations are available.

It has not been an easy year we will have all learnt things about ourselves over this time.

Little gestures of kindness will go a long way over the coming months and will be remembered even when the good times come back into all our lives.

Dr Victoria Owen