The coronavirus pandemic has undoubtedly caused many millions of people to be acutely sick while many of them are struggling with long-term side-effects including mental health issues and, sadly, many others have lost their lives. While we are all trying to play our part in limiting the spread of this virus, and dealing with its devastation, there is another pandemic that has simultaneously gripped our society. Over the past year, I have treated more patients with anxiety, depression and insomnia than ever before. Even in conversations with family and friends, I have realised that these mental health problems are widespread. Many people believe that they are isolated in their experience with lockdown, but this is not true. It is so important for us, as a community to talk about this, in an attempt to reduce the stigma and provide support for each other.
Anxiety, depression and insomnia – what is the cause of these mental health issues?
With the strict lockdown regulations, employment and economic distress are the first important factor. According to the recent SONA, President Ramaphosa acknowledged ‘that the country’s outlook seemed bleak as the economy shrunk by 6% in the third quarter of 2020. A total of 1.7 million people were jobless in the third quarter of 2020 and the unemployment rate sat at 30.8%”. This translates to thousands of households living on the breadline, and struggling to make ends meet. Many families are unable to maintain their standard of living and have to make sacrifices. Not being able to provide for their families places great stress on breadwinners, and can translate into anxiety, insomnia, and even depression. Many businesses and traders have managed to remain open during this time. However, with decreased movement of people from their households, and reduced spending, they have still been negatively impacted. Even as doctors, we see that many people may be scared to visit our consulting rooms, or are unable to afford medical costs.
Blurring boundaries between work and home
The face of work has changed. Many people now work from home and struggle to set boundaries between work and home life. Some patients report that they now have meetings at times which would previously be considered after hours, extending the work day.
Experience with infection and illness
Most people have either been personally infected by COVID, or know a family member, friend or acquaintance who have had COVID, oftentimes quite severely. This has caused a general sense of fear, and perhaps even panic. There seems to be an impending sense of doom, a fear of the unknown, and a sense of loss of control.
Limited social interactions is another cause of anxiety and insomnia, particularly for those who live alone or in an unstable household. We thrive on personal contact with others, and it is a great source of support in trying times. Thankfully, with online platforms such as Zoom and Teams, we are able to stay in touch with loved ones and colleagues; however it does not replace face to face interactions. In addition, online interactions unfortunately may not be a possibility for those with limited resources.
Lack of physical exercise
Many of my patients report that they stopped exercising during hard lockdown and didn’t regain an exercise routine once restrictions were lifted. Some are fearful of visiting the gym. Exercise has great mental health benefits and a decrease in exercise often contributes to a decline in mental health.
Delays and uncertainty
The roll out of the vaccine did seem to provide hope, with light at the end of this long COVID tunnel. However, with the temporary setbacks we have experienced and little clarity on when and how it is going to be rolled out, there is again a feeling of uncertainty about the timeline of this pandemic. This adds another stressor to the burden on mental health.
Return to School
Lastly, our children have been allowed to return to school. For many, this has been a source of relief for both parents and children. For others, it has caused stress as parents are concerned for their children’s safety, as well as the safety of vulnerable members of the family.
You are not alone – consult your GP for support
With all of these factors in play, it is understandable that many people feel depressed or anxious. What I hope people can take from this post is that you are not alone in your feelings. It is completely understandable if you are experiencing these symptoms. Do not feel isolated or alone or even embarrassed to talk about your concerns with family and friends. Try and engage in activities that may help to soothe your mind – exercise, hobbies like cooking or gardening, reading, creative outlets, journaling etc. If you have isolated yourself, consider meeting up with friends and family in a safe way- do so outside or in a well ventilated room. Seek medical help should you feel overwhelmed. Contact your GP- We are here to listen to you and guide you on treatment options to help you in this difficult time.