The physical effects of COVID-19 on the human body have been well publicised. However, the significant impact of the current pandemic and associated bereavements, lockdown measures and a looming economic recession on the mental health of the general public (Pierce et al, 2020; Robinson, 2020) has taken a backseat despite its central importance (Mind, 2020).
Depressive symptoms
Depression was already one of the commonest mental disorders in Great Britain, but new research has shown that the COVID-19 pandemic has resulted in an increase of mental distress in adults across the UK (Pierce et al, 2020). Building on this, new data from the Office for National Statistics (ONS) (2020) show that the rate of depressive symptoms among people in Great Britain has doubled to nearly one in five adults (19.2%) as of June 2020 compared with pre-pandemic data from July 2019 to March 2020 of one in 10 adults (9.7%).
Symptoms of depression can vary for different people. These can include lasting feelings of hopelessness and unhappiness, indifference towards or a loss of interest in activities they used to enjoy, and feeling very tearful (Mind, 2020).
The ONS (2020) analysis looked at a nationally representative survey of 3527 adults in Great Britain and those most likely to experience depression during the pandemic were:
- Female
- Those aged 16-39 years
- People who were unable to afford unexpected expenses
- People living with a disability.
The most common impact on the wellbeing of adults who have experienced some form of depression has been the feelings of stress and anxiety, with 84.9% of the adults in the analysis reporting this (ONS, 2020). More than 42% of these adults also reported that their relationships were being affected, compared with only 20.7% of adults with either no or mild depressive symptoms (ONS, 2020). The charity Mind (2020) notes that these data have shown that in addition to those who were hardest hit by the coronavirus pandemic such as people who were already struggling with their mental health or who were facing unemployment and debt, as well as issues with housing and benefits, people who were well prior to the pandemic have also been affected, reporting their experience of depressive symptoms for the first time (Robinson, 2020). More than one in five adults who had never experienced poor mental health now report that their mental health is poor or very poor (Mind, 2020).
Role of technology
This time has been particularly difficult for older people because of their vulnerability in the context of COVID-19 and the necessity for increased social isolation for their safety. Those living in care home settings have had restrictions on visitation from loved ones, which can only add to any feelings of loneliness, which are already identified as a risk factor for poor mental and physical health in older people (Noone et al, 2020).
One potential solution which automatically springs to mind, particularly for younger people who are increasingly reliant on technology, is the use of social media and video calling to communicate. Where there is no other option, video calling with loved ones may provide some degree of connection that could decrease feelings of loneliness. However, Cowan (2020) points out another perspective:
‘Much was made of video calls to help families stay connected, without concern for the distress that this might cause against a background of delirium and dementia in an already anxious older person.’
Furthermore, Noone et al (2020) found very uncertain evidence regarding the effectiveness of video call interventions to reduce loneliness in older adults. While their review was published during the pandemic, none of the included studies took place during COVID-19 but did shine a light on this highly relevant topic. This is not to say that there is no value in trying to keep older adults connected via various forms of technology. Further research is warranted in this area but, as with any of us, older people are individuals and different things will work for different people. During this challenging and lonely time for many, every effort is worth a try to keep one another safe but also importantly feeling loved and supported.
Towards recovery
While some people may benefit from short-term treatment with antidepressants, increasing social contact within safe and allowed limits as well as more time spent in nature can also help with these symptoms (Robinson, 2020). Furthermore, Mind (2020) highlights that while the peak of the pandemic may have passed, we are now in a mental health emergency and the charity is calling for the government to prioritise mental health by meeting the following five tests:
- Invest in community services
- Protect those most at risk
- Reform the Mental Health Act
- Provide a financial safety net
- Support children and young people.
Impact on health professionals
Beyond the public in Great Britain, others who have been particularly affected include patients with long-term conditions (Smith, 2020), older people living in care homes (Cowan, 2020), and health professionals, whether in frontline roles or not, and even those having to shield at home (Cowan et al, 2020).
Most obvious is that many frontline health professionals are risking their lives to keep the public safe, some even living apart from their families to fulfil this duty. However, less obvious are the challenges that form a part of this day-to-day experience: unbearable heat and difficulty talking from behind a mask, the challenges of offering a personal touch to patients without posing an infection risk, not being able to eat or drink, possibly not being able to use the toilet without ‘doffing’ personal protective equipment depending on where it's located, and the list goes on (Carpenter, 2020).
Those who are required to shield at home may feel conflicted between needing to protect themselves and their families, and guilt for not being able to care for patients, some longing to go back to work but unable to do so at this time (Cowan et al, 2020). Health professionals who are working, though not on the frontlines, are also facing different challenges and are contributing to the fight against COVID-19 in other ways.
Self-care, healthy coping strategies, and both social and organisational support are essential and can play a significant role in reducing work-related stress and increasing the wellbeing of health professionals during COVID-19 (Wheeler and Dippenaar, 2020).
You can visit Mind (2020) to find more information about their five proposed tests for the Government's necessary prioritisation of mental health in the current aftermath of the peak of COVID-19.