The Intersection of Mental Health and a Pandemic

Areeshya Thevamanohar is a third year Politics student at King’s. Growing up in Malaysia, and then moving to London, she hopes to keep exploring the interchangeable relationship between gender and societal norms.

[Featured Image: Illustration of a woman sitting crouched whilst wearing a mask and surrounded by particles (depicting the COVID-19 pandemic). Source.]

A pandemic and physical health make for an obvious connection. A pandemic and mental health, however, have not been discussed nearly enough. Our focus has centred on trying to prevent catching and spreading Covid-19, yet we haven’t quite acknowledged the mental and emotional costs that such preventative measures bear. 

Between June to August of this year, the World Health Organisation (WHO) surveyed 130 countries to evaluate how the provision of mental, neurological and substance use services had changed due to Covid-19. It found that over 60% of reported disruptions to mental health services were for the vulnerable, including children and adolescents (72%), and older adults (70%). Around three-quarters of the surveyed countries also reported at least partial disruptions to school and workplace mental health services (78% and 75% respectively). 

The World Economic Forum has cited continued health concerns, the breakdown of support systems due to long-term isolation, economic fallout and a rise in household abuse as common underlying factors contributing to a surge in this mental health burden. An increase could result in higher suicide rates during the duration of the pandemic (and possibly for some time after). A US study released in May predicted as many as 75,000 additional people could die in the next decade from “deaths of despair” because of the Covid-19 pandemic. In India, a study by the Suicide Prevention India Foundation noted that 65% of therapists reported an increase in self-harm and suicide ideation among patients since the start of the pandemic. 

In Hong Kong, the Samaritans – a suicide preventions charity – said more than 70% of those using its email services were students, ranging from the primary school to university level. It also said the number of users having suicidal thoughts had doubled between June and September as a result of school closures, with a sense of isolation and uncertainty about the future being key issues cited. In England, the Centre for Mental Health has predicted that up to 10 million people – almost a fifth of the population – will need mental health support as a direct consequence of Covid-19, with 1.5 million of those expected to be children and young adults under the age of 18. 

The deterioration of mental health amidst a pandemic is not uncommon. The Economist noted that when the Spanish Flu emerged in 1918 – killing around 50 million people – there was also a nearly one third increase in Europe’s suicides. In 2003, the SARS outbreak – a respiratory disease caused by the coronavirus – coincided with a similar increase in suicides among Hong Kong’s elderly population. 

In an interview with The Atlantic, Charles Benight, Professor of Psychology at the University of Colorado, explained that a pandemic – unlike a natural disaster such as an earthquake or a fire – is invisible and this makes it more anxiety-inducing. “You can’t see it, you can’t taste it, you just don’t know. You look outside, and it seems fine.” Benight rightly points out a key distinction about the pandemic that makes for further confusion around the state of our mental health at this time, especially if we are not patients, healthcare workers or families who have lost someone to the virus. 

Benight explains how such spatial uncertainty leads to temporal uncertainty as well. He states that if we don’t know where we are safe, then we can’t know when we are safe. When compared back to natural disasters such as wildfires, Benight notes that when such disasters end, the flames subside and the smoke clears. Similarly, he adds that a hurricane doesn’t last for one year. This is another critical distinction for a pandemic. They do not stay within clear cut boundaries; they instead come in waves, “ebbing and flowing, blurring crisis into recovery.” Such ambiguity makes for a more challenging environment for resilience. “It’s sort of like running down a field to score a goal, and every ten yards they move the goal. You don’t know what you’re targeting. Mental health professionals can’t provide reassurance that the danger has passed because the danger has not passed.” 

Andrew Solomon, author of The Noonday Demon: An Atlas of Depression, has grouped individuals by the four basic ways they may respond to the current crisis. Firstly, we see those who are resilient and managed to get by okay. On the other end, there are others who have already had a clinical diagnosis of a major depressive order, and who thus witness their symptoms escalate. Those in this group may require higher levels of medical care. The third group consists of individuals experiencing depressive symptoms in a real way, but who will return to their baseline eventually (as long as their symptoms are addressed). Those in this group may need basic interventions that help create routine and structure in their day-to-day lives. Lastly, there may be those who start to develop clinical depression but who had never before experienced this prior to the crisis. This group may need some formal medical intervention as well, he noted. 

You may be able to look at those four categories and identify where you stand. You may alternatively be unsure. You may find that opting for simple steps like meditation, unplugging from your devices or exercising might help you move through your day-to-day activities in better spirits. Or you may find you need to talk to a health professional because you are feeling a significant difference in your mental health. 

Preventative measures are in place to contain the virus, and they will ultimately help protect us given how little we know about the way it spreads. It is, however, alright to admit that they also take a mental health toll. Whatever it is you may be feeling, remember that this is an unusual time, and it makes for very unusual feelings that sometimes can’t be explained or articulated. There may not be a tangible reason you can point to, and that’s okay. Just don’t be afraid to reach out for help should you require it.

References:

Aadit Devanand & Shaily Tiberwala (2020) How coronavirus is affecting our mental health. World Economic Forum. Available at: https://www.weforum.org/agenda/2020/08/how-to-protect-mental-health-during-coronavirus

Ayai Tomisawa & Marika Katanuma (2020) Suicide Spikes in Japan Shows Mental Health Toll of Covid-19. Bloomberg. Available at: https://www.bloomberg.com/news/articles/2020-10-08/suicide-spike-in-japan-shows-mental-health-toll-of-covid-19

Jacob Stern (2020) This Is Not a Normal Mental-Health Disaster. The Atlantic. Available at: https://www.theatlantic.com/health/archive/2020/07/coronavirus-special-mental-health-disaster/613510/

James Hamblin (2020) Is Everyone Depressed? The Atlantic. Available at: https://www.theatlantic.com/health/archive/2020/05/depression-coronavirus/611986/

Laura Westbrook (2020) Alarming rise in Hong Kong young people struggling with mental health issues amid Covid-19 pandemic, experts warn. South China Morning Post. Available at: https://www.scmp.com/news/hong-kong/health-environment/article/3105943/hong-kong-witnesses-alarming-rise-young-people

Nosheen Iqbal (2020) UK ‘sleepwalking’ to mental health crisis as pandemic takes its toll. The Guardian. Available at: https://www.theguardian.com/society/2020/oct/17/uk-sleepwalking-to-mental-health-crisis-as-pandemic-takes-its-toll

The Economist (2020) Will the economic and psychological costs of Covid-19 increase suicides? The Economist. Available at:

WHO (2020) Covid-19 disrupting mental health services in most countries, WHO survey. World Health Organisation. Available at: https://www.who.int/news/item/05-10-2020-covid-19-disrupting-mental-health-services-in-most-countries-who-survey

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