Mental Health and the Post Corona World

This year has been a difficult one, difficult in a way that many of us never thought life would be difficult. We have been witness to the rise of a new threat, a threat that cannot be seen, that creates in its wake a disease that we call COVID-19. This novel coronavirus, something so small as to be invisible to the naked eye and all but the most sensitive of laboratory equipment, has exposed the inherent weaknesses in the structures that most of us thought of as secure. In our western world, the world of modern medicine and vaccines outbreaks of this scale and seriousness are rare occurrences, many of us have never seen this type of outbreak before.

The last pandemic that was declared by the WHO was the swine flu in 2009, however, that was a very different scenario, to the one we are facing today. This time we have no vaccines for related viruses from which to proceed towards a fast vaccination programme, we have no annual inoculations for coronaviruses such as we do for the various strains of influenza. This time our best defence comes in isolating people from each other and playing for the time necessary to develop safe and effective treatments. This ‘flattening of the curve’, while effective in its aim of stabilising the rate of infection in the general population so as to avoid overwhelming our already stretched public health systems, comes with other costs.

This year, by government order, Ireland, along with many other countries, closed for business. We shut down entertainment venues, gathering places and all but essential business. The land of a hundred thousand welcomes became a lot less welcoming. Now, as we approach what we all hope will be the beginning of the end to the restrictions placed upon movement, social interaction and commerce, it is time to seriously consider the side effects of the strong medicine with which we have been living for the past number of weeks.

Some side effects are foreseen and expected, our economy will be depressed for a while, we will have a recession, but within a year or two it is expected that we will return to growth and relative prosperity, jobs will be filled and things will more or less return to normal in that sense. However, that, to me at least, is the most minor of the issues we will be facing as we attempt to wake our society from its disease enforced hibernation.

For many people, the coronavirus outbreak has been an encounter with the ultimate threat, an invisible microbe that can be carried by seemingly well people, spread from a handshake or a hug, and most worryingly is potent enough to kill those among us who are infirm from age, underlying conditions, or even occasionally those who are just unlucky. In the aftermath of such a threat, it may be that many people will face tremendous fear and trepidation in the process of simply emerging back into society.

A society that now has had its flaws and cracks exposed, a society that is no longer the model of protection that it had once seemed. We can see now the inequity of health and social systems, we can see more clearly levels of injustice, we can see the price of the civilisation we were told to want. In emerging from isolation, society needs to be there to support people as they will experience new anxiety for a time before they readjust to social interactions. However, for those of us who already suffer from some mental health issue, for anyone who has ever had depression or suffered with anxiety, the effects could be much more profound.

Depression and anxiety change the way our brains work, they alter the neurological pathways and increase the activity in the parts of our brains that detect threats. These pathways, which form a part of the evolutionary systems that have allowed humans to thrive for millennia, are a complex and adaptive system, with one sole purpose, the protection of the organism. They are not, as some might think, irrational. They are simply dedicated to identifying threats in the environment and acting to counter them. They do not really care whether the threat comes from a lion or a microbe, once they register a threat they will begin to act accordingly. Due to the already increased activity in these neurological systems in people who suffer or have suffered from various mental health issues, there is a chance that they will experience a greater degree of discomfort than might be expected in the general population. In the end, when the lockdowns are lifted and we ask people to return to work, those people will inevitably face increased challenges.

In the post corona world, in the haze of anxiety and fear, people will seek to alleviate their symptoms however they can. In some cases, returning to work will give people a sense of normality and regularity that have been missing for the past few months, but for others, the stress of the pandemic and lockdowns will only be added to work stress. Some people will take refuge in behaviours that may be harmful to them, some will seek refuge in a bottle to numb the feelings of anxiety and loss, some will seek solace in risky behaviour to distract from the sense of mortality and some will seek the comfort of oblivion.

It is for those people that additional supports will be needed, additional time to move forward and in some cases additional time to grieve. Relationships will fail, families will be broken by the stress of the imposed isolation, many people, both male and female, will have experienced emotional or physical abuse. They too will need support, they will need the supports that only other people can give and that can only be given in person. We are a tactile, social species, and in suffering, we need to feel connected, a hand resting on a shoulder means more to us than words because we can feel it, it helps us to connect both to our own pain and to the knowledge that someone is there for us. Imagine the cruelty then of sending someone who is lost and afraid, grieving and suffering out into the world without that hand, without being able to feel that connection to another living, breathing person.

In the coming weeks and months, perhaps even years, there may be a strain on the mental health services like there has never been before. We will see people attempting to recover from trauma, bereavement, grief, addiction, anxiety, and a host of other difficulties. Many of these people will also have lost jobs, the poorest among us will be the worst affected. Low-income households will see increased levels of poverty as the more affluent will recover employment first, single parents will struggle to make ends meet as childcare is either unavailable or prohibitively expensive. Children and teens will face the difficulty of reconnecting with people in reality as opposed to online. People will need to learn to reconnect in a physical sense while still observing some levels of social distancing. These are all challenges that society will face in the coming time and it is important that we are aware of them.

People are fearful of the second wave of coronavirus and the chaos it may cause, but right now we are faced with the possibility of a different kind of outbreak, a pandemic of difficulties in living, and we must also attempt to flatten that curve before it overwhelms an even more precarious health system. Right now, people can take action that will help to maintain their own mental health and the health of the people inside their households.

If you are suffering, talk to a counsellor or psychotherapist , many are offering online and telephone sessions, many are also offering limited in-person sessions where consulting rooms are large enough to allow for social distancing and clients have not experienced any symptoms. If you know someone that may be suffering, send them a message, even better write them a letter or call them on the phone.

When restrictions begin to be lifted, be sensible, do not go running out to street or house parties, but do go and visit loved ones, make plans to see friends even while maintaining two-metre social distance. If you have a partner who lives outside your household, go and spend time together, if you have not seen your children, go and see them, spend time with them. We need to be socially distant, we need to be cautious, but we also must always be compassionate and measured in our responses. Most people will recover from COVID-19 in less than six weeks, how long will it take to recover from social distancing?