Living in anxious times: mental health and coronavirus
You awake, startled, at 2am, a horrible nightmare leaves you feeling scared and anxious.
You turn on the news, hundreds more people have died, thousands more are in hospital, your heart begins racing and your chest feels heavy.
You go for your daily walk outside and someone runs past, you jump to get away from them.
Life is full of anxious moments right now.
People with pre-existing mental health conditions are facing months without the physical contact and support they once had, those who have never experienced mental health issues before may be feeling anxious or depressed for the first time.
Breathing Space – Scotland’s free, confidential phone and online chat service for anyone aged over 16 experiencing low mood, depression or anxiety – received “the highest number of calls we’ve ever had” at the beginning of the UK's lockdown in March, national coordinator Tony McLaren tells Holyrood.
“We had over 9,000 calls,” he says, “a number of people are phoning our service who have phoned before, a number of people are new callers, but a significant number of the calls were focused on what we refer to as health anxiety.
“It may well be that they live alone and that’s just adding to the anxiety that they’re experiencing,” explains McLaren, “for people phoning us at Breathing Space with that health anxiety, it’s compounded by all sorts of difficult things.
“People talk to us about that fear they have of what the future holds, with this increased social isolation, the loneliness, the health anxiety, the stress, the economic downturn – and that’s all coming together into a kind of perfect storm.”
To cope with this increase in demand, the Scottish Government has given Breathing Space funding to increase their staff by ten full-time workers and two full-time supervisors, part of a £3.8m package of funding to increase the capacity of NHS 24’s telephone and online services.
“This is not just about here and now, this is about future proofing our mental health services because we know that even after the lockdown, that’s when people may well start to manifest signs of anxiety and stress,” McLaren says.
Anxiety and stress have been heightened by people consuming too much information about COVID-19. “We’re advising people to stay connected to other people, but not be connected with too much social media or too much news,” he says.
He adds: “The vocabulary and the language of the pandemic can be quite scary. We start to talk about people dying and scary words like apocalyptic or ‘this has never happened before’.
“That can put people who perhaps are vulnerable, into a more vulnerable space of ‘how will I be able to cope with this?’ That anxiety and stress for people that have maybe never experienced it, and they’re starting to say, ‘I’m feeling a wee bit not quite myself these days’.”
McLaren says people should look out for any changes in their sleeping habits, changes to routine, wanting to stay in bed more, skipping meals or overeating, as possible signs of worsening mental health.
He says establishing a “healthy home routine” can help people deal some of these early signs. “We know that children love routine, but adults like routine as well. So, when did we have breakfast? When did we have lunch? When did we have dinner? And can we try and keep to that kind of programme that allows us to offset any other anxieties? Because, if the routine is out the window, then that in many ways opens the door for further anxieties to creep in, potentially.”
For people diagnosed with severe mental health conditions, like schizophrenia or bipolar affective disorder, waiting in line to collect medication or groceries have become difficult chores to complete. “Going to the chemist... for someone who may be experiencing issues of paranoia, or really high anxiety, then that could be more difficult than for you and me.”
Additionally, not having any face-to-face or physical contact with people can “have a significant impact on how people see the world”.
“Maybe that adds to the world being a scary place a wee bit, or a not a very inviting place, or an exceptionally lonely place to be,” McLaren says.
For young people, the pandemic may become a defining moment in their lives, much like 9/11 was for many millennials.
A survey of 2,400 young people by YouthLink Scotland, Young Scot and the Scottish Youth Parliament found 96 per cent are worried about the impact of coronavirus on their future, with 77 per cent worried about their mental health and wellbeing and 49 per cent extremely to moderately concerned about exams or coursework.
“The impact is enormous because it touches every aspect of young people’s lives. From the survey, it’s obvious that young people are really worried about their future,” Young Scot chief executive Louise Macdonald tells Holyrood.
“It’s entirely understandable for young people to feel anxious and worried during this time. From the start of lockdown, we’ve been extremely concerned about the impact that staying at home could have on the mental health and wellbeing of young people.”
She adds: “There is good work underway across public and third sector services in Scotland to address this but the need for effective collaboration is clear and urgent – our young people need to be heard and their needs acted upon.”
The impact of the virus on the mental health of adults in Scotland is currently the subject of two separate studies, by the University of Glasgow and Glasgow Caledonian University.
The University of Glasgow’s study, in partnership with Samaritans and SAMH, will track the mental health and wellbeing of 3,000 adults from across the UK, over the next six months.
Meanwhile, Glasgow Caledonian University is surveying Scottish adults to look at whether social distancing and self-isolation is having negative psychological effects, including post-traumatic stress symptoms.
This study began on the first day of the UK’s lockdown, with individuals asked to fill out an initial 20-minute survey and then short update surveys each week for 12 weeks after, about their emotions and experiences of stress, depression and anxiety.
“We decided that there was a need for us to really understand how a situation like COVID-19 was impacting on people,” research lead Kareena McAloney-Kocaman tells Holyrood. “One of the things that we’re particularly interested in is the relationship between people with previous experiences of trauma or adverse events and how that impacts on their resilience, or their vulnerability to psychological ill health, stress, depression, and anxiety.”
Asked what will happen when social distancing restrictions are lifted, and whether this could lead to an increase in mental health issues like anxiety disorder agoraphobia, McLaren says: “That’s a future question, and we need a crystal ball for that.
“It may be that people manifest further levels of anxiety, because they’re coming back to a world that feels different.”
For support: Breathing Space (after 6pm) 0800 83 85 87; Samaritans 116 123