I had a great Ask a Psychologist question from Skyler regarding communicating with customers during COVID-19. After this question I started to look at the research around COVID-19 and mental health.
There are multiple considerations for mental health with COVID-19 including the impact of the actual virus, the financial and employment losses and the social isolation. The interplay between these and government’s ability to mitigate them will only be known after this situation has ended. We know a bit about how past pandemics and economic crises have impacted our mental health, however research on the impact of COVID-19 is only just starting to emerge.
A Little History
Historical studies on the great depression show poorer health outcomes for men during an economic crisis, however at that time men were the main breadwinners so economic hardships weighed more heavily on their shoulders. With COVID-19 it will be interesting to see if women’s greater role in the financial stability of the household and also the number of solo mothers means that women experience the negative impact of COVID-19 and the subsequent economic and social impacts in a similar manner to men.
After the Spanish flu a Norwegian researcher found that there was an increase in the number of first time hospitalisations for mental health patients in the 6 years after the pandemic. In further research he found survivors of this flu reported a range of ongoing symptoms including sleep disturbances, depression, mental distraction, dizziness, and difficulties coping at work. It is currently unknown if the COVID-19 virus has direct impacts on mental health.
American research which examined the impact of the Great Recession from 2007 – 2009 found that people who experienced losses of finances, housing, or employment were more likely to have increased symptoms of depression and anxiety as well as more problematic drug use. In this blog post I will briefly review some of the potential impacts on mental health including stress, grief, domestic violence, suicide, and alcohol misuse.
Stress, Worry, and Anxiety
A lot of people are experiencing fearfulness during COVID-19. People may be worried about different things. Regardless of what you are worried or stressed about it still causes a similar anxiety response in the brain and body. Some common worries at the moment are:
- The virus/death
- Change
- Financial losses/unemployment
- 5G
- Having children home
- Being told what to do by the government
- Uncertainty of not knowing what to do
- Missing family or friends
During this period of increased stress people with pre-existing mental health conditions may see an increase in their mental health symptoms while other people may experience mental health problems for the first time in their lives. Some people may develop a temporary adjustment disorder which involves discomfort, emotional alterations that affect their social life, and difficulty accepting the changes. Some people may go on to develop more ongoing symptoms of post-traumatic stress disorders particularly those who experience significant trauma as the result of COVID-19.
Grief, Loss, and Depression
The grief from COVID-19 will come in many forms. Some people will lose family members or friends to this virus. There will be other forms of loss from the consequences of the virus such as losing employment and social connections, feeling unsupported in a workplace, or losing of the feeling of safety. Grief during this period will be complicated by the fact that many of our traditional coping mechanisms may not be available, for example, support from loved ones or going on an overseas trip. This could mean that a loss you would have coped with relatively well under normal circumstances may feel overwhelming.
Domestic Violence
There are many ways the COVID-19 situation could increase domestic violence. Part of domestic violence often involves isolation, and this will be easier to achieve for perpetrators during this period. Finances are one of the main areas couples argue about generally however, the economic consequences of COVID-19 will increase the stress and pressure on many families in this area. With family members staying home there is less chance for teachers or work colleagues to see bruises and provide assistance. Also, the fears around contamination and infection could increase demands to clean and paranoia around dirtiness.
Research does indicate that there is potential for domestic violence to increase during COVID-19. A study by Princeton researchers found that during the Great Recession in the United States there was an increase in men’s controlling behaviour towards their romantic partners. Preliminary news reports from Wuhan, China have found that since the government imposed lockdown there was an increase in domestic abuse as well as the severity of domestic violence that occurred.
It is important to remember during this time that the police and domestic violence services continue to function during the lockdown. Domestic violence organisations have been provided with additional funding to cope with the predicted increases in violence so there is support available.
Suicide
We know that overall suicide rates increase approximately 1% for every percentage point increase in unemployment. A large review of the relationship between suicide and economic recessions has found that periods of economic recession increase overall suicide rates. Other research found that having a pre-existing mental health problem is a risk factor for suicide during a recession and that it is particularly important for people with mental health conditions to access early diagnosis and treatment. Research on the Great Depression in the 1930s found that overall mortality actually decreased during this time, however suicide rates did increase. It’s not all bad news though as research has found that government programs, similar to those already in place, which address labour and social issues can mitigate or reduce the number of suicides during an economic crisis.
Alcohol Misuse
A recent survey of Australian adults found 70% of people are drinking more than usual. Research has indicated that during periods of economic recessions, people often increase their drug and alcohol use and that this increase can result in poorer mental health. While people are not going out and drinking at bars and restaurants, they are drinking more at home possibly to deal with the stress of the current situation. It is important to remember that alcohol use has a range of negative impacts on your brain functioning and as a result your mental health. Alcohol can also negatively impact your body’s immune response. Drinking when you are stressed can at times decrease short term stress, however this feeling does not last and in the long run you may feel you need to drink more often or larger amounts to reduce your stress levels.
COVID-19 Research
A recent study examined the mental health outcomes of health care workers exposed to COVID-19 in China. They found those that were treating patients with COVID-19 had a high risk of developing unfavourable mental health outcomes, for example, depression, anxiety, insomnia, and distress. It was suggested that these workers may be in need of psychological support and interventions.
Another study from China examined mental health problems and social media exposure during COVID-19. It was found that there was a high prevalence of mental health problems including anxiety and depression. Further they found that social media exposure was associated with high odds of experiencing anxiety compared with people who had lower social media exposure.
Children
Children may be particularly affected by the worries and stresses of parents around this time. It is important for parents to focus on remaining calm and explaining what is going on to their children (it is always important to be open and honest with your children). Parents are juggling a lot during this time with kids, work, finances and changes in family dynamics.
The Future
One of the biggest reasons for anxiety currently is that the future is uncertain. Our brains do not like uncertainty and like to be able to plan for the future which we are unable to do currently. It appears that we will be experiencing disruptions for the next few years. One recent paper from Harvard suggested there would be a need for different levels of social distancing into 2022 and possibly a need for some measures to remain in place till 2025.
The government has provided funding for all Australians for 10 telehealth psychology sessions. These sessions can either be bulk billed if you are experiencing financial hardship or may have a small gap fee to pay if you are able. Many clients have asked for a clarification of bulk billing. Bulk Billing means you do not pay, and the psychology practice will directly bill Medicare for the appointment.
The most important thing to think about if you are feeling stressed or down is that this is a short-term situation that will be resolved in a couple of months or years. There will be some very hard times for many families during these months or years, however life will get better after this time is over. During the hard times the most important points are:
- Don’t harm yourself
- Don’t make impulsive decisions
- Don’t hit or hurt anyone
- Don’t drink too much
- Try to cut optional expenses as much as possible and seek help from government or financial counsellors if you are struggling to pay your bills.
- Try to keep up with some social contact via phone or video
- Look after yourself by eating well and exercising
At PsychHelp we are here to help you get through this time and then help you to get on with your life after COVID-19 is gone. A primary aim in our work as psychologists is to not have strong opinions or emotions during these types of situations. Our focus is on supporting you to navigate strong emotions you may be experiencing during this time.
