Martin Milton, Professor of Counselling Psychology explores what the pandemic means for our mental health – and shares actionable strategies for getting on top of things.
This article is part of our new series, Regent's Review: thoughts, research and academic discussion on the rapidly unfolding pandemic.
Summary
- Isolation and loneliness are hard for a social species and we are surely one of most social of all.
- Societally, we may struggle to grieve huge and unexpected losses.
- We need to take the time to recharge our emotional reserves. Wonderful moments do not make us bad people.
- To handle the situation, we can try and psychologically reframe our thoughts.
The pandemic is shaping our mental health – here’s what we can do
The coronavirus pandemic is a health crisis like none we have seen in maybe 100 years. So, while of course we must prioritise our medical and biological needs, it is pleasing to see that implications for mental health are also part of the discussion. We are, after all, facing uncertainty about everything. Any sense of normality has disappeared and, at the same time, so has our externally held security and certainty.
What can we expect?
We have seen a rise in experiences of anxiety, as the virus speaks to a fundamental existential fear for ourselves, our loved ones and our communities. A huge number of people are dealing with terrifying ill-health and death and even those of us who have yet to contract the virus are affected by anticipatory grief.
It is a paradox, but one of our best strategies to combat the pandemic – lockdown – may cause difficulties too. The need to distance ourselves from our loved ones is stressful. It runs counter to our psychological need for connection. Isolation and loneliness are hard for a social species and we are surely one of most social of all. Loneliness feeds psychological ill-health like very little else – think of solitary confinement as a form of torture, or how frequently we see depression after the loss of a partner.
And what about our mental health in the longer term? While it is unprecedented, might we learn from other lethal, life changing circumstances? After Hurricane Katrina, we saw increased distress, symptoms of depression, anxiety and PTSD experienced, including deadening, hyperarousal, sleep problems, avoidance and re-experiencing through flashbacks. Similar reactions were found after the 2004 tsunami. So we should expect something similar from this pandemic.
The spectre of the virus is likely to haunt our return to the world for a long time to come. We have to accept that the pandemic may leave the world struggling to grieve its huge and unexpected losses; many people and communities will experience guilt (albeit unrealistic) about not being able to save their loved ones, not being able to be with them as they passed, not being able to be the comfort they so want to be.
Some people will experience agoraphobia: those who found safety and respite in quarantine might find it anxiety-provoking to return to the world – especially as it will be months (at least), until we can be confident about treatment or a protective vaccine.
And then there are the psychosocial consequences of economic devastation. These all have the power to blight individual lives, put pressure on mental health services and impact the effective recovery of our professional and economic services.
So, what can we do?
Guidance from the British Psychological Society, the United Kingdom Council for Psychotherapy and the British Association for Counselling and Psychotherapy, among others, reminds services not to panic, and to refrain from redeploying all of their psychological workforce to the frontline immediately.
‘Counselling’ or ‘debriefing’ aren’t necessarily needed or wanted in the midst of a crisis. A panicky desire to ‘debrief’ all and sundry, as some kind of attempt to feel like we are doing something, would be misguided. It is also shown not to be the protective factor we would like it to be.
For many, at least in the short term, assistance with pragmatic self-care, and looking after family and friends, takes priority. When in the midst of a threat we are primed to focus on the approaching danger and prioritise safety. Although there are differences between individual traumatic events, often rooted in our previous exposure, calm reflection on our deeper motivations may simply not be possible in the eye of the storm.
Instead, psychoeducation and pragmatic support might be more immediately useful. What does that mean? We should allow ourselves to recognise that our feelings are not the problem. Upset, worry, fear and panic are realistic feelings in the face of huge difficulty. Let’s accept them and support people in managing step by step.
In the face of something as scary and worrying as a pandemic, there seems to be a tendency to assume that all of our senses may need to be permanently focused on pain and worry.
But former Regent’s Programme Director, Dr Elaine Kasket, reminds us that we should also allow ourselves to feel the full range of feelings that arise, including positive ones. We might feel bad about having a good time, enjoying a moment or experiencing gratitude. (Elaine calls this ‘gratitude guilt’. ‘How can I feel good when so many are suffering?’ is a common question.) But we need to feel all of our feelings if we are to process them.
We don’t do anyone any favours if we can’t take a moment to recharge our reserves, and to enjoy what can be enjoyed. If you find yourself marvelling at the blue sky on your walk, drink it in. If you find yourself laughing at a re-run of your favourite sitcom, make it a belly laugh. If you are lucky enough to have a hug from people you are isolating with, make it a big one. Wonderful moments do not make you a bad person. They can boost your mood and immune system, and may mean you are in better shape for the next wave of demands.
Existing distress can be exacerbated when we lose agency. We may feel powerlessness in the face of the virus, lockdown can fuel this experience, so we may want to be active. We can do this by psychologically reframing things: are you ‘staying at home,’ or ‘doing your bit for the health of your community’?
There may be other ways to be active too. Volunteering isn’t just useful to the community – it has been proven to have psychological benefits too. It offers us something important, meaningful and useful. It challenges that depleting sense of passively sitting around waiting.
And therapy? If you’re already in therapy, the UKCP encourages you to keep going, or at least discuss it with your therapist. Losing something else may not be what you need right now. Discuss the focus of your sessions? Sure. Discuss the frequency if need be but be cautious about jettisoning a source of support at a time like this.
For those struggling, now or in the future, absolutely think about therapy. Situations like this do tax us. There should be no shame in accessing support, learning why we are affected in the way we are and finding ways to be resilient. Earth-changing events like this can be destabilising, and taking care of your mental health should be something we all value and support.
